| Objective:To explore the clinical efficacy of Buyang Huanwu Decoction for patients with Qi and Yin deficiency and diabetic foot ulcer(DFU)with vein stasis.The differential genes of DFU were mined with the knowledge of bioinformatics,and the potential targets and approaches for the treatment of DFU with Buyang Huanwu Decoction were discussed with the knowledge of network pharmacology,providing new ideas for the treatment of DFU.Methods:1.Clinical observation: Data of DFU patients who met the syndrome of Qi deficiency and blood stasis were collected from the surgery department of our hospital from October2021 to December 2022.50 patients who met the inclusion criteria were selected and divided into the experimental group and the control group with 25 patients in each group according to the random number table method.The control group was treated with basic treatment and surgical debridement and dressing change,and the experimental group was additionally treated with oral Buyang Huanwu Decoction on the basis of the control group,one dose a day,warm twice in the morning and evening.The two groups were treated for 4weeks,respectively.The wound area and the quantitative score of TCM symptoms before and after treatment of the two groups were collected and recorded,and the clinical data of the two groups of patients were statistically analyzed using SPSS26.0 statistical software.2.Network pharmacology research: Log in to the NCBI database home page and select GEO Data Sets for retrieval,download two independent DFU related chip data sets GSE68183 and GSE80178,and use the "limma" and "pheatmap" packages in R language to conduct standardized data processing and screen differential genes.The signal pathway enrichment analysis was performed for the differentially expressed DFU genes.TCMSP database was used to search the active ingredients in Buyang Huanwu Decoction,and the target of active ingredients was screened.The potential target of Buyang Huanwu decoction was retrieved and the differentially expressed genes of DFU were intersected to obtain the potential target of Buyang Huanwu decoction to interfere with DFU.STRING database was used to construct PPI network,and the core targets of Buyang Huanwu decoction intervention in DFU were screened.The signal pathway enrichment analysis of potential targets of Buyanghuanwu decoction for DFU was conducted using R language,and the "component-target-disease-pathway" network of Buyanghuanwu decoction for DFU was constructed using Cytoscape3.8.0.target of active ingredients was screened.The potential target of Buyang Huanwu decoction was retrieved and the differentially expressed genes of DFU were intersected to obtain the potential target of Buyang Huanwu decoction to interfere with DFU.STRING database was used to construct PPI network,and the core targets of Buyang Huanwu decoction intervention in DFU were screened.The signal pathway enrichment analysis of potential targets of Buyanghuanwu decoction for DFU was conducted using R language,and the "component-target-disease-pathway" network of Buyanghuanwu decoction for DFU was constructed using Cytoscape3.8.0.Results:1.Clinical observation results1.1 Comparison of general data: The statistical results showed that there were no significant differences in gender and age composition between the two groups(P>0.05),which was comparable.1.2 Efficacy evaluation criteria: After treatment,the wound area of the two groups was reduced,and the quantitative score of TCM syndrome was decreased.After treatment,the wound area of the experimental group was less than that of the control group(P<0.05).After treatment,the quantitative score of TCM syndrome in the experimental group was lower than that in the control group(P<0.05).2.Network pharmacological results2.1 A total of 2262 DFU differential genes were screened,including 1064up-regulated genes and 1198 down-regulated genes.DFU up-regulated genes were significantly enriched in Toll-like receptor,NOD-like receptor,IL-17 and other signaling pathways,while DFU down-regulated genes were significantly enriched in thyroid hormone and other signaling pathways.2.2 After searching and screening,the effective ingredients of Buyang Huanwu Decoction were obtained,including 20 astragalus membranaceus,2 angelica sinensis,7ligusticum Chuanxiong,22 safflower,29 red peony root,23 peach kernel and 7 dilong.After correction and removal of repeated targets,224 effective targets of Buyang Huanwu Decoction were obtained.After the intersection of the active component targets of Buyanghuanwu Decoction and the targets of DFU,16 targets of Buyanghuanwu decoction interfering with the up-regulated genes of DFU and 14 targets of interfering with the down-regulated genes of DFU were obtained.Topological and enrichment analysis showed that PTGS2 and HMOX1 target proteins may be the core targets of Buyanghuanwu Decoction in the intervention of DFU up-regulated genes,and AR and CCND1 target proteins may be the core targets of Buyanghuanwu Decoction in the intervention of DFU down-regulated genes.2.3 Buyang Huanwu Decoction may interfere with DFU by mediating PTGS2,HMOX1 and other genes to inhibit IL-17 and other signaling pathways.Interferes with DFU by mediating CCND1,AR and other genes to up-regulate the expression of estrogen and other signaling pathways.Conclusion:1.Buyang Huanwu Decoction has a good therapeutic effect on DFU patients with Qi deficiency and blood stasis syndrome,and oral Buyang Huanwu decoction on the basis of comprehensive medical treatment and debridement and dressing change can accelerate wound healing and reduce clinical discomfort.2.DFU up-regulated genes were significantly enriched in Toll-like receptor,NOD-like receptor,IL-17 and other signaling pathways,while DFU down-regulated genes were significantly enriched in thyroid hormone and other signaling pathways.Buyang Huanwu Decoction may interfere with DFU by mediating PTGS2,HMOX1 and other genes to inhibit IL-17 and other signaling pathways.Interferes with DFU by mediating CCND1,AR and other genes to up-regulate the expression of estrogen and other signaling pathways. |
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