Clinical Study Of Linggui Zhugan Decoction In Treating Vestibular Migraine Of Spleen-deficiency And Phlegm-dampness Type Based On Network Pharmacology

Objective:1.To evaluate the efficacy and safety of Linggui Zhugan Decoction in the treatment of Vestibular Migraine(VM)of Spleen-deficiency and Phlegm-dampness type by conducting a randomized controlled clinical trial.2.Using the network pharmacological research method,further explore the potential mechanism of Linggui Zhugan Decoction in treating VM.Methods:1.Clinical study: 60 patients with VM of spleen-deficiency and phlegm-dampness type were selected and randomly divided into control group and treatment group with 30 cases each.Both groups were treated with Flunarizine Hydrochloride Capsule as the basic drug for 4 weeks,and the treatment group was added with Linggui Zhugan Decoction on this basis.The scores of Dizziness Handicap Inventory(DHI),Visual Analogue Scale(VAS),TCM syndrome score,Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale(HAMD)of the two groups were recorded and statistically analyzed before and after 4 weeks of treatment.2.Network pharmacology research: retrieval the active ingredients of Linggui Zhugan Decoction and predict the target through TCMSP platform,obtain VM target through Gene Cards,OMIM,Dis Ge NET,TTD,Drug Bank database,map and intersect the drug and disease target,and obtain the potential target of Linggui Zhugan Decoction for VM treatment.Use Cytascape 3.9.1 to construct the "drug-active component-potential target" network diagram of Linggui Zhugan Decoction in the treatment of VM to obtain the core components,and use String database to construct the protein-protein interaction(PPI)network of potential targets to obtain the core targets;Finally,the GO function and KEGG pathway enrichment analysis of the core target is carried out through the David platform.To predict and explore the potential mechanism of Linggui Zhugan Decoction in treating VM.Results:1.Compared with the treatment before,the scores of DHI,VAS,TCM syndrome score,HAMA and HAMD in both groups decreased after treatment(P<0.05).In addition,the comparison between groups after treatment showed that the scores of DHI,VAS,TCM syndrome score,HAMA and HAMD in the treatment group were significantly lower than those in the control group(P<0.05).2.Through searching,screening and prediction in the network database,a total of 103 active ingredients of Linggui Zhugan Decoction were obtained,230 predicted targets were obtained,and 88 potential targets were obtained after intersection with 1032 VM targets.Build and analyze the network diagram,and get the core components including quercetin,kaempferol,beta-sitosterol,Medicarpin,formononetin,naringenin etc.The core targets include PTGS2,TNF,AKT1,IL6,VEGFA,MMP9、IL-1βetc.Through the enrichment and analysis of core targets through David platform,579 relevant GO functional items were obtained,including 475 biological processes(BP),33 cell components(CC)and 71 molecular functions(MF);There are 146 KEGG signal pathways,including AGE-RAGE pathway,Pathways in cancer,TNF signal pathway,etc.Conclusions:1.Linggui Zhugan Decoction can effectively reduce the degree of dizziness,improve quality of daily life,TCM syndromes,anxiety,depression and other negative emotions of VM patients with spleen-deficiency and phlegm-dampness type,and has good effectiveness and safety.2.The potential mechanism of Linggui Zhugan Decoction to improve VM may be the active ingredients such as quercetin,kaempferol,beta-sitosterol affect targets such as PTGS2,TNF,AKT1,IL-6,VEGFA,and regulate the realization of AGE-RAGE,TNF and other pathways.