Clinical Observation And Network Pharmacology Study Of Tiaoqi Pingwei Decoction In The Treatment Chronic Atrophic Gastritis (Syndrome Of Heat Stagnation In Liver And Stomach)

Objective:1.To observe the clinical efficacy of Tiaoqi Pingwei Decoction in the treatment of chronic atrophic gastritis(syndrome of heat stagnation in liver and stomach).2.To study the potential active ingredients and action targets of Tiaoqi Pingwei Decoction for the treatment of chronic atrophic gastritis,and to provide a theoretical basis for its further animal tests and cellular mechanism tests.Methods:1.Clinical observation of Tiaoqi Pingwei Decoction in the treatment of chronic atrophic gastritis with syndrome of heat stagnation in liver and stomach.Sixty-four patients who met the criteria in the outpatient clinic from June2021 to January 2023 were selected and grouped into a test group and a control group using the random number table method,with 32 cases in each group.The control group was treated with Dalitong granules,3 times a day,6g each time.The experimental group was treated with Tiaoqi Pingwei Decoction,1 dose daily,with water decoction,for a total treatment period of 12 weeks.Before and after treatment,patients’ TCM syndrome scores,gastroscopy and pathological examination were compared,and the results were graded and scored for comparison.2.Network pharmacology study on the treatment of chronic atrophic gastritis with syndrome of heat stagnation in liver and stomach with Tiaoqi Pingwei Decoction.The TCMSP database was used to screen the main active ingredients and the corresponding targets of Tiaoqi Pingwei Decoction,all targets were standardized using the Uniprot database.The disease targets were searched in Genecards,OMIM,and Dis Ge NET databases.We used Cytoscape 3.9.1 software to build a "drug-active ingredient-target of action" network,and established a protein interaction network diagram by analyzing the active ingredient targets and the common targets of the disease to obtain a PPI network diagram and used the Cytoscape plug-in centiscape2.2 to The core targets of the treatment were screened out according to certain conditions,and the relevant targets were imported into the David6.8 database for GO function and KEGG pathway enrichment analysis.Results:1.clinical observations(1)Baseline comparison: The two groups of patients were compared in terms of gender,age,disease duration,total and single syndrome scores of TCM before treatment,gastroscopic grading,and pathological tissue score(P>0.05),and the results were not significantly different and comparable.(2)Comparison of TCM syndrome scores: After treatment,all symptoms of patients in the test group and the control group relieved,and the test group had better treatment effects than the control group in terms of pain and fullness in the stomach,noisy noises in the stomach,acid reflux,dry mouth and bitterness(P<0.01),and the two groups had comparable efficacy in terms of dry stools and irritability(P>0.05).(3)Comparison of the efficacy of TCM syndrome: the over all effective rate of the test group was 86.67%,and the overall effective rate of the control group was 66.67%,and the efficacy of the test group was better than that of the control group(P<0.05).(4)Comparison of the efficacy of gastroscopic grading: the effective rate of the test group was 76.67%,and the effective rate of the control group was 53.33%,and the test group was better than the control group(P<0.05).(5)Comparison of pathological scores: the pathological scores of atrophy and intestinalization decreased in patients of the test and control groups(P<0.05),and the test group was better than the control group(P<0.05),and there was no significant decrease in the scores of heterogeneous hyperplasia in both groups(P>0.05).(6)Comparison of pathological efficacy: the overall effective rates of atrophy,intestinalization and heterotypic hyperplasia in the test group were73.33%,60% and 10%,respectively,after treatment,and the overall effective rates of atrophy,intestinalization and heterotypic hyperplasia in the control group were 53.33%,36.67% and 3.33%,respectively,indicating that the efficacy of atrophy and intestinalization in the test group was better than that in the control group(P<0.05),and the efficacy of heterotypic hyperplasia there was no significant difference between the two groups(P>0.05).2.Network pharmacologyThe network pharmacology study can reveal 129 active chemical components of Tiaoqi Pingwei Decoction,and a total of 108 active components and 246 targets were obtained after removing the same active components and targets.The potential action targets of 99 chronic atrophic gastritis were involved in the treatment.Cytoscape topology analysis screened 18 core targets such as AR,RELA,STAT1,AKT1,MAPK14,and 5 core components such as quercetin,β-sitosterol,kaempferol,dousterol and isorhamnetin.Bioinformatics enrichment analysis yielded 170 pathways,mainly related to pathways in cancer,AGE-RAGE signaling pathway,lipid and atherosclerosis pathway,and PI3K/Akt signaling pathway.Conclusion:1.Tiaoqi Pingwei Decoction can significantly relieve the clinical symptoms of chronic atrophic gastritis patients with syndrome of heat stagnation in liver and stomach.2.Tiaoqi Pingwei Decoction can improve the submucosal manifestation of gastroscopy and increase the efficiency of treating pathological atrophy and intestinalization3.Tiaoqi Pingwei Decoction may play a role in treating chronic atrophic gastritis through AR,RELA,STAT1,AKT1,MAPK14,pathways in cancer,AGE-RAGE signaling pathway,lipid and atherosclerosis pathway,and PI3K/Akt signaling pathway.This study reveals the multi-component,multi-target and multi-pathway mechanism of Tiaoqi Pingwei Decoction,which provides new ideas for the clinical application of Tiaoqi Pingwei Decoction as well as animal experiments and cellular mechanism tests.