Clinical Observation And Mechanism Exploration Of Shenhuzhuzhang Decoction In Treating Idiopathic Short Stature Of Spleen Deficiency And Liver Hyperactivity Type

Objective:To clarify the clinical efficacy of Shenhuzhuzhang Decoction in the treatment of idiopathic short syndrome(ISS),explore its potential mechanism of action,and provide more clinical ideas for the treatment of ISS with traditional Chinese medicine.Methods:1.60 children with ISS of spleen deficiency and liver hyperactivity type were collected from the pediatric outpatient department of the First Affiliated Hospital,Heilongjiang University of Chinese Medicine from July 2021 to December 2022.The patients were randomly divided into control group(30 cases)and test group(30 cases).The control group was treated with Lysine Inosite and Vitamin B12 oral liquid,the test group was treated with Professor Yang Lizhen’s self-prepared formula Shenhuzhuzhang Decoction,and both groups were given lifestyle guidance.Two courses of treatment are observed.The data were sorted out and statistically analyzed by SPSS 26.0 software.2.The network pharmacology method was used to predict the target and possible pathway of action.With the help of Gene Cards database,DisGeNET database and other website databases,find the relevant targets of ISS.Venny 2.1 is used to analyze the intersection between the disease target and the compound prediction target to obtain the possible drug action target.Upload the cross target to the String database to obtain the protein-protein interaction information.Then it was imported into Cy tascape 3.9.2 software to draw protein-interaction network diagram(PPI)and drug-component-disease-target network.According to the intersection target obtained,KEGG enrichment is carried out to find the possible pathway of action,and perform molecular docking.In order to clarify the potential mechanism of Shenhuzhuzhang Decoction in the treatment of ISS.Results:1.The clinical observation of 57 cases of ISS with spleen deficiency and liver-yang hyperactivity syndromes was finally completed,of which 2 cases were lost in the control group.In the test group,1 case fell off.After two courses of treatment,the comparison of clinical efficacy within the group showed that the height and weight of children in the test group were significantly higher than those before treatment and the first course of treatment(P<0.01,P<0.05);The comparison of clinical efficacy between the two treatment courses showed that the height increase of children in the test group after the first and second treatment courses was significantly higher than that in the control group(P<0.01,P<0.01);The weight gain of children in the control group was significantly higher than that in the test group(P<0.01,P<0.01).After two courses of treatment,the TCM syndrome score and serum IGF-1 level in the experimental group were significantly improved compared with those before treatment(P<0.01).The safety evaluation showed that the incidence of adverse events in both groups was 0%,with no statistically significant difference(P>0.05).2.Through the network pharmacological research,it was found that the active ingredients(kaempferol,digitalis flavonoids β-Sitosterol,pipericin,quercetin,citrinin,naringin,etc.)combine with key targets(IL-6,TNF,STAT3,MTOR,MMP9,MMP2,IGF1R,IGFBP3,etc.),regulate the expression level of target proteins,and play the role of treating ISS through(insulin resistance,HIF-1 signal pathway,JAK-STAT signal pathway,C-type lectin receptor signal pathway,PI3K-AKT,etc.)signal pathway.Conclusion:1.Shenhuzhuzhang Decoction can promote the growth of height and weight of children with spleen deficiency and liver hyperactivity type of ISS,improve the growth and weight rate,improve clinical symptoms,reduce the score of traditional Chinese medicine syndrome,and increase serum IGF-1.It is safe and has no adverse reactions.2.Shenhuzhuzhang Decoction plays a role in treating ISS through key targets such as IGF1R and IGFBP3,and through signal pathways such as insulin resistance.