The Study Of Prescription Rule,Evidence-based Evidence And Mechanism Of Action Of AECOPD Treated By Clearing Heat And Resolving Phlegm Based On Literature Research

Objective To analyze Prescription Rule,Evidence-based evidence and mechanism of the Acute Exacerbation of chronic obstructive pulmonary disease in the treatment with Clearing Heat and Resolving Phlegm.Methods1.Prescription RuleScreen literatures and extracti data of the AECOPD treated by Clearing Heat and Resolving method in the Wang Fang Date and other datebases from the their establishment to October 2022,and use IBM SPSS Statistics 25.0 and IBM SPSS Modeler18.0 to find out the medication rule.2.Evidence-based evidenceMeta-analysis and Network Meta-analysiswas used to analyze Qingqi Huatan Decoction and another 7 Traditional Chinese Medicine ancient prescriptions ccombination therapy based on Rev‐Man5.4.1 and Stata 5.0 software.3.MechanismTo find the mechanism of “baicalensis,mori cortex and caladium” to treat AECOPD based on network pharmacology method.Result1.Prescription Rule:A total of 360 prescriptions were obtain,including 123 TCM herbs,with the total frequency was 4045.The herbs with high frequency were 55,and their total frequency was 3719,and main function is clearing heat,relieving cough,reducing phlegm and relieving asthma,further study find that Clearing Heat and Resolving Phlegm method can be sorted out 7 methods;13 core Pair medicine,25 core horn medicine and 13 core prescriptions were found out.2.Evidence-based evidence:121 studies were included,involving 9108 subjects,including 4568 patients in the experimental groups and 4540 patients in the control groups.Comparing to the control group,Besides Dingchuan Decoction,the other 7 TCM ancient prescription combination group can improve the clinical effectiveness of patient with AECOPD;Besides Yuebi and Banxia Decoction and Xuanbai Chengqi Decoction,the other 6 prescription combination groups can improve FEV1/FVC of patient with AECOPD;Besides Yuebi and Banxia Decoction,the other 7 prescription combination groups can improve FEV1% of patient with AECOPD;Besides Ding Chuan Decoction,the other 7 prescription combination groups can reduce TCM syndrome score of patient with AECOPD;Besides Yuebi and Banxia Decoction,Weijin and Dingchuan Decoction,the other 5 prescription combination groups can reduce CRP of patient with AECOPD;Qingjin Huatan Decoction,Weijin Decoction and Sangbaipi Decoction combination groups can reduce IL-6 of patient with AECOPD;Besides Maxing Shigan Decoction,Xuanbai Chengqi Decoction and Dingchuan Decoction,the other 5 prescription combination groups can reduce TNF-α of patient with AECOPD;Besides Yuebi and Banxia Decoction,Maxing Shigan Decoction and Xuanbai Chengqi Decoction,the other 5 prescription combination groups can improve PaO2 of patient with AECOPD;Qingqi Huatan Decoction,Qingjin Huatan Decoction,Weijin Decoction and Sangbaipi Decoction combination groups can reduce PaCO2 of patient with AECOPD;Qingjin Huatan Decoction and Yuebi and Banxia Decoction combination groups can reduce CAT of patient with AECOPD.As for safety,Qingjin Huatan Decoction combination group can reduce adverse reaction of patient with AECOPD,Qingqi Huatan Decoction,Weijin Decoction,Yuebi and Banxia Decoction and Sangbaipi Decoctionand combination groups are no significant difference to the control group.About efficacy ranking,The top three clinical effectiveness rates were Maxing Shigan Decoction,Xuanbai Chengqi Decoction and Qingqi Huatan Decoction combination groups;The top three FEV1/FVC rates were Weijin Decoction,Qingqi Huatan Decoction and Maxing Shigan Decoction combination groups;The top three FEV1% rates were Yuebi and Banxia Decoction,Weijin Decoction and Sangbaipi Decoction combination groups;The top three TCM syndrome score rates were Qingqi Huatan Decoction,Sangbaipi Decoction and Qingjin Huatan Decoction combination groups;The top three CRP rates were Xuanbai Chengqi Decotion,Ding Chuang Decoction,and Qingjin Huatan Decoction combination groups;The top three PaO2 rates were Wejin Decotion,Qingqi Huatan Decotion and Ding Chuang Decoction combination groups;The top three PaCO2 rates were Qingqi Huatan Decotion,Qingjin Huatan Decoction and Ding Chuang Decoction combination groups;The top three CAT rates were Qingqi Huatan Decotion,Ding Chuang Decoction and Yuebi and Banxia Decoction combination groups.And the comprehensive clinical efficacy is the Qingqi Huatan Decoction combination groups.3.Mechanism:Frstly,56 ingredients and 124 related targets of this thorn medicine(baicalensis,mori cortex and caladium),3099 targets of AECOPD were found out.Secondly,mechanism of Action about the AECOPD treated by horn the medicine mainly relate to 6 core ingredients,9 core targets and 60 pathway.Finally,a network about“AECOPD‐thorn medicine‐key ingredients‐core targets‐pathway” was built.Conclusion1.Prescription Rule:AECOPD(syndrome of phlegm-heat obstructing lung)can sort out 8 treatment methods based on Clearing Heat and Resolving Phlegm method,and also find an important horn medicine(baicalensis,mori cortex and caladium).2.Evidence-based evidence:The patient with AECOPD in the treatment of Clearing Heat and Resolving Phlegm method combination groups can get better effect and also safety.The top one effect of Clinical effectiveness,FEV1/FVC、FEV1%,TCM syndrome score,CRP,PaO2,PaO2,CAT were respectively Maxing Shigan,Weijin,Yuebi and Banxia,Qinqi Huatan,Xuanbai Chengqi,Weijin,Qinqi Huatan,Qinqi Huatan Decotion combination group;Further study is indeed to offset low quality of the literature and other the limitation of this study.3.Mechanism:The mechanism of AECOPD treated by“baicalensis,mori cortex and caladium”is related to 6 core ingredients including baicalein,9 core targets including AKT1,and 60 pathway including TNF.However this study result is need further verification.