Study On The Mechanism Of Qianjin Weijing Decoction In The Treatment Of Bronchiectasis Based On Network Pharmacology

Objective:To evaluate the clinical efficacy of Qianjin Weijing Decoction in treating patients with bronchiectasis with phlegm heat obstruction in the lung syndrome through clinical observation,as well as its impact on traditional Chinese medicine syndrome score,white blood cell count(WBC),neutrophil count(NEUT),neutrophil percentage(NEUT%),and Creactive protein(CRP),and to explore the active ingredients of Qianjin Weijing Decoction for treating bronchiectasis and their target points by network pharmacology method,to elucidate the related mechanism of action,and to provide more evidence-based medicine basis for its clinical application,and to provide new ideas and methods for improving the clinical efficacy of Qianjin Weijing Decoction as a basic prescription.Methods:To collect 60 cases of bronchiectasis patients who visited the inpatient department of Respiratory and Critical Care Medicine of Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from January 2021 to June 2022,with TCM syndrome differentiation as phlegm-heat obstructing lung syndrome,and randomly divide the included cases into two groups,namely experimental group and control group,with 30 cases each.The control group was given conventional western medicine treatment,while the experimental group was given oral Qianjin Weijing Decoction treatment on the basis of the control group,and modified according to syndrome differentiation.The course of treatment was 2 weeks.The changes of TCM syndrome score and blood inflammation indicators(WBC,NEUT,NEUT%,CRP)before and after treatment were compared between the two groups.The results were statistically analyzed by SPSS 26.0 to evaluate their clinical efficacy and safety.Then,by querying TCMSP database,using OB≥30%,DL≥0.18 as the main screening criteria to screen out the active ingredients and target points of Qianjin Weijing Decoction,through Uniprot database to correct the drug active ingredient target gene name to official name(officical gene symbol).Using “bronchiectasis” as a keyword,species selected as human(Homosapiens),retrieved relevant disease target genes from Gene Cards database.Using Cytoscape software to construct “Chinese medicine-active ingredient-target” network diagram;using Bisogenet and Merge tools,using Degree Centrality(DC),Betweenness Centrality(BC),Closeness Centrality(CC)and LAC as evaluation indicators to screen out core targets of drug and disease.Using Metascape platform to enrich core targets analysis to find out signal pathways they involved in.Using Auto Dock and Pymol software to dock main active ingredients of Qianjin Weijing Decoction with core targets.Results:1.The general situation,TCM syndrome score,as well as WBC,NEUT,NEUT%,CRP in the blood of the two groups were compared and there was no statistically significant difference(P>0.05),which was clinically comparable.After treatment,(1)The total effective rate of the experimental group and the control group were 93.1% and 86.7%,respectively,and there was a significant difference between them(P<0.05),indicating that the treatment effect of the experimental group was better than that of the control group.(2)The TCM syndrome total score of patients in both groups was lower than before treatment,indicating that the clinical symptoms of both groups had improved,but the improvement degree of the experimental group was higher(P<0.05).(3)The levels of WBC,NEUT,NEUT% and CRP in both groups were reduced,indicating that the inflammatory response of both groups had been alleviated,but the alleviation effect of the experimental group was better(P<0.05).(4)During the study process,patients’ blood routine,electrocardiogram,liver and kidney function and other indicators were normal,and no allergic reaction or serious adverse reaction occurred.2.A total of 25 effective components of Qianjin Weijing Decoction were screened out,and 224 human gene targets were obtained by matching effective components.After standardization and deduplication,54 targets were obtained.A total of 1315 disease-related targets for bronchiectasis were obtained.Through multiple screening,VCP,HSP,YWHAZ,ESR1,TP53 genes and other 53 targets were determined as the core targets of drugs and diseases;GO enrichment analysis found that the main biological processes of Qianjin Weijing Decoction in treating bronchiectasis include regulation of cellular stress response,cellular response to nitrogen compound,cell-substrate junction,ubiquitin protein ligase binding and so on.KEGG enrichment analysis results showed that Qianjin Weijing Decoction mainly involved PI3K-Akt signaling pathway,MAPK signaling pathway,Fox O signaling pathway,TGFbeta signaling pathway,IL-17 signaling pathway and so on in treating bronchiectasis.Molecular docking showed that the main active components of Qianjin Weijing Decoction had low binding energy with VCP,HSP,YWHAZ,ESR1 and TP53 respectively.Conclusion:Qianjin Weijing Decoction combined with western medicine has a significant effect on bronchiectasis of phlegm heat obstructing lung type,which can not only improve the clinical symptoms such as cough,yellow phlegm,shortness of breath,and chest tightness,but also effectively control infection,reduce pulmonary inflammation,and has high safety.No obvious adverse reactions were observed during the study.Through network pharmacology research,it was found that many effective components of Qianjin Weijing Decoction act on multiple pathways,and treat bronchiectasis synergistically through multiple pathways such as anti-oxidative stress,alleviating inflammatory damage,inhibiting tumor cell expression and so on.