Evaluation Of The Efficacy And Prescription Rules Of Heat-clearing Chinese Medicine In The Treatment Of Acute Herpes Zoster Based On Complex Network Method

Purpose:This topic firstly searched,collected,and organized the randomized controlled trials of traditional Chinese medicine therapy of acute herpes zoster,statistically analyzed the heat clearing herbs and prescriptions involved,and summarized the formula law.Then,the basic prescription composed of core drugs was selected for meta analysis to provide evidence-based support for further discussion of its therapeutic mechanism.Finally,the possible targets and pathways of this basic prescription in the treatment of acute herpes zoster were explored with the help of network pharmacology to provide reference for in-depth study of the mechanism of action of drugs.Material and method:1.Search VIP,Wan fang and CNKI to find the randomized controlled trials on the treatment of acute herpes zoster with heat clearing herbs and prescriptions from the establishment to June 2021,and establish the prescriptions database for the treatment of herpes zoster.Use SPSS25.0 to analyze the frequency of prescriptions,the frequency,cluster analysis,dose,four natures,five flavors,meridian and efficacy of herbs.IBM SPSS 18.0 Modeler was used for association rule analysis;Gephi0.9.2 was used for complex network analysis of herbs.2.Search VIP,Wan fang,CNKI,CBM,Pub Med to find the randomized controlled trials of Longdan Xiegan Decoction in the treatment of acute herpes zoster from the establishment to June 2021.The quality of the included studies was evaluated using the bias risk assessment tool recommended in Cochrane Manual.Rev Man5.4 was used for data analysis.3.The active ingredients and targets of Longdan Xiegan Decoction were collected through TCMSP.Search Disease Connect,Gene Card,and OMIM databases to find the genes associated with herpes zoster.PPI was constructed by STRING;Network Analyzer in Cytoscape was used to select the core target where the prescription overlapped with the disease.DAVID was used for enrichment analysis of GO and KEGG;Autodock Vina was used to make molecular docking between core components and target structures,then visualized in PyMOL.Results:1.A total of 140 prescriptions for the treatment of acute herpes zoster were obtained,involving 172 herbs,appearing 3468 times in total.The first three prescriptions were Longdan Xiegan Decoction,Wuwei Disinfection Drink and Huanglian Jiedu Decoction;the top 10 herbs were licorice,scutellaria baicalensis,gentian,gardenia,bupleurum,rehmannia glutinosa,alisma orientalis,angelica,plantain and radix isatidis,with an average dose between 5.74 and 24.41.The core herbs for the treatment of acute herpes zoster are licorice,scutellaria baicalensis,gentian,gardenia,bupleurum,rehmannia glutinosa,alisma orientalis,angelica,plantain and radix isatidis,and the basic prescription is Longdan Xiegan Decoction.2 A total of 28 randomized controlled trials were included in the meta analysis.The results of meta analysis showed that the total effective rate of the experimental group was higher than that of the control group,the time of stopping blister,forming scab,removing scab and analgesic was shorter than that of the control group,the VAS score and incidence of residual neuralgia were lower than that of the control group,and all the outcome indexes were statistically significant.It can be considered that longdan Xiegan Decoction oral combined with western medicine antiviral,analgesic and other symptomatic methods treatment of acute herpes zoster,compared with simple conventional western medicine treatment,simple external treatment of traditional Chinese medicine,simple other traditional Chinese medicine therapy or no intervention treatment,has a more positive impact on patients’ skin lesions and pain indicators,clinical efficacy is accurate,research significance is significant.3.186 active ingredients and 262 targets of Longdan Xiegan Decoction were collected by TCMSP.There were 519 disease targets for herpes zoster.Uniprot was used to standardize the gene names,and 40 potential targets of Longdan Xiegan Decoction for herpes zoster were obtained.GO analysis results showed that there were 1891 BP items,32 CC items and 88 MF items.KEGG analysis showed a total of 157 pathways.The results of molecular docking showed that the core components kaempferol,beta-sitosterol,quercetin could bind to epidermal growth factor receptor,tumor necrosis factor,and caspase-3.Conclusion:1.In the treatment of acute herpes zoster with traditional Chinese medicine,licorice was the most frequently used single herb,followed by scutellaria baicalensis,gentian,gardenia,bupleurum and other heat clearing herbs.Longdan Xiegan Decoction was the most frequently used prescription,followed by Wuwei Disinfection Drink and Huanglian Jiedu Decoction and other heat clearing prescriptions.The core herbs in the treatment of acute herpes zoster are all compatible with Longdan Xiegan Decoction,which is often used as the basic prescription in clinical treatment of acute herpes zoster.2.In the treatment of acute herpes zoster,Longdan Xiegan Decoction combined with western medicine antiviral,analgesic and other symptomatic methods is superior to simple conventional western medicine treatment,simple external treatment of traditional Chinese medicine,simple other traditional Chinese medicine treatment or no intervention treatment,with excellent effectiveness and safety.3.Longdan Xiegan Decoction may be through the core components such as kaempferol,beta-sitosterol,quercetin act on targets such as epidermal growth factor receptor,tumor necrosis factor,caspase-3.Their mechanism may be related to lipid and atherosclerosis signaling pathway,AGE-RAGE signal pathway and tumor necrosis factor signaling pathway,future research can use experiments to verify the above pathways.