Meta-analysis And Network Pharmacology Study Of Tripterygium Wilfordii Glycosides In The Treatment Of Autoimmune Thyroiditi

Purpose:Meta-analysis system was used to evaluate the efficacy and safety of Tripterygium wilfordii in the treatment of autoimmune thyroiditis,and network pharmacology was used to explore the potential mechanism of Tripterygium wilfordii in the treatment of autoimmune thyroiditis.The application provides valid evidence-based medicine evidence.Material and method:The first part is a Meta-analysis of Tripterygium wilfordii polyglycosides in the treatment of autoimmune thyroiditis.The four major Chinese databases as well as Pub Med,Clinical trial,Cochrane library,and Embase English databases were searched by computer to search for clinical trials of autoimmune thyroiditis with tripterygium glycosides as the main interventions published before the establishment of the database until March 1,2022.Randomized controlled study.After completion,a literature screen was independently performed by two researchers,from which data were extracted.Finally,Rev Man5.4 was used to analyze the outcome indicators one by one.The second part is the network pharmacology study of Tripterygium wilfordii polyglycosides in the treatment of autoimmune thyroiditis.The main chemical constituents and targets of Tripterygium wilfordii polyglycosides were retrieved through SEA database,Swiss Target Prediction database and literature mining.Targets of autoimmune thyroiditis were searched through Gene Cards human gene database and Dis Ge NET database.Then use Cytoscape 3.7.2 to draw the "component-target-disease" interactive network diagram.The PPI network was then visualized in the STRING database.Finally,the core targets were analyzed by GO function and KEGG enrichment pathway.Results:1.Meta-analysis: This study finally included 11 articles with a total of 617 patients with autoimmune thyroiditis.The results of Meta analysis showed that the total effective rate of the treatment group combined with tripterygium glycosides in the treatment of autoimmune thyroiditis was higher than that of the control group(RR=1.31,95%CI(1.14,1.50),P=0.0001);The levels of FT3 and FT4 were not significantly different from those of the control group(P>0.05),but were superior to the control group in reducing TSH levels(SMD=-0.79,95%CI(-1.55,-0.02),P=0.04);treatment The serum Tg Ab level in the treatment group was significantly lower than that in the control group(SMD=-0.85,95%CI(-1.59,-0.11),P=0.03);the serum TPOAb level in the treatment group was significantly lower than that in the control group(SMD=-1.66,95%CI(-2.85,-0.46),P=0.006);there was no significant difference in the improvement of thyroid volume between the treatment group and the control group(P>0.05);the incidence of adverse reactions in the treatment group was higher than that in the control group(RR=12.5,95%CI(1.77,88.48),P=0.01).2.Network pharmacology research: 14 main chemical constituents and 432 drug targets of Tripterygium wilfordii polyglycosides were screened;1572 autoimmune thyroiditis targets were screened from Gene Cards and Dis Ge NET databases;144 targets were obtained by intersection The core targets of Tripterygium wilfordii polyglycosides in the treatment of autoimmune thyroiditis,including PIK3 CA,PIK3CD,PIK3 CB,PIK3R1,BRAF,IL6,etc.;567 BP,61 CC,and 78 MF were obtained after GO screening;KEGG was screened Afterwards,71 enriched pathways were obtained,including adhesion,osteoclast differentiation,Erb B signaling pathway,Toll-like receptor signaling pathway,etc.Conclusion:1.Through Meta analysis,it can be seen that Tripterygium wilfordii polyglycosides can improve the total effective rate of clinical treatment and effectively reduce the levels of TSH,Tg Ab and TPOAb.2.Through network pharmacology research,it can be seen that triptolide can treat autoimmune thyroiditis through multiple targets and multiple pathways,which provides a theoretical basis for the study of the intrinsic mechanism of triptolide in the treatment of autoimmune thyroiditis.