Medical Record Data Mining And Drug Mechanism Research On TCM Multidisciplinary Model Intervention For Rectal Cancer Rehabilitatio

The Colorectal Cancer Multidisciplinary Rehabilitation Clinic of Xiyuan Hospital,China Academy of Chinese Medical Sciences is a diagnosis and treatment platform with oncology and anorectal departments as the core,and rehabilitation,nutrition,urology,pharmacy,psychology and other related specialties.In recent years,in the postoperative intervention of colorectal cancer,a model of multidisciplinary intervention and integrated traditional Chinese and Western medicine has been formed to help patients recover their physical functions quickly after tumor surgery,and return to family,society,and work as soon as possible.good effect.Based on the experience and achievements of colorectal cancer multidisciplinary tumor rehabilitation outpatient clinics,this study conducted data mining on rectal cancer postoperative rehabilitation medical record data under the multidisciplinary tumor rehabilitation model,explored its mechanism of drug action,and summarized the basic working model.Research on rehabilitation patterns after rectal cancer surgery provides more evidence.Research Objectives:Study 1:Analysis of the regularity and core prescription of traditional Chinese medicine for rectal cancer postoperative rehabilitation under the colorectal cancer multidisciplinary rehabilitation outpatient mode.Study 2:Use network pharmacology and bioinformatics research methods to comprehensively analyze the molecular biological mechanism of core drugs,and predict possible targets and related molecular signaling pathways;evaluate small molecule ligands of traditional Chinese medicines and predict target receptor proteins binding ability.Study 3:Summarize the working mode and clinical experience of multidisciplinary tumor clinics.Research Methods:Study 1:Using data mining methods to analyze the regularity and core prescriptions of traditional Chinese medicine in multidisciplinary.rehabilitation outpatient treatment of colorectal cancer.By limiting the search criteria for postoperative patients with rectal cancer,patients who visited the multidisciplinary rehabilitation clinic for colorectal cancer from January 2020 to December 2022 were included.After data standardization and cleaning of their medical records,a comprehensive database of medical records was established.Analysis of general data,statistics of symptoms,information of four clinics,frequency of traditional Chinese medicine,meridian distribution of sex and flavor,drug classification,using association rules,cluster analysis and other analysis methods,combined with clinical practice,summed up the multidisciplinary rehabilitation outpatient treatment of colorectal cancer.The overall medication plan and core treatment ideas for patients after cancer surgery.Study 2:Predict the mechanism of action of core traditional Chinese medicine based on network pharmacology and verify the drug binding ability using molecular docking technology.Using the network pharmacology analysis method of traditional Chinese medicine compound prescriptions,the pharmacological mechanism of traditional Chinese medicine of core prescriptions in multidisciplinary rehabilitation outpatient clinics for colorectal cancer was analyzed.Network pharmacology analysis was performed on the core prescriptions excavated in Study 1,and the corresponding pharmaceutical active compound components of traditional Chinese medicine were obtained from the database of the pharmacology platform of traditional Chinese medicine,and the protein molecular targets of these active pharmaceutical compounds were determined.In addition,rectal cancer-associated genes were obtained from GEO,GeneCard,OMIM,and Disgenet databases,and the intersection part with the drug active compound target was used to draw the traditional Chinese medicine-active compound-gene target-rectal cancer association network,which was realized by Cytoscape Visualize and build a protein interaction network based on gene information on the STRING platform and find core targets through topological analysis.Finally,use R software related packages to conduct gene ontology and Kyoto Encyclopedia enrichment analysis to find potential intervention biological processes of drug ingredients And molecular signaling pathways,and visualize the results,and finally use molecular docking technology to evaluate the binding ability of the drug ingredient compound ligand and the associated protein receptor.Study 3:By summarizing typical colorectal cancer multidisciplinary rehabilitation outpatient medical records,the whole process of the multidisciplinary collaborative rehabilitation diagnosis and treatment model for rectal cancer intervened by traditional Chinese medicine is described.Research Result:Study 1:Data mining included a total of 96 patients with colorectal cancer multidisciplinary rehabilitation outpatient treatment after rectal cancer surgery,with a total of 436 visits.The age distribution of the included patients was 58.9±12.6 years old,and the symptom distribution was mainly intestinal dysfunction related to LARS syndrome The distribution of the tongue coating is mainly dark red and dark tongue,the tongue coating is thin white and more thin,the pulse distribution is mainly stringy,thin,and heavy pulse;the four gases of the drug are mainly warm,cold,and flat,and the five flavors are mainly Sweet,bitter,and acrid are the main meridians,and the spleen meridian,liver meridian,kidney meridian,stomach meridian,and lung meridian account for the largest proportion of the meridian distribution of medicines;51.58%of the total frequency is the most commonly used drug in this patient group;the most frequently used drugs are Poria cocos,Codonopsis pilosula,Stir-fried Atractylodes macrocephala,Scutellaria baicalensis,Eclipta chinensis,Ligustrum lucidum,Zhigancao,Astragalus,Suanzaoren,Coptis chinensis,etc.;The results of correlation analysis show that a total of 15 herbs have a high degree of support,including Codonopsis pilosula,Ligustrum lucidum,Eclipta chinensis,fried Atractylodes macrocephala,roasted licorice,astragalus,tangerine peel,ginger pinellia,plantago seed,psoralen,dodder,yam,Pueraria,Poria,Coptis.Cluster analysis revealed 6 significant clusters of traditional Chinese medicines,including:Sijunzi Decoction:Poria cocos,Stir-fried Atractylodes macrocephala,Codonopsis pilosula,Zhilicorice;Erzhi Pills:Eclipta chinensis,Ligustrum lucidum;commonly used medicine for invigorating spleen,nourishing qi and eliminating food:hawthorn,Chicken Neijin,Divine Comedy,Malt,Guy a;anti-tumor heat-clearing,detoxifying,and blood-activating drugs:Achyranthes bidentata,Scutellaria barbata,Hedyotis diffusa,Smilax tuckahoe,Predict seed,Guijianyu,Shi Jianchuan.Chishao;Sishen Pills:Psoralen,Nutmeg,Evodia,Schisandra;Liuwei Dihuang Pills:Poria,Chinese Yam,Rehmannia glutinosa,Alisma,Cortex Moutan,Cornus officinalis.Study 2:A total of 1,355 rectal cancer genes obtained from multiple databases were merged and deduplicated.After proofreading,262 compound-related genes corresponding to traditional Chinese medicines were obtained,and a total of 97 disease-compound crossover genes were obtained.The core compound selected by network pharmacology is quercetin Core gene targets determined by topological analysis of PIN map,luteolin,wogonin,kaempferol,nobiletin,baicalein,naringenin,acacia,diosgenin,licochalcone A Spots are JUN,RELA,MAPK3,FOS,MAPK1,ESR1,HIF1A,MYC,IL6 and NR3C1.GO analysis of core target genes indicated that genes were enriched in the positive regulation of miRNA transcription,transcriptional regulatory complexes,DNA-binding transcriptional activator activity,DNA polymerase Ⅱspecificity,etc.KEGG pathways were enriched in Th17 cell differentiation pathway,chemical carcinogenesis Drug-receptor activation pathway,PD-L1 expression and PD-1 checkpoint pathway in cancer,IL-17 signaling pathway,Toll-like receptor signaling pathway,TNF signaling pathway,chemical carcinogen-reactive oxygen species pathway,MAPK signaling pathway,B cell receptor signaling pathway,colorectal cancer pathway,Thl and Th2 cell differentiation pathway,choline metabolism pathway in cancer,etc.Molecular docking verification shows that the binding ability of the compound ligand to the protein receptor is good.Study 3:The Colorectal Cancer Multidisciplinary Rehabilitation Clinic of Xiyuan Hospital,China Academy of Chinese Medical Sciences coordinates multi-departmental intervention and comprehensive treatment,aiming to provide patients with comprehensive and individualized diagnosis,treatment,nursing and rehabilitation services.This interdisciplinary collaboration can Give full play to the professional advantages of each specialist to ensure that patients receive comprehensive treatment.Study conclusion:1.According to the results of data mining in Study 1,it was concluded that the main treatment methods used in the multidisciplinary rehabilitation clinic for colorectal cancer after rectal cancer surgery are to support righteousness,invigorate the spleen and eliminate stagnation;stasis.The three treatment methods embody the treatment principles of multidisciplinary rehabilitation clinics for colorectal cancer that focus on adjusting qi,yin and yang,nourishing righteous qi,invigorating the spleen and kidney,and eliminating heat pathogens,blood stasis and other pathological factors.2.Study 2 found that the components of commonly used traditional Chinese medicine prescriptions obtained through data mining may be involved in multiple inflammatory signaling pathways,immune checkpoint pathways,TNF pathways,NF-κB pathways,colorectal cancer and other pathways to regulate the immune,tumor microenvironment,and inflammatory environment of patients after rectal cancer surgery,and intervene in the development of the disease.3.Study 3 concludes that the mode of multidisciplinary rehabilitation clinic for colorectal cancer is to form a comprehensive plan through consultation and discussion of oncology department,anorectal surgery department,rehabilitation department,urology department,pharmacy department,nutrition department,etc.Intervention in the rehabilitation of patients,to achieve one-stop,individualized diagnosis and treatment services.Based on medical records in clinical practice,this study carried out multi-dimensional analysis and exploration with the help of statistical methods,network pharmacology,and bioinformatics methods,laying a foundation for the construction of a diagnosis and treatment system under the multidisciplinary tumor rehabilitation model of traditional Chinese medicine.