Professor Wei Beihai's Treatment Of Chronic Atrophic Gastritis And Network Pharmacology Researc

Objective:1.Using the cloud platform of ancient and modern medical cases to excavate the evidence pattern of Professor Wei Beihai’s treatment of chronic atrophic gastritis,screen out the core symptoms and explore the academic thoughts and clinical ideas of Professor Beihai Wei.2.To address the core symptoms of chronic atrophic gastritis treated by Prof.Beihai Wei,a network pharmacology approach was used to explore the mechanism of action and effective targets for the treatment of chronic atrophic gastritis.Methods:1.A total of 272 cases of Chinese medicine prescriptions for chronic atrophic gastritis treated by Prof.Beihai Wei were collected and organized,and the data were standardized and established into a database.Symptoms are analyzed through frequency analysis,hierarchical cluster analysis,association rule analysis on the Ancient and Modern Medical Case Cloud platform and K-Means clustering algorithms.2.Use the online database to screen the core symptoms and disease targets,and the two were intersected to obtain the common targets,and the PPI protein interaction network was constructed by String database;the PPI network was analyzed by Cytoscape 3.8.2 software to obtain the clustered sub-networks and Hub genes,and then the GO function and KEGG pathway analysis of the sub-networks and Hub genes were performed by Metascape platform.Compounds could act on Hub genes were screened using the TCMSP database to construct a target-compound network,then the mechanism of action of herbs in the experience of Prof.Beihai Wei was searched through the literature.This study predicts and investigates the active ingredients and potential mechanisms of action of herbal medicines in the treatment of chronic atrophic gastritis.Results:1.Of the 272 case patients included,154 were female and 118 were male.In terms of age distribution,the consultation population was predominantly middle-aged,accounting for 38.97%,with 102 young people,106 middle-aged,51 middle-aged and 10 elderly.The distribution of inner organs elements in the order of stomach(218 times),spleen(203 times),and liver(191 times);the distribution of pathogenic evidence elements in the order of qi stagnation,qi deficiency,dampness,blood stasis,yin deficiency,heat,yang deficiency,and phlegm.The top 10 symptoms were insomnia,gastric distension,dry mouth,stomach pain,hiccups,weakness,acid reflux,poor appetite,loose stools,and heartburn.The main symptom combinations are:①insomnia ②hiccups,acid reflux,heartburn ③stomach distension,stomach pain ④dry mouth ⑤loose stools,weakness,and poor appetite.CAG with insomnia is treated with calamus,shouwu teng,hooked vine and sour date,together with panax quinquefolium and salviae to invigorate the blood and promote blood circulation,xuanfuhua and daizheshi to lower the rebellion,and chai hu and yanhu suo to move the qi..The rules of correlation between symptoms and herbs and between symptoms and herbs with a high degree of confidence include "insomnia-sour date nut","weakness-huangqi","stomach painpanax ginseng","hiccups-xuanfuhua","stomach distension-salvia miltiorrhiza" and"spleen and stomach weakness-huangqi","Liver and stomach stagnation-chuanxiong ".The core formula for each type of symptoms is "Huang Qi-Fu Ling-Ban Xia-Gan Jiang" for weak spleen and stomach,"Huang Lian-Wu Zhu Yu-Chuan Xiong-Hooked Vine" for liver and stomach heat,"Chai Hu-Red Peony-Chuan Xiong" for liver and stomach qi stagnation,and "Dan Shen-Bei Sha Shen" for stomach yin deficiency.K-Means clustering of symptoms yields 8 classes of four diagnostic information corresponding to disease pathology.2.The top 10 most frequently used symptoms obtained by data mining as core symptoms were screened through the database to obtain 1960 gene targets,while 261 gene targets related to CAG were obtained in the disease database,and 130 common targets were obtained after taking the intersection,and the PPI protein interactions network contained 121 nodes with 917 edges,and the more important targets in the network were TP53,EGFR,CTNNB1,IL6,IL10,AKT1,ALB,STAT3,Topological analysis of the PPI network yielded 5 sub-networks and 30 Hub genes.The key pathways are PI3K-Akt pathway,TGF-β signaling pathway,P53 pathway.PD-L1 pathway,NER pathway,etc.The classical medicine pair "huangqi-chuanxiong " is used to treat CAG and improve the main symptoms through PI3K-Akt,TGF-β and P53 signaling pathways.The experience of using " Huang Qi-Chuanxiong" for the treatment of CAG is probably through the PI3K-Akt,TGF-β and P53 signalling pathways.Conclusions:1.The data mining suggests that the disease location of CAG is mainly in the stomach,which is related to the liver and spleen.The pathogenesis of the disease is the original deficiency and the symptomatic reality,the original deficiency is mainly the weakness of the spleen and stomach,and the symptomatic reality includes pathological factors such as qi stagnation,dampness-heat and stasis.Symptom analysis shows that CAG disease is often associated with insomnia.Treatment is based on nourishing the heart and calming the mind,together with drugs to regulate the spleen and stomach.An analysis of the association between symptoms and Chinese herbal medicines revealed that sour date nut and shouwu vine were the main treatments for insomnia,while panax ginseng,danshen and chuanxiong were the main treatments for gastric distension and stomach pain.The analysis of the evidence types and Chinese traditional medicine has led to the composition of the core medicines for each evidence type of CAG,and the summary of Professor Wei Beihai’s clinical classical medicine pair "Huang Qi-Chuan Xiong" for the treatment of CAG.To sum up his clinical experience,the treatment of Qi deficiency and blood stasis is the main treatment,supplemented by regulating the spleen to raise and lower the stomach.In the case of Qi deficiency,the key points are thin pulse,weakness and white fur;in the case of heat,the key points are red tongue,yellow fur and bitter mouth;in the case of blood stasis,the key points are dark tongue,etc.2.Network pharmacology studies indicate that the disease mechanism of CAG may be achieved by the active ingredients in herbs affecting important targets such as TP53,EGFR,CTNNB1,IL6,IL10,AKT1,STAT3,ALB,and modulating PI3K-Akt pathway,TGFβpathway,P53 pathway,PD-L1 pathway,and NER pathway.Among them,the drug pair "huangqi-chuanxiong" may be achieved by regulating PI3K-Akt pathway,TGF-β pathway and P53 pathway.