Professor Qu Nini's Study On Medication Rules And Network Pharmacology In The Treatment Of Sub-centimeter Ground-glass Density Pulmonary Nodule

Objective:1.Using data mining methods,analyze the medication prescription rules of Professor Qu Nini for the treatment of subcentimeter-glass density lung nodules,and inherit the traditional medicine of the motherland.2.Use network pharmacology to explore the mechanism of action of core prescription for the treatment of subcentimeter-glass density pulmonary nodules,and provide a basis for the treatment of pulmonary nodules by traditional Chinese medicine.3.Material and method:1.Collect the medical cases of patients with subcentimeter ground-glass density pulmonary nodules who were treated in the Affiliated Hospital of Liaoning University of Chinese Medicine from September 2020 to September 2022 and diagnosed and treated by Professor Qu Nini,screen the medical records according to the criteria of the arrangement,and then standardize and clean the data,and use WPS Offic Excel to establish a database to statistically analyze the basic information of patients and the frequency,efficacy and sexual taste of drugs in prescriptions;SPSS Modeler 18.0 was used to analyze association rules and analyze common drug pairs.SPSS Statistics 26 was used to cluster analysis of commonly used drugs and screen out core drugs.Combining the statistical analysis results with the clinical diagnosis and treatment experience of Qu Shi,the academic ideas and core prescriptions for the treatment of subcentimeter ground-glass density pulmonary nodules were further summarized.2.Through TCMSP database,BATMAN-TCM database and literature search,select the active ingredients and targets of core drugs,combine and remove duplicate targets,collect lung nodule-related targets in OMIM database,Genecards database,and DisGeNET database.and combine to remove duplicate targets.The drug and disease targets were imported into the venny2.1.0 database to obtain the intersection target and Wayne diagram,and the obtained intersection target was imported into the String database to set the relevant conditions to construct the target protein interaction(PPI)network,and the core targets were further screened.The "drug-active ingredient-core target" network diagram was constructed by Cytoscape 3.7.1,and GO and KEGG enrichment analysis of core targets was performed with DAVID database,so as to analyze the mechanism of action of core drugs for subcentimeter ground-glass density pulmonary nodules.Results:1.Medication:A total of 103 flavors of Chinese medicine were counted.The frequency of use>20%of traditional Chinese medicine is 25 flavors,according to the frequency of total drug occurrence from high to low:zombie silkworm,bellflower,summer subtilis,banxia,mountain ci mushroom,white mustard seed,Zhejiang fritillary,chaihu,sand ginseng,astragalus,Mai dong,oyster,baiju,poria,tangerine peel,Chuanxiong,scutellaria baicalensis,white flower snake tongue grass,lily,angelica,citrus husk,cat’s claw grass,half-branched lotus,skull,three-edged.2.Commonly used medicine pairs:banxia-white mustard;Chuanxiong-angelica;Sand ginseng-Mai Dong;Chaihu-Citrus husk;Triangular-curcum surgery.3.Cluster analysis:a total of 4 cluster combinations.The first category:zombie silkworm,bellflower,sunmer subtilis,banxia,mountain mushroom,white mustard seed,Zhej iang fritillary triangular,curcumina;The second category:chaihu,citrus husk,Chuanxiong,angelica;The third category:sand ginseng,wheat dong,astragalus white art poria,tangerine peel,lily,cat scratch grass;Fourth category:oysters,white-flowered snake tongue,skullcap,half-branched lotus.4.1 core prescription,the drug composition is:zombie silkworm,bellflower,summer subtilis,banxia,mountain mushroom,white mustard seed,Zhejiang fritillary,three-edged,curcum.5.Network pharmacology research analysis:the core drug combination has an active ingredient and 420 related targets.There were 1581 subcentimeter ground-glass density lung nodules-related targets,and 176 intersected targets with drug targets.PPI network analysis can obtain 149 coretargets,the top ten are JUN,MAPK3,MAPK1,SRC,HSP90AA1,TP5 3,RELA,AKT 1,TNF,MAPK14.The construction of the "drug-active ingredient-core target"network diagram shows that the main components of its core drug treatment of pulmonary nodules are quercetin Luteolin,beauverilide A kaempferol,palmitic acid,baicalein beta-sitosterol,formononetin,acacetin,and Stigmastero.GO enrichment analysis yielded 393 biological processes(BP),including positive regulation of gene expression,positive regulation of RNA polymerase Ⅱ promoter transcription,cell response to lipopolysaccharides,and cell response to hypoxia.67 cell components(CC),involving extracellular space,chromatin,RNA polymerase Ⅱ transcription factor complex,extracellular exosomes,etc.;The 83 molecular functions(MF)mainly include transcription factor binding,enzyme binding,peptidase activity,protein homodimer activity,etc.8.KEGG pathway analysis yielded 167 signaling pathways,among which PI3K-Akt signaling pathway,HIF-1 signaling pathway,interleukin 17 signaling pathway,AGE-RAGE signaling pathway in diabetic complications signaling pathway,TNF signaling pathway,etc.are important pathways for core drug treatment of subcentimeter-density lung nodules.Conclusion:1.In the understanding of the etiology and pathogenesis,the onset of positive and false feelings and the "evil" pathogenesis of positive and void form a pulmonary effusion;Based on the deficiency of righteous qi and the body’s ability to resist evil,it is based on qi,depression,phlegm,coagulation,blood stasis,heat and poison.Accumulated for a long time,the yin and evil condensed,the phlegm and stasis knotted with each other,the depression turned into fire,the heat poison was brewed,and finally it became cancer poison.2.In terms of treatment,Qu Shi is good at using wind medicine to dissolve phlegm and disperse knots when identifying lung nodules,supplemented by clearing heat and detoxification,activating blood and removing stasis,replenishing qi and yin,and thinning the liver and qi;Make good use of Tibetan elephant theory and Xuanfu theory,accurately grasp the pathogenesis changes of lung nodules(Le.qi depression→phlegm coagulation→stasis→sputum stasis heat toxicity→cancer toxicity),and skillfully apply various drugs at the right time to carry out effective intervention.It organically combines the macroscopic dialectical thinking of the overall concept with the microscopic pathway structure,and flexibly applies it to the treatment of subcentimeter ground-glass sarcoidosis.