Meta-analysis And Network Pharmacology Study On The Treatment Of Myocardial Bridge With Traditional Chinese Medicin

Purpose:Using a systematic evaluation method to evaluate the effectiveness and safety of traditional Chinese medicine in treating myocardial bridge,providing a reliable basis for the treatment of this disease with traditional Chinese medicine;And organize and summarize the usage of traditional Chinese medicine,using the top three most frequently used traditional Chinese medicines,Danshen,Chuanxiong,and Ginseng,as the core drugs for treating myocardial bridge.Based on network pharmacology methods,explore the potential mechanism of action for its treatment of myocardial bridge.Materials and methods:Using keywords such as "Traditional Chinese Medicine","Traditional Chinese Medicine","Myocardial Bridge","Coronary Myocardial Bridge",and "Myocardial Bridge Angina Pectoris",we searched Chinese databases such as CNKI,VIP,Wanfang Digital Journal Full Text Database,and CBM using computers,Retrieve RCT literature on the treatment of myocardial bridge with traditional Chinese medicine from the establishment of the database until October2022,and collect and organize data using Excel tables based on the established inclusion criteria.Evaluate the quality of the literature using the Cochrane risk assessment tool,and use Rev Man 5.4 software to draw forest maps and funnel maps for meta-analysis.And summarize the use of traditional Chinese medicine in the treatment of myocardial bridge included in the literature,and explore the potential mechanism of its core drugs,Danshen,Chuanxiong,and Ginseng,based on network pharmacology methods,in the treatment of myocardial bridge.Result:1.A total of 12 Chinese literature that met the standards were included in this study for meta-analysis,with a total of 832 samples,including 417 in the treatment group and 415 in the control group.2.Meta analysis results:(1)The improvement of clinical symptoms(angina)in patients with myocardial bridge in the traditional Chinese medicine treatment group was better than that in the control group [RR=1.32,95% CI:(1.22,1.43),Z=6.90(P<0.0001)];(2)The improvement of electrocardiogram efficacy in patients with myocardial bridge in the traditional Chinese medicine treatment group was better than that in the control group [RR=1.35,95% CI:(1.22,1.50),Z=5.58(P<0.0001)];(3)The traditional Chinese medicine treatment group showed better improvement in the efficacy of traditional Chinese medicine symptoms in patients with myocardial bridge than the control group [RR=1.35,95% CI:(1.21,1.51),Z=5.23(P<0.0001)];(4)The improvement of traditional Chinese medicine syndrome scores in patients with myocardial bridge in the traditional Chinese medicine treatment group was better than that in the control group [SMD=-2.45,95% CI:(-4.13,-0.77),Z=2.85(P=0.004)];(5)Safety analysis found no statistical significance between groups.3.This study included a total of 12 prescriptions and 55 traditional Chinese medicines,with the top three most frequently used being Danshen(10 times),Chuanxiong(5times),and Ginseng(5 times).4.Conducting network pharmacology analysis on Danshen,Chuanxiong,and Ginseng as core drugs for treating myocardial bridge,a total of 56 effective compounds from Danshen,3 from Chuanxiong,and 5 from Ginseng were selected to participate in the regulatory network.42 intersecting genes were identified,and 10 core action targets were identified through PPI network screening;GO enrichment analysis enriched 360 BP entries,31 CC entries,and 60 MF entries;KEGG enrichment analysis revealed131 signaling pathways.Conclusion:1.Traditional Chinese medicine treatment can significantly improve the clinical symptoms(angina pectoris),electrocardiogram efficacy,and traditional Chinese medicine symptom efficacy of patients with myocardial bridge,and can improve their traditional Chinese medicine symptom scores.2.In the treatment of myocardial bridge,Danshen,Chuanxiong,and Ginseng have the highest frequency of use.3.Salvia miltiorrhiza,Ligusticum chuanxiong and Ginseng treat myocardial bridges through a multi-component,multi target and multi pathway mechanism,mainly including luteolin,tanshinone IIA,dihydrotanshinolide,myricone,shrub polyglycone A and other active ingredients,acting on AKT1,CYP3A4,IL6 and other targets,involving fluid shear stress and atherosclerosis,cancer pathways,lipid and atherosclerosis and other signal pathways.