Professor Li Xiaojuan's Medication And Network Pharmacology Research In The Treatment Of Stage Ⅲ Type 2 Diabetic Nephropath

Objectives:1.To explore the medication pattern of Professor Li Xiaojuan in the treatment of type 2diabetic nephropathy stage III based on data mining techniques,to derive core drugs and clustered prescriptions,and to summarize clinical experience.2.To explore the potential mechanism of action of the core drugs in the treatment of diabetic nephropathy stage by using the research method of network pharmacology.Materials and methods:1.Patients who attended the outpatient clinic of Prof.Li Xiaojuan’s National Medical Hall and the inpatient department of Liaoning Chinese Medicine Rehabilitation Centre at the Affiliated Hospital of Liaoning University of Chinese Medicine for the past 2 years from September2020 to September 2022 were collected,and the case data of patients who were clearly diagnosed with DKD stage III and met the inclusion criteria were screened,and the data of clinical cases were registered using Excel software,and the information in the excel database was summarize and analyze the frequency of Chinese medicine use,number of flavors,sexual flavor attribution and efficacy of Chinese medicine,and use SPSS22.0 software to perform cluster grouping analysis to summarize the pattern of medication use of Li Shi in treating type2 diabetic nephropathy stage III.2.Using the research method of network pharmacology,drugs used ≥50 times were searched and screened for drug targets in the TCMSP database,while disease targets were searched in the OMIM,Gene Cards,TTD and Drugbank databases,and drug targets and disease targets were intersected on the venny platform,using Cytoscape 3.9.1 The drug-component-target network map was constructed in Cytoscape 3.9.1 software,and the PPI network map was constructed in String database,and the network map information was imported into Metascape database for GO and KEGG pathway enrichment analysis.Results:1.126 patients with type 2 diabetic nephropathy stage III were collected in this study,among which,76 cases(60.3%)were male and 50 cases(39.7%)were female.The ratio of male to female was 1.52:1.The youngest of the 126 patients was 27 years old and the oldest was 83 years old,the highest age group was "56-65" years old,accounting for 34.9% of the total.A total of 188 drugs were analysed for the number of flavours in this study,and the results showed that the number of flavours ranged from 8-19,with prescriptions for 12-16 drugs predominating.The top 10 drugs in order of frequency of drug use were Cornus officinalis,Cuscuta sinensis,Astragalus,Panax ginseng,Icariin,Phellodendron,Zhi Mu,Sheng Di Huang,Huang Lian and Dan Shen.Among them,cold medicines,sweet medicines and medicines attributed to the liver,kidney and spleen meridians were most frequently used.The statistics of drug efficacy showed that deficiency tonics were used most frequently.Cluster analysis yielded five clustered formulas.2.75 drug active ingredients were obtained after core drug screening,with 281 targets of action,and 150 intersecting targets were obtained after taking intersection with disease targets.The core drugs modulate TNF,IL6,IL1 B,AKT1,VEGFA,GAPDH and other active ingredients through quercetin,kaempferol,β-sitosterol,dousterol,isorhamnetin,diosgenin element,safranin and other Gene targets,through AGE-RAGE,TNF,IL-17 and MAPK signaling pathways and other signaling pathways to reduce inflammatory response,reduce kidney damage and protect kidney function.The mechanism of DKD treatment by core drugs is multi-component,multi-target and multi-pathway.Conclusion:1.Patients with stage III diabetic nephropathy are located in the kidney and involve the liver and spleen,with spleen and kidney deficiency dominating and blood stasis blocking the kidney ligaments.In treating patients with stage III diabetic nephropathy,Master Li uses mainly cold medicines,with the five flavours being mainly sweet medicines,sweet-cold to nourish yin and sweet to tonify qi,mainly to the liver,kidney and spleen meridians,with the largest proportion of deficiency tonics.Treatment is to tonify the spleen and kidney and invigorate blood circulation to remove blood stasis.2.The core drugs exert their effects on reducing inflammatory response,mitigating renal injury and protecting renal function through active ingredients such as quercetin,kaempferol,β-sitosterol and dousterol via signalling pathways such as AGE-RAGE,TNF,IL-17 and MAPK signalling pathways.