| Objective:1.Through the method of data mining,this study explored Professor Li Ping’s medication rules for the treatment of arrhythmia,analyzed commonly used drug pairs,summarized the core prescriptions for the treatment of arrhythmia,and summarized the overall treatment rules and treatment methods,so as to provide possible quality treatments of arrhythmia by TCM.This study provided direction for further clinical trials and laid the foundation for further exploration of the mechanism of action.2.Through the method of Meta analysis,a comprehensive and systematic assessment of the treatment of arrhythmia by the method of clearing heat and removing phlegm was carried out,and at the same time,a qualitative analysis of the research that was not suitable for meta-analysis was carried out.This study provided a reliable evidence-based medicine basis for objectively evaluating the efficacy of the method of clearing heat and removing phlegm on arrhythmia3.Through the method of network pharmacology,the mechanism of Lianxia Ningxin Decoction in the treatment of arrhythmia with the method of clearing heat and removing phlegm was predicted,and it would provide a theoretical basis and reference basis for the future research direction and clinical decision-making of the prevention and treatment of arrhythmia by Chinese medicine.In the mean while,this study tried to analyze the essence of TCM syndromes from the perspective of molecular mechanism.Methods:1.Data miningThis study screened the comprehensive outpatient medical records of Professor Li Ping’s used Chinese medicine to treat arrhythmia.And then,carried out data standardization,used Excel inputting and proofreading,and cleaned and built the included medical records and mining through the software platform V2.3.8 and the web platform of the Gujinyianyunpingtai.Through frequency statistics,cluster analysis,association rules,point-based mutual information analysis methods,this study excavated and explored the common drug pairs of Professor Li Ping and the core prescriptions for the treatment of arrhythmia.2.Meta-analysisThis study collected nearly all the published randomized controlled clinical trials(RCTs)on clearing heat and removing phlegm therapy for arrhythmia,through retrieving PubMed,Cochrane Library,Embase,CNKI,Wanfang Medical Database,VIP Journal Database and Chinese Biomedical Literature Database.The literature included was analyzed by R software(metafor package).The results were presented by forest map,funnel chart,Egger’s test and Begg’s test were used to analyze the publication bias,and the robustness of the conclusion was evaluated by sensitivity analysis3.Network pharmacologyLianxia Ningxin Decoction is an empirical prescription summed up by Professor Li Ping based on many years of clinical experience,evolved from Huanglian Wendan Decoction.It can be recognized as a representative prescription for clearing heat and removing phlegm,including 9 herbs such as Pinellia ternata,Coptis chinensis,tangerine peel and so on.Through the method of network pharmacology,we preliminary studied the related components,targets and signal pathways of these 9 herbs on arrhythmia,and tried to explore the molecular mechanism of phlegm-heat syndrome of arrhythmia,so as to provide a reference basis for the later studies of the mechanism of TCM in the treatment of arrhythmia.Results:1.Data mining results of Professor Li Ping’s treatment of arrhythmiaA total of 244 medical records were included,of which phlegm-heat syndrome accounted for 54.92%,both qi stagnation and blood stasis syndrome and phlegm and blood stasis syndrome accounted for 15.57%.A total of 195 herbs were involved.Professor Li Ping takes cold nature medicine as the main medicine,supplemented by warm nature medicine.There were a total of 32 herbs with a frequency of not less than 20.Among them,the frequency of Turmeric,Poria,Calamus,Caulis bambusae,Tangerine peel,Ginger pinellia,Coptis,Fried citrus aurantium with bran,and Fleeceflower stem were significantly higher.Cluster analysis found 10 drug combinations:Turmeric,Rhizoma acori graminei;Chuanxiong rhizome,Pueraria lobata;Poria,Polygala tenuifolia;Ginger Pinellia,Poria,Dried old orange peel;Fleeceflower stem,Caulis bambusae,Coptis chinensis;Ophiopogon,Vinegar,Schisandra,Pseudoginseng;Seed of oriental arborviate,Angelica,Fried jujube seed;Bupleurum,Keel,Oyster;Codonopsis,Scutellaria,Cassia twig;Calcined amethyst,Gansong,White peony root,Earthworm,Rhodiola.A total of 3 core prescriptions for the treatment of arrhythmia by Professor Li Ping were summarized through association rules and dot-type mutual information They are Lianxia Ningxin Decoction for phlegm-heat syndrome,core prescription for Qi stagnation and blood stasis syndrome,and Qi Yin deficiency The Shengmaiyin changed prescription.2.Meta-analysis results of the treatment of arrhythmia with heat-clearing and phlegm-removing prescriptionsA total of 27 studies were included and meta-analysis was performed on them.The results showed that the treatment of patients with generalized arrhythmia,ventricular premature beats.and atrial fibrillation with heat-clearing and phlegm-resolving prescriptions was better than conventional Western medicine in improving the efficacy of electrocardiogram and the efficacy of TCM syndromes.In the control group,there was a significant difference(P<0.05).At the same time,it was found that the heat-clearing and phlegm method was significantly better than atrial fibrillation in the treatment of room early;it was found that the use of traditional Chinese medicine alone had a greater advantage in improving the efficacy of electrocardiogram,and the combined use of Chinese and Western medicine had more advantages in improving the symptoms of traditional Chinese medicine.3.Network pharmacology research results of Lianxia Ningxin Decoction in intervention of arrhythmiaComponents of the 9 herbs in Lianxia Ningxin Decoction were searched,and 57 active components and 198 nodes were obtained.1229 arrhythmia targets were retrieved.After the construction of protein-protein interaction network,53 drug-disease related targets were obtained.The common targets were enriched by GO and KEGG pathways,and 15 pathways.35 gene targets and 27 active components were obtained.Further screened 7 pathways.8 core targets and 17 active components,and visualized them.Conclusion:Data mining suggests that Lianxia Ningxin Decoction is the core prescription for Professor Li Ping to treat arrhythmia with phlegm-heat syndrome.Meta-analysis results suggest that the combination of heat-clearing and phlegm prescriptions combined with conventional western medicine has a definite effect on arrythmias,and it has certain advantages compared with the treatment of conventional western medicine alone,and has high safety and fewer adverse reactions,and it proves that the legislation of Lianxia Ningxin Decoction for treating arrhythmia with phlegm-heat syndrome is correct.Internet pharmacological research has initially revealed the effective ingredients and potential targets of Lianxia Ningxin Decoction in the treatment of arrhythmia.It is speculated that Lianxia Ningxin Decoction may be a signaling pathway network based on Cyclic Adenosine Monophosphate(cAMP)signaling pathway To interfere with arrhythmia,its main effect is the regulation of ion channels and tissue structure,and it also has an impact on lipid metabolism and inflammation.Its main target is MMP9,and its secondary target is PIK3CA;ESR1 and SRC are auxiliary targets of estrogen pathway;ACHE and CHRM1 are auxiliary targets of signal transmission;PTGS2 is auxiliary target of inflammatory response;HMGCR is blood lipid regulation The auxiliary target point.The advantages of heat-clearing and phlegm-removing method in treating ventricular premature beats may be related to the final effect of multiple pathways as L-type Calcium Channel(LTCC). |
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