Clinical And Experimental Studies On Shengyang Yiwei Decoction For The Treatment Of Early Of Parkinson’s Disease

Objective: To observe the clinical effects of Shengyang Yiwei Decoction on patients with early-stage Parkinson’s disease(spleen lung qi deficiency),and to explore the effects of Radix Astragali on the protein expression of apoptosis related targets in Parkinson’s disease.Methods:(1)Sixty patients with early-stage Parkinson’s disease who met the inclusion criteria from January 2016 to February 2021 were collected and divided into experimental group and control group according to whether they took Shengyang Yiwei Decoction,and a clinical research was performed.The two groups were compared before treatment,after 2 weeks,and after 4 weeks of treatment with the new version of the world movement disorder society sponsored review unified Parkinson’s Disease Rating Scale(mds-updrs I&II&III),the Parkinson’s Disease Non-motor Symptoms Rating Scale,NMSS),fatigue severity scale(FSS),modified Hoehn & Yahr stage.Changes were evaluated by statistical analysis using spss23.0.(2)Candidate action targets of Shengyang Yiwei Decoction and the Jun drug Radix Astragali were screened using the traditional Chinese medicine systems pharmacology database(TCMSP),cd-hit database,Parkinson’s disease-related disease targets were screened using the genecards database,OMIM database;ingredient target networks were performed by Cytoscape,and protein interaction networks were constructed using string database,GO(gene ontology)enrichment analysis and KEGG(Kyoto Encyclopedia and genomes)pathway enrichment analysis were performed by Bioconductor Clusterprofiler.(3)Validation of network pharmacology partial target proteins by PC-12 Parkinson’s disease in vitro cellular model.Protein expressions of phosphorylated extracellular regulated protein kinase 1/2(p-ERK1/2),ERK1/2,blymphoblastoma-2(Bcl-2)-associated X protein(Bax),Bcl-2,Caspase-3,cleaved caspase-3were analyzed by Western Blot.Results:(1)MDS-UPDRS I,MDS-UPDRS total score,NMSs total score,NMSS cardiovascular system score,NMSS sleep/fatigue score,NMSS mood/cognition score,NMSS attention/memory score,and NMSS gastrointestinal score were significantly improved in the TCM treated group compared with the control group after treatment(P<0.05).No significant differences were observed in MDS-UPDRS II&III scores,modified H& Y stage,and NMSS urinary symptom scores.(2)Network pharmacology found that many compounds including quercetin,kaempferol,luteolin,isorhamnetin,and formononetin from Shengyang Yiwei decoction might perform the effects through multi-target and multi-pathway.From the intersection target results,Radix Astragali had the highest proportion(nearly 75%)of intersection targets,covering the most multiple intersection targets,and contained the core targets in the PPI network of Shengyang yiwei decoction.The specific mechanism of Shengyang Yiwei Decoction and its Jun drug Radix Astragali for treating Parkinson’s disease may involve ERK signaling pathway,PI3K-Akt signaling pathway,AGE-RAGE signaling pathway,and the action targets may involve Bax,Bcl-2,casp-3,IL-6,and ERK and other proteins.(3)Using the PC-12 Parkinson’s disease in vitro cell model we observed that Radix Astragali extract significantly enhanced cell viability(P<0.05),and significantly promoted cell survival in the PD in PC-12 Parkinson’s disease in vitro cell model;Western Blot showed that the expression of Bax,p-ERK1 / 2,and c-casp-3 decreased,and Bcl-2 increased in the Radix Astragali extract group compared with those in the model group(P<0.05).Conclusion:(1)Shengyang Yiwei decoction can significantly improve some specific non-motor symptoms(fatigue,depression,anxiety,constipation,etc.)and improve the non-motor symptom experience of patients on the basis of conventional anti-Parkinson’s disease drugs.(2)Shengyang Yiwei decoction may play a therapeutic role for Parkinson’s disease through multi-target and multi-pathway,network pharmacology suggests that Radix Astragali,as the Jun drug,may hold an important position in Shengyang Yiwei decoction.(3)Radix Astragali extracts can affect the phosphorylation level of ERK1 / 2,and the expression of apoptosis related proteins such as Bax,Bcl-2,and casp-3,and promote the survival of cell model cells with Parkinson’s disease in vitro.