Meta-Analysis And Network Pharmacological Study Of Clinical RCT Of Chuanxiong Qingnao Granules For Migraine

Objective:1 Systematic evaluation of the clinical efficacy and safety of Chuanxiong Qingnao Granule in the treatment of migraine,and provide evidence-based medical evidence for the clinical application of Chuanxiong Qingnao Granule in the treatment of migraine based on the results of the systematic review.2 Use the network pharmacology method to study the mechanism of "Chuanxiong-Baizhi" medicine in Chuanxiong Qingnao Granules in the treatment of migraine.Methods:1 Meta-analysisAccording to the established search strategy,comprehensive search of Pub Med,Cochrane library,Embase,CNKI,Wan Fang Data,VIP database,CBM seven databases related to Chuanxiong Qingnao Granules for migraine treatment,the search time is limited to November 2019.According to the set inclusion and exclusion criteria,the literature was comprehensively screened,and the quality of the included literature was evaluated according to the Cochrane evaluation method.Meta-analysis was performed on the clinical effectiveness,headache score,VAS score,NAS score,headache duration,number of headache attacks,cerebral blood flow velocity,blood rheology indexes,and adverse reactions reported in the literature.2 Network pharmacologyAccording to the database of traditional Chinese medicine system pharmacology technology platform,the compound's oral drug bioavailability,drug-like properties and blood-brain barrier permeability were used as the standard to screen the compounds of Ligusticum chuanxiong-Angelicae dahuricae.Prediction,through Gene Cards,OMIM and CTD database search for genes related to migraine With the help of Cytoscape3.5.1 software to construct the drug-target network map,the STRING platform was used to construct the relevant target protein interaction network map,and the target gene was subjected to GO enrichment analysis and KEGG analysis through the biological information annotation database(DAVID).Results:1 Meta-analysisIn the end 17 randomized controlled studies were included in this study,1865 migraine patients were included,including 936 in the experimental group and 929 in the control group.The results of Meta analysis showed that Ligustticum chuanxiongqingnao granule alone was superior to flunarizine hydrochloride in improving clinical efficiency and reducing the number of migraine attacks,and the difference was statistically significant.Ligustticum chuanxiongqingnao granule combined with flunarizine hydrochloride was superior to flunarizine hydrochloride in improving clinical efficiency,reducing VAS score,improving hemorheology index,improving blood flowvelocity of middle cerebral artery,anterior artery and posterior artery.safety,chuanxiongqingnao granule alone or flunarizine hydrochloride was not significantly different from control group.2 Network pharmacology28 active components were obtained from the screening of chuanxiong-dahurica,29 targets related to migraine,and the key targets include AKT1?TNF?PTGS2?PPARG?NR3C1?ESR1?CAT?CRP?CNR1 ? F2 and so on.the main targets are involved in the nitric oxide biosynthesis process,inflammatory response,regulation of insulin secretion,regulation of blood pressure,positive regulation of apoptosis process,negative regulation of dopamine secretion,negative regulation of smooth muscle contraction and other biological processes.and play a role by regulating the regulation of NF-?B signaling pathway,cAMP signaling pathway,adipocytokine signaling pathway,insulin resistance,calcium signaling pathway,TNF signaling pathway,dopaminergic synapse,cGMP-PKG signaling pathway.Conclusion:1 Meta-analysisIn the treatment of migraine with Ligusticum chuanxiong Qingnao granule or Ligusticum chuanxiong Qingnao granule combined with flunarizine hydrochloride,it is better than flunarizine hydrochloride alone in improving the overall clinical efficiency and reducing the number of migraineattacks.Ligusticum chuanxiong chuanxiongqing combined with flunarizine hydrochloride was significantly better than flunarizine hydrochloride in reducing VAS score,improving hemorheology index and improving blood flow velocity in middle cerebral artery,anterior artery and posterior artery.However,due to the low quality of the literature included in this systematic evaluation and the high heterogeneity of the results of related outcome indicators,the results of this study need to be further verified in the future by focusing on high quality multicenter,large sample clinical randomized controlled trials.2 Network pharmacologyLigusticum chuanxiong-dahurica in chuanxiongqingnao granule may treat migraine by regulating nitric oxide biosynthesis process,inflammatory reaction,neurotransmitter transmission,regulating insulin secretion,vascular function,etc.the pathways involved include NF-?B signaling pathway,cAMP signaling pathway,adipocytokine signaling pathway,insulin resistance,cGMP-PKG signaling pathway,calcium signaling pathway,TNF signaling pathway,dopaminergic synapse,cGMP-PKG signaling pathway,etc.To provide a theoretical basis for future research on the pharmacological mechanism of the important components of Chuanxiong Qing brain in the treatment of migraine.