Study On The Screening And Mechanism Of Traditional Chinese Medicine For The Treatment Of Essential Hypertension

Study 1:Traditional Chinese Medicine in the treatment of Essential Hypertension:An Overview of Systematic ReviewsObjective To evaluate the quality of methodology and the reliability of the strength of evidence for the systematic reviews/Meta-analyses of traditional Chinese medicine(TCM)in the treatment of essential hypertension.Methods The databases of PubMed,Embase,Cochrane Library,CNKI,VIP,and Wanfang Data were searched to screen the systematic reviews/Meta-analyses of TCM in the treatment of essential hypertension.We used the PRISMA statement,the AMSTAR 2 tool and the GRADE method to evaluate the quality of the reports,methodologies,and evidence included in the system reviews/Meta-analyses.Results There were evetually included in 24 reviews/Meta-analyses,containing 120 outcome measures.According to the PRISMA statement evaluation,the quality of all included systematic reviews/Meta-analyses reports was high,the results of the AMSTAR 2 tool evaluation showed that the quality ratings of all included systematic reviews/Meta-analyses were very low,Grade evidence quality evaluation showed that most of the outcome indicators were low or very low,the main degradation factors affecting the strength of evidence are limitation,inconsistency,inaccuracy,and publication bias.Conclusion This study found that the treatment of essential hypertension by TCM was supported by low quality evidence-based medical evidence,but the systematic reviews/Meta-analyses methodology for the treatment of essential hypertension by TCM was generally poor in quality and the standardization still needed to be improved.Study 2:Bibliometrics Study of Traditional Chinese Medicine in treating Essential HypertensionObjective Analyze the current status of literature on TCM for the treatment of essential hypertension,and screen out high-frequency Chinese medicine in treating essential hypertension.Methods We searched the databases of PubMed,Embase,Cochrane Library,CNKI,Wanfang Data,VIP,and CBM since foundation till December 31,2019.By using the bibliometrics method,we analyzed the aspects of research types,periodical distribution,author area distribution,syndrome differentiation,common Chinese medicine,and adverse reactions,and screened out the high-frequency TCM for treating essential hypertension.Results A total of 665 studies were included,including 538 randomized controlled trial studies,73 empirical studies,42 case reports,and 12 case-control studies.All included articals were distributed in 208 journals,among which 21 were distributed in 7 T1 grade journals and 59 were distributed in 19 T2 grade journals.The study authors were distributed in 21 provinces and regions,mostly in Shandong Province,Guangdong Province,and Beijing.There are 5 TCM syndromes of essential hypertension,including liver yang hyperactivity,yin deficiency of liver and kidney,excessive phlegm dampness,blood stasis,yang deficiency of the kidney,the common syndromes are liver yang hyperactivity and yin deficiency of liver and kidney.The top ten high-frequency TCM for treating essential hypertension are Gastrodiae Rhizoma(Tianma),Achyranthis Bidentatae Radix(Niuxi),Uncariae Ramulus cum Uncis(Gouteng),Poria(Fuling),Eucommiae Cortex(Duzhong),Haliotidis Concha(Shijueming),Paeoniae Radix Alba(Baishao),Salviae Miltiorrhizae Radix et Rhizoma(Danshen),Alismatis Rhizoma(Zexie),and Taxilli Herba(Sangjisheng).Conclusion At present,the main study type of traditional Chinese medicine for the treatment of essential hypertension is the randomized controlled trial,the distribution of journals and study authors are scattered.The research literatures of core journals are relatively small,and the research quality needs to be improved.The common syndromes of essential hypertension are liver yang hyperactivity,yin deficiency of liver and kidney,the high-frequency Chinese herbs used to treat essential hypertension are Gastrodiae Rhizoma(Tianma),Achyranthis Bidentatae Radix(Niuxi),Uncariae Ramulus cum Uncis(Gouteng),Poria(Fuling),Eucommiae Cortex(Duzhong),Haliotidis Concha(Shijueming),Paeoniae Radix Alba(Baishao),Salviae Miltiorrhizae Radix et Rhizoma(Danshen),Alismatis Rhizoma(Zexie),and Taxilli Herba(Sangjisheng).Study 3:Active Components and Mechanism of Traditional Chinese Medicine in Treating Essential Hypertension Based on Network PharmacologyObjective To explore the effective components and mechanism of high-frequency TCM for treating essential hypertension by using the method of network pharmacologyMethods The information of chemical components and targets of high-frequency Chinese medicine was collected through TCMSP database(the screening condition is OB?30%,DL?0.18)and BATMAN-TCM platform(the screening condition is Score cutoff?20,p-value cutoff<0.05).The disease targets of essential hypertension were obtained in the databases of TTD,OMIM,DrugBank,Pharmgkb,GeneCards,HPO.The multi-dimensional regulatory network of "TCM-active ingredients-disease targets" was constructed by Cytoscape software,and the core targets and key components of TCM were screened out.Go Functional Annotation(the screening condition is FDR<0.01)and KEGG Pathway Analysis(the screening condition is p-value<0.01)of action targets were set up by DAVID DatabaseResults A total of 41 active components from high-frequency TCM acted on 60 disease gene targets of essential hypertension,and 12 core targets and 25 key active components were selected based on the core network.The 12 core disease targets are ADRA1B,ADRB2,DPP4,DRD1,ESR1,F7,KCNH2,NOS2,NOS3,NR3C2,PDE3A,and PPARG,and the 25 key active components are mainly quinones,sterols,and flavonoids.The GO functional annotation found that the high-frequency TCM gene targets for treating essential hypertension involve 20 biological processes,8 molecular functions,and 5 cellular components.The KEGG pathway analysis found that the high-frequency Chinese herbs play a therapeutic effect on essential hypertension through the TNF pathway,calcium ion pathway,HIF-1 pathway,CAMP pathway,cGPKG pathway,PI3K-Akt pathway,MAPK pathway,Gap junction,Toll-like receptor pathway,and T cell receptor pathway,etc.Conclusion Based on the network pharmacology methods,it was found that the main active components of high-frequency Chinese medicine may act on the core gene targets related to essential hypertension of ADRA1B,ADRB2,DPP4,DRD1,ESR1,F7,KCNH2,NOS2,NOS3,NR3C2,PDE3A,and PPARG,as well as TNF signal pathway,calcium signal pathway,HIF-1 signal pathway,cAMP signal pathway,cGMP-PKG signal pathway,PI3K-Akt signal pathway,and other signal pathways,participate in the regulation of intracellular iron transport,inflammatory response,Glucose and Lipid metabolism,and other mechanisms to play a role in treating essential hypertension.