Systematic Evaluation Of Danhong Injection In The Treatment Of COPD And Its Network Pharmacology Analysis

Objective:To evaluate the efficacy of Danhong injection in the treatment of COPD by Meta-analysis and systematic review,and to provide evidence-based medicine for its rational use in clinical practice;Based on the methods and techniques of Network Pharmacology,to study the molecular mechanism of Danhong injection in the treatment of COPD.Methods:Retrieving PubMed?CNKI?VIP,and Wan Fang and other Data databases,to collect RCT of Danhong injection in the treatment of COPD,The search time limit is from the establishment of the database to February 2020,After screening the literature,extracting the data and evaluating the quality according to the Cochrane Systematic Review,then Meta-analysis was conducted with RevMan 5.3 software.The main active components of Danhong injection were selected through related literature reports,and the potential targets of the active components of Danhong injection were obtained by using TCMSP,Swisstarget Prediction,BATMAN-TCM and other data platforms,the potential targets of Danhong injection in the treatment of COPD were screened by mapping the target genes related to COPD in GeneCards,DisGeNET and OpenTargets databases,and the protein-protein Interaction?PPI?network was constructed by STRING platform,the potential active targets were analyzed by KEGG signal pathway and GO enrichment,and the mechanism of multi-component-multi-target-multi-pathway treatment of COPD was discussed.Results:25 RCTS included 2407 patients,analysis showed that Danhong injection combined with regular treatment of COPD was superior to regular treatment in total effective rate[OR=5.11,95%CI?3.75,6.95?,P<0.00001]?high shear viscosity of whole blood[MD=-0.82,95%CI?-0.86,-0.77?,P<0.00001]?low shear viscosity of whole blood[MD=-1.54,95%CI?-1.72,-1.36?,P<0.00001]?plasma viscosity[MD=-0.21,95%CI?-0.24,-0.18?,P<0.0001]?D-two polymer[MD=-0.20,95%CI?-0.25,-0.15?,P<0.00001]?PaO₂[MD=7.53,95%CI?6.84,8.22?,P<0.00001]?PaCO₂[MD=-3.93,95%CI?-4.98,-2.88?,P=0.0001]?FEV1/FVC[MD=9.06,95%CI?6.94,11.19?,P<0.00001],the difference was statistically significant.And the combined minimum dose of 20ml[OR=5.81,95%CI?3.58,9.43?,P<0.00001]can significantly increase the total efficiency.Sixteen cases of adverse reactions were reported.The 17 active components of Danhong injection acted on 76 targets,including IL6,TNF,MAPK1,IL1B,PTGS2,SRC,CASP3,EGFR,MMP9,NOS3,PIK3CA,ADRB2,etc,and participated in negative regulation,response stimulus,immune regulation and so on,and focuses on Tumor necrosis factors,Hypoxia-inducible Factors 1,regulation of TRP channels,Toll-like receptor,PI3K-Akt and other 19 signaling pathways.Conclusion:The clinical efficacy of combined Danhong injection in treating COPD is better than that of simple regular treatment,Danhong injection can treat COPD by anti-inflammation,anti-coagulation,improving pulmonary microcirculation and protecting vascular endothelium.