Clinical And Mechanism Research On The Treatment Of Drug Dependence Constipation(Qi-Yin Deficiency Type)by Jiawei Qilang Prescription Based On Analysis And Prediction Of Network Pharmacology

Purpose:1.To find targets of Jiawei Qilang prescription through the analysis and prediction of network pharmacology.2.To observe the clinical efficacy and safety of Jiawei Qilang prescription in the treatment of drug dependence constipation,and to make a preliminary discussion in the mechanism.Method:1.To find side of each component of Jiawei Qilang prescription through the UPLC-Q-TOF-MS method,and get compound composition on the basis of accurate mass number compounds identified parsing.Using STITCH database which based on random forest law predict get compound targets for ligands,and associated with constipation disease related genes for disease targets,and then use the STRING database to build compound-targets networks,protein interaction network filter core targets,further excavate flavored stilbene Lang party treatment in accordance with the specific mechanism of constipation.2.A randomized,controlled method was used to divide 72 cases of drug dependence constipation patients(Qi-Yin deficiency type)into two groups.Due to shedding off 6 cases,actually 34 cases were involved into treatment group with Jiawei Qilang prescription for 8 weeks,and 32 in control group were treated with lactulose oral solution for 8 weeks.The scores of clinical symptoms Qi-Yin deficiency,disease symptom scale,Patient Assessment of Constipation symptom(PAC-SYM),Patient-Assessment of Constipation Quality Of Life(PAC-QOL)were observed and recorded.The correlative symptoms and improvement in scores were evaluated before and 8 weeks after therapy,2,4,8 weeks after withdrawal.The short and long-term clinical effect on treating drug dependence constipation patients were compared and analyzed.Safety evaluation was conducted by comparing the changing of blood,urine,fecal routine test,ALT,AST,serum creatinine,urea nitrogen levels,and ECG before and after therapy.Result:1.Content determined by UPLC-Q-TOF-MS method with 58 chemical composition,points and compound targets are obtained by STITCH,the data of 86 prediction and 143 disease related targets;And drug forecast targets after maps to get four key genes which is Interleukin-8(IL-8),Selectin-E,(SELE),hypoxia inducible factor-1(HIF-1),Multidrug resistance 1(MDR1)that prompt Jiawei Qilang prescription may regulate effect through the above gene to achieve the goal of improve the symptoms of patients with constipation.2.No adverse reactions were found with drug dependence constipation patients before and after therapy.3.The overall effective rate of TCM syndrome by Jiawei Qilang prescription(treatment group)was 79.41%,and the other by lactulose(control group)was 68.75%;The curative effect of TCM syndrome in treatment group was better(P<0.05).In the improvement of patients' abdominal distention,annoying,accidie and hypodynamia,the treatment group was superior to the control group(P<0.05).Jiawei Qilang prescription is superior to lactulose in improving rectal symptoms and abdominal symptoms in PAC-SYM scale(P<0.05).Jiawei Qilang prescription could improve four dimension score of PAC-QOL chart(P<0.05),and it was better than control group.And for Jiawei Qilang prescription,the long-term reoccurrence rate is low.4.Compared with the healthy,the serum content of IL-8 and HIF-1? in drug dependence constipation patients increased,but the serum content of P-gp decreased significantly(P<0.05).And the serum content of SELE had no significant changes(P<0.05).5.On regulating the serum content of IL-8 and P-gp,the curative effect of Jiawei Qilang prescription was better than lactulose oral solution(P<0.05).These two groups had no significant influence on serum content of HIF-1? and SELE(P<0.05).Conclusion:1.Both Jiawei Qilang prescription and lactulose oral solution have remarkable curative effect on treating drug dependence constipation patients,but Jiawei Qilang prescription is better and safer.And for Jiawei Qilang prescription,the long-term reoccurrence rate is low.It is worth being popularized in clinical use to embody the excellent value of medical.2.Intestinal barrier dysfunction may be one of the pathogenesis in patients with drug dependence constipation by the elevated IL-8 and HIF-1? levels and decreased the P-gp level.Jiawei Qilang prescription can lower the serum content of IL-8 and rise the P-gp in drug dependence constipation patients.In order to further explore the role of material basis and mechanism in the reference.