Clinical Observation And Network Pharmacological Study Of Shengqi Xiaoshou Recipe In Treating Ascites Due To Mild To Moderate Liver Cirrhosis

Objective:1.To explore the clinical efficacy and safety of empirical formulas--ShengQi Xiaogu Decoction in the treatment of patients with mild to moderate Cirrhosis Ascites(CA)through clinical observation,and to provide reference ideas and methods for clinical treatment of patients with mild to moderate CA.2.Use network pharmacology method to predict the multi-component-target-pathway mechanism of Astragalus in the treatment of CA,and provide a reference for further mechanism verification experimental research.Methods:1.A single-arm clinical trial was designed and the inclusion and exclusion criteria were formulated.45 patients who met the criteria were enrolled.On the basis of conventional treatments such as diuretics and other Western medicines,patients were treated with oral ShengQi Xiaogu Decoction,adjusted every 14-30 days for 12 weeks.symptoms,weight,abdominal circumference,urine output,liver function,and abdominal ultrasound were used as evaluation indicators,Collect those data before and after treatment.After the course of treatment,the data was statistically analyzed to evaluate the efficacy and safety of ShengQi Xiaogu Decoction in treating patients with mild to moderate CA.2.Taking the main Astragalus as research object,the main ingredient of Professor Xu Chunjun's empirical formulas--ShengQi Xiaogu Decoction.TCMSP was used to search and screen the active ingredients of Astragalus and its targets,and through Genecard and OMIN to jointly search and screen the CA related targets.The target of the activeingredient and the target of CA disease are matched to obtain the potential target of Astragalus in the treatment of this disease,and the corresponding data set is established.Cytoscape software was used to construct the Astragalus-active ingredient-shared target-CA network,Use String database to visually display protein-protein interactions network.The number of connections between targets is calculated and sorted through R scripts to obtain the core target.The enrichment analysis of GO biological process and KEGG pathway were conducted to reveal the potential mechanism of the core target.Results:1.There were statistically significant differences between before and after treatment scores in most of the patients' TCM symptoms(including fatigue,anorexia,oil tired,flank pain,bloating,diarrhea,oliguria,lower extremity edema),but the improvement of lower back pain and cold end aren't clear(P>0.05);patients' weight,abdominal circumference,and average 24-hour urine output were significantly different between before and after treatment(P<0.05);patients'ALT,AST,ALB,TB,DB,CHE were all significantly different between before and after treatment(P<0.05);patients' ascites depth and portal vein width is statistically significant between before and after treatment(P<0.05);comprehensive evaluated,the clinical effective rate of the patients after treatment was 92.68%,and the effective rate of TCM syndromes was 95.12%.In the study,3 patients had loose stools and increased bowel movements while taking the medicine,they were relieved after the prescription was adjusted,and no obvious adverse reactions were seen.The results of the study show that Shengqi Xiaogu Decoction is effective and safe in treating mild to moderate cirrhosis of ascites,and it can be further promoted in clinical and related research.2.The results of network pharmacological analysis showed that 28 active ingredients and their targets were screened from Astragalus,which were genetically mapped to 270 disease targets of CA,and matched to obtain 10 active ingredients and 41 potential targets.Gene function and pathway enrichment analysis of the top 30 core targets.predicted that Astragalus in the treatment of CA is mainly involved in regulating vascular endothelial function,regulating cellular immunity,controlling inflammation,protecting liver cells,regulating liver cells apoptosis and proliferation regeneration,improving protein synthesis function,inhibiting anti-fibrosis,signal transmission,etc.The predicted mechanism is consistent with the literature reports on the whole.From the molecular level,revealing the synergistic characteristics of the multi-component-target-pathway network of Astragalus in the treatment of CA.It is speculated that the active ingredients Formonitin and Calycosin,target NOS,Relaxin signaling pathway play an important role in the treatment of C A by Astragalus,and provides a certain reference for further fundamental research in the future.