Data Mining And Network Pharmacology Research On Clinical Treatment Of Overweight/Obesity Guided By Qi Transforming Theory

Objective:Under the guidance of Qi transforming theory,this study selected clinical overweight/obesity patients’case data,and used data mining and network pharmacology research methods to summarize the syndrome differentiation and treatment rules of obese patients,extract the core prescription,and explore the potential mechanism of core prescription,so as to lay the foundation for further research.Methods:The clinical data of overweight/obese patients who were treated with traditional Chinese medicine from January 2018 to December 2020 were collected.The data mining method is used to summarize the rules of treatment.The collected medical records were sorted out according to the four diagnosis information,syndrome information,the prescription of traditional Chinese medicine used by the patients who received traditional Chinese medicine treatment up to the standard was entered,and imported into Excel.At the same time,the information was standardized and the frequency statistics were completed.The prescription information was analyzed by using IBM SPSS modeler14.1 software for association rules and IBM SPSS statistics 23 software for cluster analysis.Cytoscape 3.7.0 was used to construct a core network of overweight/obesity drugs.Taking the core drugs screened out by the core network construction as the core prescription,the mechanism of the core prescription acting on overweight/obesity was explored through network pharmacology.The TCMSP database,BATMAN-TCM database and SwissADME database were used to search and screen the active ingredients of traditional Chinese medicine in the core prescription.The TCMSP database was used to query the protein target names,and the protein target names were standardized in the Uniprot protein database.Overweight/obesity related targets in OMIM,Drugbank,Genecard,TTD,DisGeNet and KEGG databases were mined.Cytoscape 3.7.0 software was used to construct a single traditional Chinese medicine-active ingredient-target network.The targets of core prescription and overweight/obesity-related targets were intersected,and input to the BisoGenet module in Cytoscape 3.7.0 to construct the PPI network of core prescription-obesity targets,and input to the Metascape platform for GO biological function and KEGG pathway enrichment analysis.Finally,the component-obesity related target-pathway network of core prescription was constructed in Cytoscape 3.7.0,and the mechanism of action of the core prescription was fully explained.Results1.Basic characteristics of patients:A total of 82 overweight/obese patients who met the inclusion criteria were collected in this study.The lowest body weight was 62 kg,the highest was 155 kg,and the average body weight was 89.22±20.13kg.The lowest BMI was 24.53kg/m2,the highest was 52.09kg/m2,the average BMI was 32.46±5.66kg/m2。Collect the symptoms of patients,and count the frequency of various symptoms.Among them,loose stools,fatigue and restlessness at night were the most frequent,accounting for 47.56%of the total cases,followed by dry mouth(14 times,30.43%).The frequency of purplish tongue was the most,accounting for 29.27%of the total cases.The tongue greasy fur was the most common,and the pulse condition was mainly thin.From the syndromes,overweight/obese patients mostly had syndrome of spleen deficiency and dampness obstruction,Yang deficiency,Qi deficiency and blood stasis syndrome,liver and kidney deficiency syndrome.2.Law of medication:46 cases of overweight/obese patients used 146 prescriptions of traditional Chinese medicine,and data mining was carried out on 146 prescriptions.The frequency,category,meridian tropism,nature and taste of traditional Chinese medicine were statistically analyzed.The frequency of using traditional Chinese medicine was higher for licorice(119 times,81.51%),white atractylodes rhizome(74 times,50.68%),Amomum villosum(68,46.58%),tortoise shell(67,45.89%),Aconitum carmichaeli(66,45.21%),Poria cocos(50,34.25%),Angelica sinensis(45 times,30.82%),Astragalus membranaceus(45 times,30.82%),Pinellia ternata(44 times,30.14%),Semen coicis(44 times,30.14%).The drugs are mainly tonic drugs,which mainly enter the spleen,lung,liver and other meridians.They are warm in nature and sweet in taste.Association rules of traditional Chinese medicine show that the commonly used drug pairs mainly include licorice and Atractylodes macrocephala,licorice and Amomum villosum,licorice and baked ginger,tortoise shell and Astragalus membranaceus or Aconitum carmichaelii,Achyranthes bidentata and Fructus Chaenomelis or Aconitum carmichaelii,Amomum kravanh and Mangnolia officinalis,Coicis Semen,etc.Six groups of cluster results were obtained by high-frequency cluster analysis of traditional Chinese medicine,which were ① Aconitum carmichaeli,Tortoise Shell,Amomum villosum and Glycyrrhiza uralensis②Magnolia officinalis,Coicis semen,Pinellia ternata,Codonopsis pilosula③Tangerine Peel,Astragalus membranaceus,radix Saposhnikoviae④ Radix Paeoniae Alba,Radix Bupleuri,Radix Pseudostellariae,Radix Angelicae⑤Ophiopogon japonicus;⑥Schisandra chinensis.The core prescription of traditional Chinese medicine is Wenyang Huayin Decoction,which consists of Aconitum carmichaeli,Tortoise Shell,Amomum villosum,liquorice,Rhizoma Atractylodis and Poria cocos.3.Network pharmacological research:there were 205 targets for Wenyang Huayin Decoction,and the main targets included NOS2,PGR,PTGS1,NCOA2,ESR1,PTGS2,NR3C2,SCN5A,GABRA1,ADRA1B.There were 132 traditional Chinese medicine components in Wenyang Huayin Decoction,mainly including quercetin,kaempferol,beta-sitosterol,naringenin,hederagenin,maackiain,phytosterol,3-acetoxyatractylone,isorhamnetin,medicarpin,etc.There were 2570 targets related to obesity,and 139 targets acting together with Wenyang Huayin Decoction.The PPI network of Wenyang Huayin Decoction-obesity targets showed that its core targets were HSPA5,EEF1A1,HSPA8,FUS,PARP1,TARDBP,RPS27A,CUL4B,FLNA,MCM5.The bioenrichment analysis of GO showed that its biological processes were mostly reactions to toxic substances,lipopolysaccharides,extracellular stimuli and others;cell components mainly involved membrane rafts,presynaptic membrane components,receptor complexes,etc.Molecular functions mainly involve nuclear receptor activity,transcription factor binding,cytokine receptor binding,etc.Enrichment analysis of KEGG pathway showed that the possible pathways of action were cancer pathway,AGE-RAGE signaling pathway in diabetic complications,IL-17 signaling pathway,etc.Conclusion1.Clinical overweight/obese patients often show mixed syndromes of deficiency and excess,such as syndrome of spleen deficiency and dampness obstruction,Yang deficiency,Qi deficiency and blood stasis syndrome,liver and kidney deficiency syndrome.The essence of such syndromes is the poor Qi transforming function of the body.2.Under the guidance of Qi transforming theory,the core prescription of Wenyang Huayin decoction was summarized by using drugs of Wenyang Huayin such as licorice,Atractylodes macrocephala,Amomum villosum,tortoise shell,aconite root,Poria cocos,etc.to treat overweight/obesity by Warming Yang and promoting the transportation of Qi,blood and body fluid,so as to restore the body’ s Qi transforming function.3.Through the network pharmacological study of the core prescription Wenyang Huayin Decoction,it is preliminarily speculated that Wenyang Huayin Decoction can treat overweight/obesity mainly through quercetin,kaempferol,naringenin,acting on NOS2,PTGS1,NCOA2,HSPA5,EEF1A1,PARP1 targets,so as to reduce chronic inflammation of obese patients.At the same time,two pathways,AGE-RAGE signaling pathway and IL-17 signaling pathway,are closely related to the occurrence of obesity,which is worth further exploration.