Research On Zhang Zhongjing’s Law Of Using Aconite And Its Pharmacological Mechanism In Treating RA And AS

PurposeAconite is a processed product of the roots of the ranunculaceae plant Aconitum.It tastes pungent,sweet,and has a hot sex.It has the functions of replenishing fire and assisting yang,regaining yang,relieving adversity,dispelling cold and relieving pain..Among the existing works,Zhang Zhongjing,a well-known medical scientist in the Han Dynasty,made the earliest expositions in Treatise on Febrile Diseases and Synopsis of the Golden Chamber,with the highest clinical application frequency,and the most extensive influence on later generations.This paper uses the literature research method to sort out and summarize the provisions and prescriptions related to Aconite in Treatise on Febrile Diseases and Synopsis of the Golden Chamber,and find out the principles of application and dose-effect relationship of Aconite in Treatise on Febrile Diseases and Synopsis of the Golden Chamber.,Compatibility characteristics,thus summed up Zhongjing’s law of using aconite.Later,the network pharmacology method was used to explore the possible mechanisms and pathways of aconite treatment of rheumatoid arthritis and ankylosing spondylitis to guide clinical applications,expand the scope of use,and improve clinical efficacy.PethodsBibliography research method: select and sort out the prescriptions and prescriptions containing aconite in "Treatise on Febrile Diseases" and "The Synopsis of the Golden Chamber",and conduct frequency statistics according to the efficacy of the preparation method,drug dosage,and compatibility rules,and combine the annotations of later medical doctors and their own research Learn knowledge,conduct induction and analysis.Basic statistical methods: use the EXCEL chart data processing function to process and descriptive analysis of the preparation method,efficacy,dosage,compatibility and other data of aconite.Network pharmacology method: use the TCMSP database to search and screen the highly active ingredients in Aconite,and then match the targets of rheumatoid arthritis and ankylosing spondylitis retrieved in the Gene Cards database and the OMIM database;enter the common targets into the String database Construct the PPI network,visualize the network through Cytoscape software,and perform functional enrichment analysis,so as to infer the pathway and mechanism of aconite treatment of rheumatoid arthritis and ankylosing spondylitis.OutcomeStatistics on the prescriptions and prescriptions of Aconite in Treatise on Febrile Diseases and Synopsis of the Golden Chamber: The Treatise on Febrile Diseases contains a total of 113 prescriptions,33 clauses related to Aconite,and 3 additions and subtractions afterwards.Abandoning the repetitive formulas,there are 20 formulas for Fuzi,accounting for 17.69% of the total formulas;the first 22 chapters of "The Synopsis of the Golden Chamber" contains 205 formulas,and the formulas for repetitive discussions are discarded,20 formulas involving Fuzi(Fuzi Decoction)Only the name of the party is listed without the drug being recorded,so no statistics are made)."The Synopsis of the Golden Chamber" has6 attached formulas of aconite,which are proven prescriptions by various families.They are not the original appearances of Zhongjing’s formulas,and no statistical research has been done.19 Aconite formulas were finally included in the statistics,accounting for 9.27% of the total prescriptions.Research on the efficacy of Aconite in Treatise on Febrile Diseases and Synopsis of the Golden Chamber: According to the Pharmacopoeia of the People’s Republic of China in 2020,Aconite has three functions: regaining yang and relieving adversity,replenishing fire and assisting yang,and dispelling cold and relieving pain.In Treatise on Febrile Diseases and Synopsis of the Golden Chamber,the three effects are not enough to summarize the prescriptions and indications.Therefore,combined with the elaboration in the works of doctors of the past dynasties,they are based on the three effects of regaining yang and relieving adversity,replenishing fire and assisting yang,and dispelling cold and relieving pain.In addition,Tongyang Lishui,igniting fire and returning to Yuan are added for statistics.In "Treatise on Febrile Diseases",Aconite is the most commonly used to return to Yang and save adversity.A total of 8 Aconite formulas have this effect,accounting for 40%.In "The Synopsis of the Golden Chamber",Aconite is most commonly used to dispel cold and relieve pain.There are 10 Aconite formulas in total.This effect accounts for 52.63%.According to the concocting method,it can be found that the Shengfuzi prescriptions in "Treatise on Febrile Diseases" and "The Synopsis of the Golden Chamber" are used to restore the Yang and save adversity;while the Paofuzi prescriptions have 24 recipes,which are used to supplement the fire.There are 10 poems of Yang and dispelling cold and relieving pain.It can be seen that Zhong Jingyou emphasizes the two effects of replenishing fire and relieving yang and dispelling cold and relieving pain.He likes to use Pao Fuzi to treat the arthralgia syndrome of yang deficiency and cold coagulation.The dose-effect relationship of Aconite in Treatise on Febrile Diseases and Synopsis of the Golden Chamber: According to the statistics of the "Guanghe Dasinong Copper Rights" collected by the Chinese History Museum,it is calculated that the 1 tael in the Eastern Han Dynasty is about 15.625g;According to the "Lecture Notes on Treatise on Febrile Diseases" published by People’s Medical Publishing House in 2016,the small aconite is about 15 g and the larger one is about 30 g.In "Treatise on Febrile Diseases",there are 12 prescriptions using Paofuzi,7 of which are used for one piece(approximately 15 g today),accounting for 58.33%,and 2 are used for two pieces(approximately 30 g today).It accounts for 16.67%;and the prescription of Paofuzi in "The Synopsis of the Golden Chamber",which is less than 30 g today,accounts for 70.59%.It can be seen that Zhongjing generally uses no more than 30 g of Paozizi,and the three doses of the prescription temperature divided by the back injection,the effective dose of a single dose is not high.In "Treatise on Febrile Diseases" and "Golden Chamber Synopsis",Paofuzi is generally not more than 15 g when used to replenish fire and assist yang,improve yang and dilute water,and induce fire to return to the yuan.It is in line with modern pharmacopoeia standards.Aconite dosage range is wider,ranging from 15 g to90g.The raw aconite in "Treatise on Febrile Diseases" and "The Synopsis of the Golden Chamber" are both used to restore yang and save adversity,and 15-30 g is used according to different degrees of yang deficiency.In modern times,aconite is generally not used.If the method of preparing aconite to restore the aconite in the classic prescription is used as an emergency method,it requires a large amount,light decoction,and emergency taking,and the illness will stop.The compatibility of Zhang Zhongjing’s use of Aconite: The drugs compatible with Aconite in "Treatise on Febrile Diseases" and "The Synopsis of the Golden Chamber" generally aim at enhancing efficacy and detoxification.The ten most common drugs are licorice,dried ginger,cassia twig,ginger,jujube,atractylodes,ginseng,ephedra,asarum,and peony.Most of these drugs are generally used,and a small part are supported by glory.They are often used for various types of arthralgia,and they are very common analgesic drugs in Chinese medicine.Network pharmacology results: Based on the above research results,it is known that Zhang Zhongjing often uses aconite to treat the syndrome of cold coagulation.The discussion of arthralgia syndrome was first seen in "Huangdi Neijing·Suwen" : "The three qi of wind,cold and dampness are mixed,and they become arthralgia." Neijing simply summarizes the causes of "bi" into three types: wind,cold,and dampness,among which wind predominates wandering,cold predominant arthralgia,and dampness predominantly heavy.These symptoms are common in rheumatoid arthritis and ankylosing spine in modern medicine.Immune system diseases such as inflammation.In modern medicine,the causes of the two diseases are not yet clear,and clinical treatment has become the primary problem."Treatise on Febrile Diseases" and "Golden Chamber Synopsis" are the earliest existing prescriptions for diagnosis and treatment of diseases.Zhang Zhongjing proposed the treatment of rheumatism arthritis as early as the Han Dynasty."Sickness" is similar.Among the prescriptions used by Zhongjing to treat rheumatic arthralgia,aconite is the most common.In order to explain the modern pharmacological mechanism of Zhongjing’s use of Aconite to treat these diseases,he conducted network pharmacology to study the relationship between Aconite in the treatment of rheumatoid arthritis and ankylosing spondylitis.Firstly,a total of21 active ingredients and 468 targets were obtained by searching Aconite using TCMSP database;Gene Cards and OMIM databases were used to obtain 2450 RA and AS-related genes(combined deletion).221 common targets are obtained through the Venn diagram,72 key targets are obtained after network mapping and PPI network analysis.APP and MAPK1 can be regarded as potential therapeutic targets for RA and AS.ConclusionIt can be seen from the above that Zhang Zhongjing likes to use Fuzi very much.Through the research of the principles of application,dose-effect relationship,and compatibility characteristics of Fuzi in "Treatise on Febrile Diseases" and "The Synopsis of the Golden Chamber",we can find that Zhongjing often uses Fuzi to treat Hanning Bi.disease.Later,using network pharmacology to study the relationship between aconite treatment of rheumatoid arthritis and ankylosing spondylitis,some potential therapeutic targets were obtained,which provided ideas and directions for more in-depth research in the future.All in all,discovering classics and developing ideas is of great significance to the development of clinical work in traditional Chinese medicine.