Exploration On Mechanism Of Qingre Chushi Decoction In Treating Dampness-heat Eczema Based On Network Pharmacology And Meta-analysis

Research purposesStudy one:To systematically evaluate the efficacy and safety of Qingre Chushi Decoction in the treatment of eczema based on Meta-analysis,and to provide evidence-based medicine evidence and reference for further research.Study two:Based on network pharmacology,to explore the effective components,targets and potential mechanisms of Qingre Chushi Decoction in the treatment of eczema.In order to provide guidance for future clinical medicine and experimental research.Research methodsStudy one:Using"Qingre Chushi Decoction,Modification and Subtraction of Qingre Chushi Decoction,eczema,random,RCT"as search terms,CNKI,Wanfang,VIP,CBM and other databases were searched to screen out the treatment of damp-heat eczema with Qingre Chushi Decoction.Clinical randomized controlled study.The data were retrieved and screened by 2 professionals for quality assessment,and the data were tested for heterogeneity,sensitivity analysis,pooled effect size,subgroup analysis,and publication bias detection with the help of Revman 5.3 software.Study two:Search for"eczema"in OMIM database,Drug Bank database,Gene Cards database;in TCMSP,chemical professional database,ETCM and other databases,respectively use gentian grass,skullcap,gypsum,Daqingye,Imperata rhizome,plantain,habitat,licorice,and talc were used to retrieve the chemical constituents in Qingre Chushi Decoction.The Venn diagram was drawn using the online mapping network platform"Weishengxin"to obtain the intersection genes.The intersection genes were imported into the STRING database and Cytoscape v3.9.1 software to obtain protein-protein interaction（PPI）networks.GO functional enrichment and KEGG pathway enrichment analysis were performed using the Metascape database.Research resultsStudy one:Heterogeneity test results:P=0.94>0.1,and I~2=0%<50%,indicating that the heterogeneity is small;effective rate analysis:RR=1.31,95%CI[1.21,1.43],P<0.00001,the effective rate of the experimental group was better than that of the control group;analysis of the cure rate:RR=2.24,95%CI[1.69,2.96],P<0.00001,the cure rate of the experimental group was better than that of the control group.The TCM symptom score,pruritus score and EASI score in the experimental group were significantly decreased,and the reduction range was greater than that in the control group.The experimental group could significantly increase CD₄+,CD₄+/CD₈+,and the increase was greater than that in the control group.The incidence of adverse reactions was lower than that of the control group.The funnel plot is asymmetric,suggesting a high possibility of publication bias.Study two:A total of 1224 possible targets were obtained through 3 disease databases.Through 3 drug component databases and predicted by TCMSP,a total of 71 active ingredients were screened.The main chemical components of 15 heat-clearing and dehumidifying soups were obtained by topological analysis:Stigmasterol,beta-sitosterol,baicalein,kaempferol,luteolin,wogonin,indirubin,oroxylin a,sesamin,Gentianidine,sitosterol,Gentianine,Gentisin,isovitexin,Gentiopicroside.Using the STRING database and Cytoscape v3.9.1 software,the PPI network was obtained,and the top 10 key targets were obtained:JUN,RELA,TNF,IL6,IL4,IL10,TP53,AKT1,IL2 and STAT1.The GO enrichment analysis results are:may be related to"response to xenobiotic stimulus","response to lipopolysaccharide","response to molecule of bacterial origin","cellular response to lipid","response to tumor necrosis factor","gland"development","regulation of leukocyte cell-cell adhesion","regulation of defense response","regulation of cell adhesion","regulation of cell-cell adhesion"and so on.The results of KEGG enrichment are:may be related to tumor necrosis factor（TNF）signaling pathway,interleukin-17（IL-17）signaling pathway,Toll-like receptors（TLRs）signaling pathway,T cell receptor signaling pathway,C-type agglutination It is related to hormone receptor signaling pathway,MAPK signaling pathway,Th17 cell differentiation,Th1 and Th2 cell differentiation,JAK-STAT signaling pathway,etc.ConclusionStudy one:Modified Qingre Chushi Decoction in the treatment of damp-heat eczema can improve the total clinical effective rate,cure rate,reduce TCM symptom score,pruritus score,EASI score,increase serum T cell CD₄+,CD₄+\CD₈+,and reduce the incidence of ADRs,the safety is good,and it can be used for clinical reference.There is a possibility of publication bias in this study and more RCTs are needed for validation.Study two:71 possible active chemical components of Qingre Chushi Decoction act on 1224 possible targets of eczema.JUN,RELA,TNF,IL6,IL4,IL10,TP53,AKT1,IL2 and STAT1 are possible key targets of Qingre Chushi Decoction in the treatment of eczema,and may mainly act on the tumor necrosis factor（TNF）signaling pathway,interleukin-17（IL-17）signaling pathway,Toll-like receptors（TLRs）signaling pathway,T cell receptor signaling pathway,C-type lectin receptor signaling pathway,MAPK signaling pathway,Th17cell differentiation,Th1 and Th2 cell differentiation,JAK-STAT Signal pathways,B cell receptor signaling pathway,Natural killer cell mediated cytotoxicity,etc.may achieve the purpose of treating eczema through anti-inflammatory and immune regulation.