Discussion On The Difference Of Gout And HUA Metabolism And Summary Of Tutor's Experience In Treating Asymptomatic HUA With Traditional Chinese Medicine

Object1.A systematic review of clinical studies on patients with hyperuricemia(HUA)and gout based on metabolomics was conducted to explore the metabolic differences between HUA and gout,hoping to provide some theoretical basis for the search of clinical predictive markers of gout.2.Interview research and network pharmacology research were used to summarize and discusse my tutor's experience in applying traditional Chinese medicine to treat asymptomatic HUA,so as to explore and comb professor Yu xiuchen's ideas in the differentiation and treatment of asymptomatic HUA accurately and effectively.In this way,we hope to provide some clinical reference,and provide theoretical basis for further mechanism research.Method1.Part 2:In this study,four databases including PubMed,Embase,Web of Science and Cochrane Library were searched to screen all the metabolomic analysis studies of HUA and gout published before February 4,2021.The literatures that met the standards were included for quality assessment and literature information extraction.Finally,the results of HUA group and gout group were qualitatively analyzed and compared.2.Part 3:Semi-structured interview was made to record on Professor Yu Xiuchen's views on the etiology,pathogenesis,syndrome differentiation,treatment and medication of asymptomatic HUA.3.Part 4:TCMSP platform was used to search the active ingredients and their related targets of the Yiqi Huazhuo Jiangsuan formula(Astragalus membranaceus,Codonopsis codonopsis,Atractylodes atractylodes,Poria,Sangli,Zedoary,Pinellia ternata,Cassiae cassia.Polygonum cuspidatum,Common Clubmoss Herb),respectively.For the components without corresponding targets,SwissTargetPrediction database was used as a supplement.The disease target of hyperuricemia was mined through GeneCards database,OMIM database,DISGENET database and DRUGBANK database,and then,we compare these two group of targets and get the common disease-formula compound target.The target PPI network was established on the STRING platform and imported into Cytoscape3.7.2 for visualization.Go and KEGG enrichment analysis was performed on the Metascape data analysis platform to extract the main biological functions and biomolecular signaling pathways.Results1.Part 2:We got 2999 studies in total after literature retrieval,and 19 of them were final included.By comparing HUA and gout patients with healthy people respectively,as well as the comparison between HUA and gout population directly,it was found that there were some metabolites showing differently between HUA and gout population,include lipid metabolites and derivatives,carbohydrate metabolism and derivatives,amino acids,nucleotides and their analogues metabolites,and other small molecule compounds such as aldehydes and ketones.However,the main research results so far can be inconsistent,which may be caused by the limited sample size,differences in test platforms or differences in the specific implementation criteria included in the tested population.2.Part 3:Through the combination of tongue and pulse differentiation,disease differentiation,syndrome differentiation and look for the nuances,the tutor considered that Qi deficiency played a major role in the pathogenesis of asymptomatic hyperuricemia.The overall pathogenesis was Qi deficiency,blood stasis,phlegm and turbidity.The treatment was to invigorate Qi and promote blood circulation,dissolve phlegm and remove turbidity,so a prescription for invigorating Qi and turbidity to reduce uric acid was created,included 10 herbs:Rough Astragalus membranaceus,Poria cocos,Dangshen,Fried Atractylodes Atractylodes,Polygonum cuspidatum,Shenjin grass,Rhizoma curcumae,Pinellia ternata,Cassia grass.3.Part 4:?A total of 106 active ingredients,241 associated targets in Yiqi Huazhuo Jiangsuan formula and 613 targets of HUA disease were screened,among which 67 targets were both identified in the formula and disease group.? The main active molecules of Yiqi Huazhuo Jiangsuan formula in the treatment of HUA include quercetin,luteolin,stigmasterol,?-sitosterol,kaanol,etc.The main targets were TP53,IL6,MAPK8,AKT1,TNF,RELA,VEGFA and CASP3.?GO functional annotation revealed 20 biological processes(BP),9 cellular components(CC),15 molecular functions(MF).67 formula-disease targets were mainly enriched in AGE-RAGE(HSA04933),NF-?B(HSA04064),FoxO(HSA04068),HIF-1(HSA04066)signaling pathways.Conclusions1.Most of the studies on the metabolomics of HUA and gout are in the preliminary stage and lack of clinical confirmation,but the research results can still provide a further understanding of the pathological mechanism of metabolic differences between HUA and gout.The identification of the different metabonomics biomarkers identified by this Systematic review might provide a theoretical support for the selection of the biomarkers to predict gout occurrence.2.Qualitative expert interview method can help to comb the experts' clinical experience,make the research results more comprehensive and rich,and can accurately reflect the tutor's academic views.By using the network pharmacology method to explore the mechanism of the tutor's empirical prescription for HUA tentative,we made more comprehensive and in-depth comprehension of the tutor's experience,and also hope to provide theoretical support for further research in the future.