Analysis Of Medication Rule For Lymphedema After Treatment Of Tumor With Jingfang And (or) After Radiotherapy

Purpose:In this paper,we explore the classical prescriptions for the treatment of lymphedema after tumor operation and /or radiotherapy in Treatise on febrile diseases,and search,collect and sort out the clinical research literature of traditional Chinese medicine in the treatment of lymphedema after tumor operation and /or radiotherapy,make statistical analysis on the traditional Chinese medicine and prescriptions,and summarize their medication rules,and explore the classical prescription Fangji Huangqi Decoction based on network pharmacology The treatment of lymphedema can provide data support for clinical treatment and drug research.Material and method:1.In CNKI,VIP and Wanfang,the keywords were "tumor,malignant tumor,gynecological malignant tumor,cancer" and "lymphedema".the literatures published from the establishment of the database to June 2020 were searched with "Classical Prescriptions" as the subject word.The final included articles were determined according to the inclusion criteria.The classical prescriptions for the treatment of lymphedema after tumor operation and / or radiotherapy were summarized.2.In CNKI,VIP and Wanfang,the keywords were "tumor,malignant tumor,gynecological malignant tumor,cancer" and "lymphedema".In the search results,the keywords were "traditional Chinese medicine" and "prescription" to search the literatures published from the establishment of the database to June 2020.The final included articles were determined according to the inclusion criteria.To standardize the name of traditional Chinese medicine according to Chinese medicine and Chinese Pharmacopoeia.Input the collected data into Microsoft Excel 2013,count the frequency of each traditional Chinese medicine,screen out the core drugs and analyze the association rules.3.The chemical components and targets of Fangji Huangqi Decoction were found in tcmsp,the compound disease target network was constructed,PPI were constructed,and go analysis and KEGG pathway enrichment analysis were carried out.Results:1.Conclusion Guizhi,Huangqi,bupleurum and Fuzi are four kinds of prescriptions in the treatment of lymphedema after tumor operation and / or radiotherapy.2.From 1371 documents which were not in conformity,109 documents were collected.A total of 114 prescriptions were collected,and 189 Chinese herbs were sorted out.41 herbs appeared more than 10 times in this statistics.The top 10 herbs with the highest frequency were Astragalus,angelica,Poria,chuanxiong,mulberry branch,Guizhi,Atractylodes,Alisma,peach kernel and red peony.The core drugs include Astragalus Sangzhi,Astragalus angelica,peach kernel red flower,and core corner drugs such as Astragalus peach kernel red flower,Chuanxiong peach kernel red flower,etc.the core drugs composed of four drugs include peach kernel Chuanxiong red peony red flower,etc.the classic prescriptions can be included in the combination of these core drugs: Fangji Astragalus decoction,Buyang Huanwu Decoction,Danggui Buxue Decoction,Chaihu keen oyster soup,Fangji Poria decoction,etc.3.20 Astragalus,3 Fangji,7 Atractylodes,5 ginger,29 jujube and 92 licorice were obtained in Fangji Huangqi Decoction.The repeated active components were deleted and 142 were kept.There are 1303 targets for lymphedema,64 of which intersect with the decoction of Fangji Astragalus.The network of target disease,a compound of Fangji Huangqi Decoction for the treatment of lymphedema,was constructed.A total of 181 nodes and 1098 sides were obtained,including 1 disease node,6 drug nodes,110 active component nodes,64 target nodes,and median degree of 6.Through screening,the core active components were Mol000098(quercetin),Mol000422(chanol),Mol000497(glycyrrhizin),Mol002773(?-carotene),Mol004328(grapefruit),Mol000358(?-gssterol).There are 2317 GO items obtained by the bioaccumulation analysis of GO,including 2167 biological processes,66 cell components and 83 molecular functions.The main biological functions involved are protein connection,gene transfer,etc.There are 46 pathways in KEGG pathway,including MAPK signal pathway,tumor necrosis factor signal pathway,PD-L1 expression in tumor,PD-1 detection point pathway,PI3K-Akt signal pathway,NF-?B signal pathway,etc.Conclusion:1.This paper summarized four kinds of classical prescriptions: Guizhi,Chaihu,huangqi and Fuzi.In clinical application,it can be treated according to the patients' constitution or the similar prescriptions.Guizhi formula can be used for lymphedema with Spleen Yang deficiency syndrome,Chaihu formula can be used for liver depression and qi stagnation syndrome,Astragalus formula can be used for spleen qi deficiency syndrome,Fuzi formula can be used for lymphedema with spleen kidney yang deficiency syndrome,and specific prescriptions can be selected according to the specific clinical manifestations of patients.Lingguizhugan Decoction,Wuling powder and Guizhi Shaoyao Zhimu Decoction can be used in Guizhi prescriptions.Chailin Decoction,Chaihu plus Longgu oyster Decoction,Xuefu Zhuyu Decoction and Xiaoyao Powder can be used in Chaihu prescriptions.Fangji Huangqi Decoction,Huangqi Guizhi Wuwu Decoction and Buyang Huanwu Decoction can be selected in Huangqi prescriptions.Zhenwu Decoction is used in Fuzi prescriptions.2.Astragalus is the most commonly used traditional Chinese medicine in the treatment of lymphedema after tumor surgery and / or radiotherapy.Through correlation analysis,the core drugs can be combined into classic prescriptions,including Fangji Huangqi Decoction,Buyang Huanwu Decoction,Danggui Buxue Decoction,Chaihu Longgu Muli Decoction,Fangji Fuling Decoction,etc.3.Based on network pharmacology,the main active components of Fangji Huangqi Decoction for preventing and treating postoperative tumor and / or lymphedema were quercetin,kaempferol,liquiritin,?-carotene,naringenin and ?-sitosterol.It is mainly involved in protein connection and gene transfer and other biological functions.KEGG pathway enrichment analysis revealed 46 pathways,including MAPK signaling pathway,PD-L1expression in tumor and PD-1 checkpoint pathway,PI3 K Akt signaling pathway,NF-?B signaling pathway,etc.