| Chronic heart failure is a very common clinical syndrome in cardiovascular diseases,and it is also the end stage of many cardiovascular diseases.Chronic heart failure has the characteristics of "three highs" in epidemiology,namely "high morbidity,high disability rate and high mortality",which seriously endangers the public health worldwide.In recent years,with the deepening understanding of the pathophysiological mechanism of chronic heart failure in Western medicine,new drugs and devices have emerged continuously,which have played a positive role in improving the clinical symptoms and prognosis of patients with chronic heart failure,but have not changed the status quo of the "three highs" in chronic heart failure.Therefore,there is still a long way to go in the prevention and treatment of chronic heart failure in the world.Professor Xiaochang Ma has been specialising in the prevention and treatment of cardiovascular diseases with integrated traditional Chinese and Western medicine for more than 30 years,and has a unique approach to the treatment of cardiovascular diseases,especially chronic heart failure,with significant clinical efficacy.In this study,we first summarised the clinical medication patterns used by Professor Xiaochang Ma through data mining to explore his clinical medication characteristics.Then,the network pharmacology was used to analyze the mechanism of his high-frequency traditional Chinese medicine in the treatment of chronic heart failure,laying the foundation for further in-depth research.Study 1:Exploration of clinical medication rules of Professor Xiaochang Ma in the treatment of chronic heart failure based on data miningObjective:To summarise the patterns of prescriptions and medications used by Professor Xiaochang Ma in the treatment of chronic heart failure through data mining.Methods:Through the outpatient information system of Xiyuan Hospital of China Academy of Chinese Medical Sciences,the clinical medication data and other data of patients with chronic heart failure treated by Professor Xiaochang Ma in the cardiovascular outpatient clinic during the past 10 years(from November 2011 to November 2021)were summarized,the drug names were standardized and the database was established.The data were inputed into the traditional Chinese medicine inheritance support system V3.0,and the frequency statistics of the four properties,five flavors,and channel tropism of the herbs were performed on the platform.The data processing methods such as association rules and cluster analysis were also used to obtain combinations such as cluster analysis formulas.Results:General information:A total of 87 patients and 300 prescriptions were included in this study.Among the patients included in this study,there were 47 males and 40 females,accounting for 54%and 46%,respectively,with a gender ratio of 1.175:1,slightly higher for males than females;the youngest patients included in this study was 30 years old and the oldest was 91 years old,with an average age of 67.81 years.Frequency of traditional Chinese medicines:A total of 187 herbs were involved in this study,with a cumulative frequency of 6272 uses.The order of the single herbs with high frequency(>140 times)was:Astragalus membranaceus,Salvia miltiorrhiza,Poria Cocos,Spatholobus Suberectus,Ophiopogon Japonicus,Pseudostellaria Heterophylla.The effects and properties of drug:Four natures of drugs in this study were mainly cold,warm and flat;The five flavors of drugs were mainly sweet,bitter and pungent.The drug effects were mainly tonic,promoting blood circulation to dissolve blood stasis,and removing dampness and promoting diuresis.Channel tropism were mainly lung meridian,spleen meridian,liver meridian,stomach meridian,heart meridian and kidney meridian.Drug combination analysis:Support degree of 45%and confidence degree of 0.6 were set as the parameters of association rules.A total of 6 pairs of drug combinations were obtained,including Astragalus membranaceus,Salvia miltiorrhiza,Poria Cocos,Spatholobus Suberectus,Ophiopogon Japonicus,Pseudostellaria Heterophylla.The drug combination with the highest confidence degree was Chixueteng and Salvia miltiorrhiza.The k-means algorithm was used to set the number of clusters to 5,and a total of 5 clustered drug groups were extracted.Conclusion:The main therapeutic method of Professor Xiaochang Ma’s high-frequency traditional Chinese medicine for chronic heart failure is"supplementing qi and nourishing yin,promoting blood circulation and diuresis",which means paying attention to supplementing qi and nourishing Yin while eliminating blood stasis and fluid retention,so as to eliminate pathogenic factors without harming the body resistance and achieve the purpose of treating both manifestation and root cause of chronic heart failure.Study 2:Study on the network pharmacology of high-frequency traditional Chinese medicine used by Professor Xiaochang Ma for the treatment of chronic heart failureObjective:To explore the mechanism of high-frequency traditional Chinese medicine in the treatment of chronic heart failure by analyzing the active components and action targets of high-frequency traditional Chinese medicine in the treatment of chronic heart failure by Professor Xiaochang Ma through network pharmacology.Methods:The chemical components of Astragalus membranaceus,Salvia miltiorrhiza,Poria Cocos,Spatholobus Suberectus,Ophiopogon Japonicus,Pseudostellaria Heterophylla was searched through Traditional Chinese medicine systems pharmacology database and analysis platform(TCMSP)database.The eligible active ingredients were included and target proteins were collected using oral bioavailability≥30%and drug similarity≥0.18 as screening criteria.In addition,the main active components of drugs confirmed by relevant literature but not included in TCMSP database were also included in this study,and the target proteins were collected in TCMSP database.Finally,the above results were corrected by the UniProt database to standardize the target proteins.The targets related to "chronic heart failure "were obtained from the OMIM、Drugbank、TTD and DisGeNET databases using"chronic heart failure" as the main keyword.Then the intersection of disease and drug targets were input into the STRING database to obtain the protein-protein interaction network.The Cytoscape 3.7.2 software was used to construct and visualize the"drug-active component-disease-target" network.Finally,GO and KEGG analysis of key targets were performed using R 64 4.0.3.Results:129 main active ingredients and 361 drug targets were retrieved from 6 high-frequency herbs.1542 targets related to chronic heart failure were retrieved.Then 132 targets were obtained by taking the intersection of the two.729 items were enriched in biological processes,61 items in cellular components and 136 items in molecular functions in GO enrichment analysis.Furthermore,A total of 165 signaling pathways were obtained from the KEGG pathway,involving PI3K/AKT signaling pathway,etc.Conclusions:Through network pharmacology research,the mechanism of high-frequency traditional Chinese medicine used by Professor Xiaochang Ma for the treatment of chronic heart failure was preliminarily explored,which mechanisms may be related to the active components such as luteolin,wogonin,tanshinone ⅡA,etc and the signal pathway such as PI3K/Akt signal pathway,etc. |
