| Objective:This study evaluated the clinical efficacy of Mahuang Fuzi Asarum decoction combined with Yupingfeng San in the treatment of allergic rhinitis through clinical randomized controlled experiments,and systematically analyzed the relevant targets and pathway mechanism of Mahuang Fuzi Asarum decoction combined with Yupingfeng San in the treatment of allergic rhinitis with the help of network pharmacology and other related technical methods.Methods:Sixty patients who attended the ENT outpatient clinic of Shandong Provincial Hospital of Traditional Chinese Medicine from October 2020 to October 2021 and met the criteria of this study were collected.SPSS 22.0 was used to generate the random number and group.The patients were randomly divided into treatment group and control group,with 30 cases in each group.The treatment group was treated orally with Ephedra with Eucommia and Sinensis decoction combined with Yu Ping Feng San decoction with a reduction of 200 ml each time in the morning and evening after meals.The control group was given loratadine citrate tablets 1 tablet/time,1 time/day,plus fluticasone propionate nasal spray,2 sprays/day in each nostril,applied in the morning.the duration of treatment in both groups was 4 weeks,and the patients were followed up 3 months after the completion of the treatment course,and before and after the treatment and at the follow-up.The visual analogue scale(VAS),Chinese medicine symptom score scale and rhinoconjunctivitis quality of life questionnaire(RQLQ)were used for evaluation and analysis.At the same time,the technical methods related to network pharmacology and bioinformatics databases were used to obtain the relevant targets of the components of Ephedra with Eucommia and Fine Pine Soup combined with Yu Ping Feng San and allergic rhinitis diseases.After mapping the two,a correlation network was constructed and annotated with gene enrichment to explore the potential mechanism of Ephedra with Eucommiae Hossein decoction combined with Yu Ping Feng San in the treatment of allergic rhinitis.Results:1.In the treatment cycle and follow-up period,there were no cases of rejection and abscission in the two groups.(1)After treatment: The advantage of effective rate in the treatment group(90.00%)over the control group(83.33%)was more significant(P < 0.01).The VAS score,total TCM symptom score and total RQLQ score in each group were all significantly lower than those before treatment(all P < 0.01),and the points in the treatment group were significantly lower than those in the control group(all P < 0.01).In each group,the total score of TCM primary symptoms and individual points were significantly lower than before treatment(all P < 0.01),but no significant difference was found between the groups(all P > 0.05);the total score of TCM secondary symptoms and individual points in the treatment group were significantly lower than before treatment(all P < 0.01),but no significant decrease was found in the control group(all P > 0.05).All individual scores were significantly lower than those of the control group(all P < 0.01);the individual scores of RQLQ in each group were significantly lower than those before treatment(all P < 0.01),the scores of sleep,emotion and nasal symptoms in the treatment group were significantly lower than those of the control group(all P < 0.01),the scores of activity were lower than those of the control group(P < 0.05),and no difference was found in the scores of non-nasal eye symptoms,practical problems and eye scores(all P > 0.05).(2)Follow-up: The treatment group had a more significant(P < 0.01)advantage in efficiency(80.00%)compared to the control group(60.00%).The VAS score,total TCM symptom score and total RQLQ score in each group were all significantly lower than those before treatment(all P < 0.01),and the points in the treatment group were significantly lower than those in the control group(all P < 0.01).The total TCM primary symptom score and each individual point in each group were significantly lower than before treatment(all P < 0.01);the sneezing points in the treatment group were significantly lower than those in the control group(P < 0.01),and the nasal itching and runny nose points were lower than those in the control group(all P < 0.05),and no difference was seen in the total TCM primary symptom score and nasal congestion points(all P > 0.05).In the treatment group,the total TCM secondary evidence score and each individual point were significantly lower than before treatment(all P < 0.01),while no significant decrease was seen in the control group(all P > 0.05).The total secondary evidence score,spontaneous sweating score,shortness of breath score and fear of cold wind score were significantly lower in the treatment group than in the control group(all P < 0.01),and the low speech score and pale face score were lower than in the control group(all P < 0.05).The individual RQLQ points in each group were significantly lower than before treatment(all P < 0.01).The activity,sleep,emotion and non-nasal eye symptom points were significantly lower in the treatment group than in the control group(all P < 0.01),and the nasal symptom points were lower than in the control group(P < 0.05),while no difference was seen in the eye symptom and practical problem points(all P > 0.05).2.Network pharmacological analysis: The main active ingredients involved in Mahuang Fuzi Asarum decoction combined with Yupingfeng San are quercetin,kaempferol,β-sitosterol,dousterol and cryptoprine.These active ingredients act on core targets such as IL6,TNF,VEGFA,PTGS2,TP53 and related pathways such as HIF-1,TNF,Estrogen and MAPK,interfering with cell proliferation,cellular drug response,angiogenesis,enzyme binding and other pathways,thus playing a role in the treatment of AR.Conclusion:The combination of Mahuang Fuzi Asarum decoction and Yupingfeng San has good clinical efficacy in the treatment of AR with lung qi deficiency cold evidence,and has significant advantages over Western medicine in improving secondary and long-term effects in Chinese medicine.Through network pharmacological analysis,this formula showed high specificity in intervening in the process of AR,and the targets,pathways and routes of action involved were closely related to the processes of inflammatory response,immune response,nasal mucosal tissue remodelling and angiogenesis and remodelling,which is highly compatible with the research direction of today’s AR treatment.At the same time,many nonspecific high correlation pathways and action pathways have also been enriched.There may be invalid research due to the universality of gene association,or there may be some micro association that has not been found,which has become a breakthrough in the new research direction.We need further experimental verification to provide a basis for the theory of Supplementing Qi and warming yang in the treatment of AR. |
PDF Full Text Request