Professor Park Yongzhu’s Medication Law And Network Pharmacology In The Treatment Of Rheumatoid Arthritis Cold Dampness Obstruction Syndrome

Objective:1.Application of data mining techniques to explore the tutor in the treatment of Rheumatoid Arthritis with Cold and Dampness Blockage Syndrome of the drug law and core drugs,summed up the tutor’s clinical experience in treating this disease.2.To Study the Mechanism of Action of the Core Drugs in Treating Rheumatoid Arthritis with Cold and Dampness Blockage Syndrome by Network Pharmacology Method.Methods:1.Collect between January 2019 and December 2021,during the tutor in The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine rheumatism clinic diagnosis and treatment of rheumatoid Arthritis with Cold and Dampness Blockage Syndrome first confirmed cases of the data,will be standardized treatment cases after establishing a database,using the inheritance of traditional Chinese medicine computing platform V3.0 to data mining of case data,Through the statistical analysis,prescription analysis,association rules,cluster analysis,and other operations,the medication rules and core drugs of the tutor in the treatment of rheumatoid arthritis cold and the wet bi syndrome were explored,and the treatment experience of the tutor was summarized.2.Network pharmacology analysis was conducted on the core drugs of the tutor for the treatment of Rheumatoid Arthritis with Cold and Dampness Blockage Syndrome.TCMSP database was used to screen out compounds with high active components and collect target proteins.The gene targets of diseases are searched in Gene Cards and Dis Ge NET disease databases,and the intersection of the two is obtained.The intersection targets were imported into Cytoscape to construct the "drug-component-target" network and the STRING database to construct the PPI network,and the visualization analysis was carried out.R software was used for GO and KEGG enrichment analysis,and Cytoscape was used again to construct a "target-pathway" network to explore the mechanism of action.Results:1.A total of 201 cases were included in this study,among which 162 were female(80.59%)and 39 were male(19.41%).The average age was 47± 7.96 years,and the age of onset was 41-50 years(48.76%)and 51-60 years(29.35%).2.Among the 201 cases included in this study,light tongue was the most common,with a frequency was 154 times;The most common tongue coating was white coating,with a frequency was 95 times.The most pulse condition was a tight pulse,the frequency was 61 times.Symptom statistics showed a total of 22 symptoms,the top five symptoms were joint cold and pain,joint swelling,morning stiffness,cold touch,skin color is not red.3.A total of 137 herbs were used in 201 cases,of which 31 herbs were used ≥ 50 times.Among them,the top eight drugs in the frequency of use were Monkshood,Atractylodes macrocephala,Cassia twig,Licorice root,Duhuo,Mustard seed,Rhizoma dioscoreae nipponicae,and Papaya.The ranking of the four qi of the drugs was warmth,flat,cold,hotness,and coolness;the ranking of the five flavors was bitterness,pungency,sweetness,saltiness,and sourness;the ranking of the meridians was liver meridian,spleen meridian,kidney meridian,lung meridian,stomach meridian,heart meridian,bladder meridian,gall bladder meridian,large intestine meridian,small intestine meridian,triple energizer meridian,and Pericardial meridian;There are 17 categories in the efficacy of drugs,among which the top five categories are dispelling rheumatism,tonifying deficiency,stasis-resolving and blood-activating,exterior-releasing,interior-warming.4.Drug association analysis resulted in 62 drug patterns,93 association rules,and a total of 8 core drugs: Monkshood,Atractylodes macrocephala,Cassia twig,Licorice root,Duhuo,Mustard seed,Rhizoma dioscoreae nipponicae,and Papaya.Commonly used drug combinations are Monkshood,Atractylodes macrocephala;Monkshood,Cassia twig;Atractylodes macrocephala,Papaya;Cassia twi,Duhuo.5.Drug cluster analysis A total of six groups of drug core combinations were selected: C1: Chinese pine Festival,Rhizoma dioscoreae nipponicae,Cassia twig,Monkshood,Duhuo,Atractylodes macrocephala,Mustard seed,Drynaria;C2: Atractylodes macrocephala,Monkshood,Glycyrrhiza uralensis,Cassia twig,Duhuo,Mustard seed,Rhizoma dioscoreae nipponicae,and Papaya;C3:Cassia twig,Glycyrrhiza uralensis,Monkshood,Papaya,Atractylodes macrocephala,Notopterygium incisum,Mustard seed,and Ramulus mori;C4: Monkshood,Atractylodes macrocephala,Cassia twig,Licorice root,Duhuo,Papaya,Mustard seed,Staghorn cream;C5: Cassia twig,Monkshood,Glycyrrhiza uralensis,Atractylodes macrocephala,Duhuo,Rhizoma dioscoreae nipponicae,Mustard seed,Zaocys dhumnades;C6:Glycyrrhiza uralensis,Duhuo,Mustard seed,Monkshood,Atractylodes macrocephala,Cassia twig,Rhizoma dioscoreae nipponicae,Poria cocos.6.A total of 66 active components of core drugs were obtained through network pharmacological analysis,including 337 action targets,813 disease targets,and 80 intersection targets.The main active ingredients are quercetin,kaempferol,isorhamnetin,chlorogenic acid,etc;The key targets were TNF,IL-6,and IL-1β,AKT1,MMP9,CASP3,etc;There are 1915 biological function items in go analysis,involving 1768 biological processes,30 cell components and 117 molecular functions;A total of 145 pathways were obtained by KEGG pathway enrichment analysis,mainly involving AGE-RAGE signaling pathway,IL-17 signaling pathway,TNF signaling pathway,Toll-like receptor signaling pathway and Nod-like receptor signaling pathway.Conclusion:1.Among the 201 cases in this study,female patients were the main ones,the most of them were light tongue;The most common tongue coating was white coating,and tight pulse is the most common pulse.In the symptom statistics,the main symptoms are joint cold and pain,joint swelling,morning stiffness,cold touch,skin color is not red.2.The four qi of the drugs used by the tutor in the treatment of rheumatoid arthritis with the cold-dampness syndrome are mainly warm and flat;the five flavors are mainly bitter,pungent,and sweet,and return to the liver meridian,spleen meridian,and kidney meridian;and the medicinal are mainly expelling dispelling rheumatism medicinal,tonifying deficiency medicinal,stasis-resolving and blood-activating medicinal,exterior-releasing medicinal,interior-warming medicinal.3.The core drugs used by the tutor in the treatment of Rheumatoid Arthritis with Cold and Dampness Blockage Syndrome are Monkshood,Atractylodes macrocephala,Cassia twig,Licorice root,Duhuo,Mustard seed,Rhizoma dioscoreae nipponicae,and Papaya.Uralensis Four groups of commonly used drug combinations and six groups of drug core combinations were also obtained.4.Through network pharmacology research,it is found that the main components of core drugs such as quercetin,kaempferol,isorhamnetin and chlorogenic acid may act on TNF,IL-6,IL-1β,AKT1,MMP9,CASP3 and other key targets may treat Rheumatoid Arthritis by regulating AGE-RAGE signal pathway,IL-17 signal pathway,TNF signal pathway,toll like receptor signal pathway,nod like receptor signal pathway and other pathways.