Data Mining Based Medical Case Analysis And Core Prescription Network Pharmacology Study Of Professor Chi Lili’s Treatment Of IBS-D

Objective:Data mining technology was used to analyze the medical records of Professor Chi Lili in the treatment of diarrhoe-predominant irritable bowel syndrome(IBS-D),summarize the rules of medication in the treatment of IBS-D,and dig out the core prescription.Network pharmacology was used to predict the potential targets and signaling pathways of core prescription,and to explore the mechanism of action in the treatment of IBS-D.Method:1.The medical records of IBS-D patients who visited the outpatient clinic of Professor Chi Lili in the Second Department of Gastroenterology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine from January2019 to December 2022 were collected.After screening,the information of the medical records were extracted.Then Excel was used to establish a database,and the data were standardized.The frequency statistics of gender,age,symptoms,tongue and pulse,traditional Chinese medicine syndrome type,traditional Chinese medicine(TCM),TCM meridians,four qi and five flavors were carried out.SPSS Modeler18.0 and SPSS Statistics26.0 software were used to analyze the TCM association rules and cluster analysis,and dig out the core prescription.2.The active ingredients of core prescription were obtained and screened by TCMSP database,HERB database,chemical source network and literature review,and the corresponding protein targets were obtained.The target names were standardized by Uniprot protein database.Gene Cards,OMIM,Drug Bank and TTD databases were used to obtain the target information of IBS-D,and the intersection targets of core prescription and IBS-D were obtained through VENNY2.1 platform.Cytoscape3.7.2 software was used to construct disease-intersection target-active ingredient-TCM network diagram.Then main active ingredients were obtained according to the degree value.Through the STRING database,the protein interaction network was obtained.Then key targets were obtained according to the degree value and displayed visually using Cytoscape3.7.2.Metascape database was used to analyze the GO function enrichment and KEGG signal pathway enrichment of the intersection targets,so as to research the mechanism of the core prescription in the treatment of IBS-D.Result:1.A total of 662 medical records were included in this study,including375 males and 287 females.Male: female =1.31:1.The age distribution was mainly between 30 and 39 years old(39.73%),followed by 40 to 49 years old(21.45%),50 to 59 years old(19.18%),and 20 to 29 years old(11.03%).2.According to statistics,there were 70 kinds of symptoms,and the top10 high-frequency symptoms were loose stool(89.12%),increased stool frequency(81.12%),abdominal pain(77.19%),decreased pain after diarrhea(63.60%),irritability(57.85%),loss of appetite(57.40%),fatigue(52.87%),bowel ringing(32.02%),abdominal cold(31.57%),and insomnia(28.70%).3.The tongue texture was mainly light red tongue(37.92%),teeth marks tongue(32.48%),dark red tongue(30.82%),and fat tongue(30.06%).The tongue coating was mainly thin white coating(38.97%)and thin yellow coating(23.26%).Chord pulse was the most common pulse,accounting for 52.42%,and there were heavy chord pulse(19.03%),thin chord pulse(12.54%),etc.4.The most frequent syndrome type of TCM was liver depression and spleen deficiency syndrome,accounting for 72.21%,followed by spleen deficiency and dampness syndrome(13.90%),spleen and stomach damp-heat syndrome(7.55%),mixed cold and heat syndrome(3.63%),spleen and kidney yang deficiency syndrome(2.72%).5.This study involved 110 traditional Chinese medicines,and TCM with frequency >50% were poria cocos(99.70%),roasted licorice(96.98%),fried a tractylodes macrocephala with bran(88.37%),white peony(87.16%),bupleurum(86.10%),cyperus(85.05%),codonopsis(81.27%),saposhnikoviae radix(79.91%),stir-fried malt(66.16%),burnt hawthorn(61.03%),fried Shenqu with bran(61.03%),galangal(60.88%),cassia twig(59.37%),tangerinepeel(55.89%).6.The properties of TCM are mainly mild(33.30%),warm(27.00%)and slightly cold(19.40%).The flavors of TCM are mainly sweet(34.22%),pungent(26.78%)and bitter(17.98%).The meridians of TCM mainly include spleen meridian(28.17%),stomach meridian(17.19%),lung meridian(16.78%),liver meridian(13.50%)and heart meridian(10.39%).7.The minimum support was set as 40%,the minimum confidence was 95%,which can obtain 868 association rules.The TCM pairs with high support i ncluded poria cocos-roasted licorice,roasted licorice-poria cocos,poria c ocos-bran fried atractylodes macrocephala,etc.The TCM combinations with100% confidence included bupleurum-codonopsis-cyperus,white peony-saposh nikoviae radix-bupleurum,etc.Combined with the TCM pairs with high cooccurrence frequency in the co-occurrence network diagram,it is concluded that fried atractylodes macrocephala with bran,white peony,saposhnikovi ae radix,poria cocos,bupleurum,cyperus,codonopsis,roasted licoricean d constitute the core prescription for treating IBS-D.8.After cluster analysis,three cluster combinations were obtained.T he first one was roasted licorice,saposhnikoviae radix,codonopsis,cype rus,fried atractylodes macrocephala with bran,bupleurum,white peony,tangerine peel,stir-fried malt,galangal,cassia twig,fried Shenqu with bran,burnt hawthorn.The second category was coix seed,kudzu root,malt,pinellia ternata,Paris polyphylla,salvia miltiorrhiza,sandalwood,stir-fried coix seed with bran,fructus amomi,polygalae radix,oysters,Long gu.The third type was poria cocos.9.A total of 55 active ingredients and 209 targets were collected from8 traditional Chinese medicines in the core prescription.3189 IBS-D related targets were retrieved.The core prescription targets were intersected with the IBS-D related targets,and 158 intersected targets were obtained.10.Quercetin,kaempferol,luteolin,beta-sitosterol,stigmasterol,iso rhamnetin were most closely associated with the intersection targets,and were the main ingredients of IBS-D treatment.Through the protein interac tion network,it can be seen that the key targets were AKT1,TNF,IL6,TP53 and so on.11.In the analysis of GO function enrichment,there were 1918 biological processes,including cellular response to nitrogen compound,response to inorganic substance,cellular response to organic cyclic compound,etc.There were 192 molecular functions,including protein domain specific binding,DNA-binding transcription factor binding,protein homodimerization activity,etc.There were 103 cell components,including membrane raft,transcription regulator complex,vesicle lumen,etc.12.There were 197 KEGG signal pathways,including pathways in cancer,AGE-RAGE signaling pathway in diabetic complications,lipid and atheroscl erosis,PI3K-Akt signaling pathway,etc.Conclusion:1.Professor Chi Lili believes that IBS-D is located in the intestine and rooted in the spleen and stomach,which is closely related to the liver and heart.Spleen deficiency is the root of the disease,and disease caused by dampness.Liver qi stagnation runs through the whole time,and both body and mind are suffering from harm,which leads to spleen deficiency anddampness,spleen and stomach cannot function normally,moisture accumulation,intestinal turbidity and confusion,and diarrhea.In the treatment of IBS-D,both primary and secondary symptoms are considered,and reinforcing and reducing are applied.Lnvigorating spleen and qi to cure the root cause,removing dampness and stopping diarrhea.At the same time,emotionis very important for the disease.Then regulating the liver and qi,and to treat both body and mind.The core prescription for treating IBS-D was obtained,which consisted of fried atractylodes macrocephala with bran,white peony,saposhnikoviae radix,poria cocos,bupleurum,cyperus,codonopsis,roasted licoriceand.2.Through the network pharmacology research,it is speculated that the active ingredients of the core prescription act on multiple targets,and play a role in inhibiting intestinal inflammatory response,enhancing immunity,protecting intestinal mucosal barrier,regulating intestinal motivity,reducing visceral sensitivity,regulating intestinal flora,regulating sleep and mental disorders by regulating multiple signal pathways.The core prescription is multi-ingredient,multi-target and multi-path treatment for IBS-D.