| Objective: To investigate the mechanism of Baitong Decoction in treating cold asthma through network pharmacology.To evaluate the clinical efficacy of Baitong decoction in treating cold asthma so as to verify the key target obtained from the network pharmacological result.This study might provide new ideas for the treatment of asthma using traditional Chinese medicine.Methods:1.Network pharmacology study: The pharmacological database and analysis platform(TCMSP)of traditional Chinese medicine system were used to search and screen for active components and potential targets of the three herbs in Baitong Decoction(Fuzi,Ganjiang and Congbai).The asthma disease targets were searched and screened through Gene Cards database,within which the intersecting part with the action targets of Baitong Decoction was obtained.The interaction among various targets was counted on SRTING website.Cytoscape3.8.2 software was used for network analysis,and R program was used for biological process analysis and KEGG pathway enrichment analysis.Molecular docking between drug components and targets was performed through PDB,Pubchem,Autodock and Pymol.The key target was selected as one of serum indicators in the clinical study based on the signaling pathway transduction map.2.Clinical study: A total of 60 patients with acute attack of bronchial asthma(mild and moderate)belonging to “cold asthma” of TCM differentiation were included and randomly divided into treatment group and control group evenly.The control group was treated with budesonide/Formoterol inhalant and other drugs.The treatment group was treated additionally with Baitong decoction.After 2 weeks of observation,the improvement of TCM syndrome,lung function,ACT score,inflammatory indicators and serum key target levels of the two groups were evaluated.At the end of the treatment,SPSS was used for statistical analysis.Results:1.Network pharmacology study: Forty-seven key target genes of Baitong Decoction were obtained to interfere with cold asthma.The final core targets were JUN,PTGS2 and HMOX1.Cell biological processes including oxidative stress,lipopolysaccharide response,heme binding,oxidoreductase activity,and G-protein-coupled amine receptor activity were obtained by GO enrichment analysis.KEGG enrichment analysis revealed that aquired signaling pathways included tumor necrosis factor(TNF)signaling pathway,lipid metabolism and atherosclerosis signaling pathway.Docking results showed that PTGS2 had great affinity for kaempferal,(+)catechin and deltoin.And JUN had great affinity for kaempferal.2.Clinical study:(1)There were statistically significant differences between the two groups in terms of clinical efficacy and TCM syndrome improvement(P<0.05).And the treatment group was better than the control group(P<0.05)in their treatment effect.(2)The levels of FEV1% and FEV1/FVC in both groups were improved after treatment and the differences before and after treatment were statistically significant(P<0.05).The improvement rate of FEV1/FVC% in the treatment group was better than that in the control group(P<0.05).(3)After treatment,ACT scores in both groups were higher than before and the difference was statistically significant(P<0.05),and the treatment group was better than the control group(P<0.05).Conclusion:1.Lipopolysaccharide response and tumor necrosis factor(TNF)signal pathway may play a key role in the therapeutic effect of Baitong Decoction on cold asthma.Drug components including kaempferal,catechin(+)and deltoin may affect TNF signaling pathway by acting on PTGS2 and JUN targets,and then regulate the immune inflammatory response.Baitong Decoction can reduce airway inflammation,improve lung function and clinical symptoms in treating mild and moderate acute attack of bronchial asthma(cold asthma).The effect of Baitong decoction is better than that of simple Western medicine treatment,and its safety is worthy of affirmation.The mechanism of active components in Baitong Decoction deserves further study. |
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