| Objectives:1.Using data mining technology to explore the medication rules and core drugs of the tutor in the treatment of osteoarthritis with cold-dampness obstruction syndrome,and summarize the relevant clinical experience of the tutor in the treatment of osteoarthritis with cold-dampness obstruction syndrome.2.The mechanism of action of the core drugs in the treatment of osteoarthritis with cold-dampness obstruction syndrome was studied by network pharmacology.Methods:1.Collect the first diagnosis data of 167 patients with osteoarthritis of cold-dampness obstruction syndrome diagnosed and treated by the tutor in the outpatient department of rheumatology of the First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from October 2020 to October 2022,standardize the case data,establish a database,and then upload it to the traditional Chinese medicine inheritance calculation platform V3.0 software,frequency analysis,association rule analysis,cluster analysis of case data,mining the medication rules and core drugs of the tutor in the treatment of osteoarthritis of cold-dampness obstruction syndrome,and summarizing the relevant treatment experience of the tutor.2.The network pharmacology analysis of the core drugs of the tutor in the treatment of osteoarthritis with cold-dampness obstruction syndrome was carried out,and the chemical components and targets of the core drugs were obtained through the TCMSP and BATMAN-TCM databases,and corrected in the Uni Prot database;disease targets were obtained through Gene Cards,Drugbank,OMIM,and TTD databases.The ’ drug-active ingredient-key target’ network was constructed by Cytoscape software,and 10 targets and important components were screened out.PPI network was constructed through STRING database.GO enrichment analysis and KEGG pathway enrichment analysis were performed by DAVID6.8 database.Results:1.Among the 167 cases included in this study,there were 123 females,accounting for about 73.65 % of the total number of cases,and 15 males,accounting for about 26.35 % of the total number of cases.The number of female patients was significantly higher than that of male patients.The incidence was concentrated in the age range of 51-70 years,with a total of123 cases,accounting for about 73.65 % of the total number of cases.2.In this study,25 symptoms were counted,and the top 10 symptoms were : joint cold pain,increase in cold,joint flexion and extension adverse,warm pain reduced,cold like warm,rainy days aggravated,not warm limbs,acid fatigue,limb heavy,joint swelling.3.A total of 135 kinds of traditional Chinese medicine were counted in this study,of which 44 kinds of drugs were used more than 40 times.The top10 traditional Chinese medicines were aconite,atractylodes,cassia twig,achyranthes,tortoise shell,antler frost,sea breeze rattan,green wind rattan,mulberry twig,and pangolin.The frequency of four qi of drugs from high to low is warm drugs,flat drugs,cold drugs,hot drugs and cool drugs.The frequency of five flavors of drugs from high to low is bitter,pungent,sweet,salty and sour.The frequency of meridian tropism of drugs from high to low is liver,spleen,kidney,lung,stomach,heart,bladder,large intestine,gallbladder,small intestine,triple energizer and pericardium.A total of 17 results were obtained from the statistics of drug efficacy categories.The top 5efficacy categories were rheumatism,tonifying deficiency,promoting blood circulation and removing blood stasis,relieving exterior and warming interior.4.Drug association analysis obtained 81 medication patterns,62 association rules,and 9 core drugs,including aconite,largehead atractylodes rhizome,cassia twig,twotooth achyranthes root,tortoise shell,antler frost,kasdura pepper stem,orientvine stem,mulberry twig.Commonly used drug combinations are aconite,largehead atractylodes rhizome;aconite,cassia twig;twotooth achyranthes root,tortoise shell,antler frost;kasdura pepper stem,orientvine stem.5.Drug cluster analysis obtained 6 groups of drug core combinations :Core combination 1 : aconite,cassia twig,largehead atractylodes rhizome,kasdura pepper stem,fortune’s drynaria rhizome,twotooth achyranthes root,orientvine stem,antler frost;core combination 2 : aconite,atractylodes macrocephala,cassia twig,tortoise shell,antler frost,twotooth achyranthes root,kasdura pepper stem,orientvine stem;core combination 3 : aconite,largehead atractylodes rhizome,cassia twig,twotooth achyranthes root,yam,tuckahoe,antler frost,tortoise shell;core combination 4 : Atractylodes macrocephala,cassia twig,aconite,mulberry twig,antler frost,twotooth achyranthes root,tortoise shell,orientvine stem;core combination 5 : aconite,largehead atractylodes rhizome,kasdura pepper stem,mulberry twig,cassia twig,orientvine stem,twotooth achyranthes root,antler frost;core combination6:cassia twig,aconite,largehead atractylodes rhizome,tortoise shell,twotooth achyranthes root,antler frost,kasdura pepper stem,tangshen root.6.Network pharmacology analysis obtained 61 active ingredients of core drugs,455 targets,3887 disease targets and 192 intersection targets.The top five active components of the drug were quercetin,kaempferol,β-sitosterol,phenylalanine,and wogonin.The top 10 key targets were JUN,AKT1,TNF,TP53,IL-6,EGFR,CASP3,IL-1β,MAPK1 and FOS.There were 518 biological function items in GO analysis,involving 391 biological processes,50 cell components and 77 molecular functions.Through KEGG pathway enrichment analysis,133 pathways were obtained after screening,mainly involving PI3K-Akt signaling pathway,MAPK signaling pathway,TNF signaling pathway,IL-17 signaling pathway,etc.Conclusions:1.In this study,167 patients with osteoarthritis of cold-dampness obstruction syndrome were mainly female.The symptoms of high frequency were joint cold pain,aggravated by cold,joint flexion and extension adverse,warm pain reduced,cold like warm,rainy days aggravated,not warm limbs,acid fatigue,limb heavy,joint swelling.2.Tutor treatment of osteoarthritis with cold-dampness obstruction syndrome is mainly based on warm and flat drugs;the five flavors are mainly bitter,spicy and sweet;the liver meridian,spleen meridian and kidney meridian are the main meridians;the drug efficacy categories are mainly rheumatism,tonifying deficiency,and promoting blood circulation and removing blood stasis.3.The core drugs for the treatment of osteoarthritis with cold-dampness obstruction syndrome by tutor are aconite,largehead atractylodes rhizome,cassia twig,twotooth achyranthes root,tortoise shell,antler frost,kasdura pepper stem,orientvine stem and mulberry twig.Four groups of commonly used drug combinations and six groups of drug core combinations were obtained.4.Through network pharmacology research,it was found that the main active components of core drugs were quercetin,kaempferol,β-sitosterol,phenylalanine,wogonin,etc,which may act on JUN,AKT1,TNF,TP53,IL-6and other targets,and treat osteoarthritis by regulating multiple signaling pathways such as PI3K-Akt signaling pathway,MAPK signaling pathway,TNF signaling pathway and IL-17 signaling pathway. |
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