| Objective:Clinical research : To observe the clinical efficacy of Huanglian decoction flavored in the treatment of advanced endometrial cancer with damp invasion of lower energizer.Network Pharmacology: Using the network pharmacology to explore the molecular mechanism of Huanglian decoction flavor in the treatment of endometrial cancer.Methods:Clinical observation part: 60 patients with modern medical diagnosis of advanced endometrial cancer and TCM diagnosis of damp-heat infiltration type were collected from September 2020 to December 2021 at the outpatient clinic of the Department of Oncology,The First Affiliated Hospital of Heilongjiang University of Chinese Medicine,who met the inclusion criteria.Patients were given Huang Lian Detoxification Tang Plus Flavor Formula for three cycles(four weeks per cycle)using its own before-and-after control method,and the indices of tumor size,TCM evidence score,tumor markers,and Karr’s score were recorded before treatment,after one cycle of treatment,and after three cycles of treatment,respectively.The results were analyzed using SPSS25.0 statistical software to evaluate the clinical efficacy of Huang Lian Detoxification Tang Plus Flavor Formula.Pharmacological part of the network: The active ingredients and targets of Huang Lian Jie Wu Tang Plus Flavour Formula were obtained from the TCMSP database and related literature,and the "ingredient-target" network was constructed using Cytoscape 3.9.1 and the core ingredients were screened.The targets of endometrial cancer-related diseases were collected in Gene Cards and Drug Bank databases,and the drug-disease intersection targets were entered into STRING database for protein interaction(PPI)analysis and core targets were obtained,and GO and KEGG enrichment analysis were performed on the intersection targets in DAVID database.Results:Clinical observation part: 60 cases meeting the criteria were included in this study,there were no cases of rejection or shedding throughout the treatment,and the patients cooperated well.1.In the evaluation of the efficacy of solid tumours,the objective remission rate and disease control rate of solid tumours were improved after 1cycle of treatment and after 3 cycles of treatment compared with those before treatment,the difference was not statistically significant(p>0.05).2.In terms of TCM evidence score,the individual and total scores decreased after 1 cycle of treatment compared to before treatment(P<0.05),and the scores decreased more significantly after 3 cycles of treatment(P<0.01).3.In terms of tumour markers HE4,CA125,CA19-9 and CEA,compared with the levels before treatment,the levels decreased after 1 cycle and 3cycles of treatment,the difference was not statistically significant(P>0.05).4.In terms of KPS scores,compared with the pre-treatment period,the scores improved after 1 cycle of treatment and significantly after 3 cycles of treatment,and the difference was statistically significant(P<0.05).5.Safety: There were no abnormal changes in blood routine,liver and kidney functions of the patients after treatment.Network pharmacology section:There are 97 active ingredients in the 10 Chinese herbs in the formula of Huang Lian Jie Wu Tang Plus,which potentially act on endometrial cancer through 171 targets.The top-ranked target genes screened based on network topology analysis were TP53(tumour protein p53),MAPK1(human mitogen-activated protein kinase 1),c-Myc(proto-oncogene),TNF(tumour necrosis factor),IL-6(interleukin-6),IL-10 interleukin-10);the key active ingredients were: quercetin,kaempferol,lignocaine and baicalein.The GO analysis using the DAVID database yielded a total of 394 GO functionally enriched entries,including 523 biological processes,67 cellular components and 130 molecular functions.The main signalling pathways associated with cervical cancer in the KEGG pathway are the cancer signalling pathway,the phosphatidylinositol 3-kinase signalling pathway(PI3K-Akt signaling pathway),the The main signaling pathways associated with cervical cancer were cancer signaling pathway,PI3K-Akt signaling pathway,TNF signaling pathway,etc.Conclusion.Clinical observation part:1.Huang Lian Detoxification Tang Plus Formula can stabilize tumor size and control tumor growth.2.Huang Lian Detoxification Tang Plus Wei Formula has the effect of reducing the values of tumour markers CA125,CA199 and HE4,CEA.3.Huang Lian Detoxification Tang with Wei Wei can improve the patient’s Karlsberg score and improve the quality of life.4.Huang Lian Detoxification Tang with Wei Wei can relieve patients’ clinical symptoms such as vaginal bleeding,profuse and yellowish coloured discharge,abdominal pain,drowsiness and weakness,and burning sensation in the vagina.Pharmacological part of the network:Huang Lian Detoxification Tang Plus can exert therapeutic effects on endometrial cancer through multiple components,multiple targets and multiple pathways... |
