Professor Song Liqun’s Medication Rules And Core Prescription Network Pharmacology Analysis In The Treatment Of Early Renal Damage In MS

Objective: This study aims to summarize the medication rules of Professor Song Liqun in treating early renal injury in patients with metabolic syndrome(MS)and explore the potential mechanism of the core formula using network pharmacology research methods.Methods: The clinical data of patients with early renal damage and MS who visited Professor Song Liqun ’s clinic from January 2016 to December2021 were collected.After standardization,the data was imported into the TCM Inheritance Calculation Platform V3.0 for data mining.The results were comprehensively analyzed to summarize Professor Song Liqun ’s medication experience and extract the core formula for treating early renal injury in MS.Network pharmacology was used to explore the mechanism of the core formula.Effective active ingredients of each drug in the core formula were screened from the TCMSP database,and the active ingredient targets were substituted using the Uniport database.Gene targets for early renal injury in metabolic syndrome were obtained from the Gene Cards,OMIM,Pharm Gk B,Drug Bank,and TTD disease databases.The intersection targets of drugs and diseases were extracted,and their protein-protein interactions were obtained using the STRING database to construct a protein interaction network.The core genes were then screened using Cyto NCA.GO and KEGG enrichment analyses were performed using R software,and the core formula-component-target-pathway-early renal injury in metabolic syndrome regulatory network was constructed using Cytoscape 3.9.1.Results:1.This study included a total of 251 initial prescriptions involving 180 types of drugs.Frequency statistics of drugs showed that the top ten Chinese medicines were Atractylodis Macrocephalae Rhizoma,Astragali Radix,Euryales Ferox Semen,Armeniacae Amarum Semen,Citri Reticulatae Pericarpium,Rubi Fructus,Salviae Miltiorrhizae Radix,Poria,Pinelliae Rhizoma Praeparatum and Cuscutae Semen.The four qi analysis of drugs showed that the top qi was warm(41.25%),followed by neutral(29.22%),cold(21.88%),cool(7.52%),and hot(0.13%).The statistics of five flavors showed that the top flavor was sweet(46.22%),followed by bitter(25.68%),pungent(15.40%),sour(9.75%),and salty(2.95%).The statistical results of the meridians showed significant use of the spleen meridian(20.94%),liver meridian(17.52%),and kidney meridian(17.44%).The main drug efficacy categories were tonifying deficiency(26.97%)and astringing(16.83%).The statistical results of TCM syndrome types showed that the main deficiency syndrome was spleen and kidney deficiency(85.26%),and the main excess syndrome was phlegm and stasis obstruction(62.50%).The association rules showed that the top five core drug combinations were Atractylodis Macrocephalae Rhizoma-Astragali Radix,Atractylodis Macrocephalae Rhizoma-Euryales Ferox Semen,Astragali Radix-Euryales Ferox Semen,Atractylodis Macrocephalae Rhizoma-Astragali Radix-Euryales Ferox Semen and Atractylodis Macrocephalae Rhizoma-Armeniacae Amarum Semen.The cluster analysis obtained four core prescriptions,and the core prescription was obtained by comprehensive evaluation of association rules and cluster analysis results,including Astragali Radix,Atractylodis Macrocephalae Rhizoma,Euryales Ferox Semen,Armeniacae Amarum Semen,Citri Reticulatae Pericarpium,Pinelliae Rhizoma Praeparatum,Salviae Miltiorrhizae Radix,Rubi Fructus and Poria.2.The results of network pharmacology showed that the effective components of the core prescription for the early stage renal damage in MS were mainly Quercetin,Diosmetin,β-Sitosterol,Myricetin,and Danhong Injection,and the key target genes shared by the two were PTGS2,PTGS1,HSP90AA1,NCOA2,etc.The protein interaction network showed that the key protein targets were STAT3,MYC,HIF1 A,ESR1,etc.The GO and KEGG enrichment analyses showed that the key pathways for the mechanism of action were PI3K-Akt,AGEs-RAGE,TNF,HIF-1,IL-17,etc.Conclusions:1.The main characteristics of Professor Song Liqun ’s treatment of early stage renal damage in MS were warm nature and neutral nature of the four qi,sweet and bitter flavors of the five flavors,and the meridians involved were the spleen meridian,liver meridian,and kidney meridian.The key drug combination was Atractylodis Macrocephalae Rhizoma-Astragali Radix.2.Professor Song Liqun believes that the early renal damage of MS is the syndrome of deficiency,deficiency and deficiency mixed with deficiency and deficiency,and should be treated with flexible legislation based on the principle of fuzheng,dispelling evil,attacking and tonifying.3.Astragali Radix,Atractylodis Macrocephalae Rhizoma,Euryales Ferox Semen,Armeniacae Amarum Semen,Citri Reticulatae Pericarpium,Pinelliae Rhizoma Praeparatum,Salviae Miltiorrhizae Radix,Rubi Fructus and Poria were the core formula for the treatment of early stage renal damage in MS by Professor Song Liqun.4.The results of network pharmacology showed the mechanism of core prescription for treating early renal damage in MS may be through regulating the expression of cellular biomolecules such as PTGS2,PTGS1,HSP90AA1 and regulating signaling pathways such as PI3K-Akt,AGE-RAGE,TNF,IL-17,HIF-1 through active ingredients such as quercetin,β-sitosterol and luteolin in drugs.Intervention of oxidative stress,inflammation,atherosclerosis,apoptosis,etc,multi-component,multi-target,multi-channel to improve early renal damage in MS.