Meta Analysis And Network Pharmacological Study On The Treatment Of Idiopathic Membranous Nephropathy With The Method Of Tonifying Spleen And Kidney

Objective:1.Study 1: systematically evaluate whether the traditional Chinese medicine of invigorating the spleen and kidney combined with western medicine is superior to western medicine alone in the treatment of idiopathic membranous nephropathy.2.Study 2,based on the literature research,to explore the drug thinking of the syndrome of deficiency of spleen and kidney in idiopathic membranous nephropathy.3.Study 3: carry out network pharmacology research based on the basic formula excavated in study 2,with a view to clarifying its mechanism of action.Methods:1.Study 1: Search multiple databases at home and abroad,and the search time is limited from the beginning of the database to June 2022,so as to obtain the clinical research on the treatment of idiopathic membranous kidney disease by invigorating the spleen and kidney.Two researchers filtered the documents that meet the research requirements according to the inclusion criteria and exclusion criteria,and used RevMan5.4 software for meta-analysis.2.In study 2,extract the prescription of traditional Chinese medicine for IMN treatment with invigorating spleen and kidney method included in study 1,standardize the prescription and name of traditional Chinese medicine and enter it into Microsoft Excel 2020,and count the frequency of use and the taste of traditional Chinese medicine,and use statistical software to conduct association rule analysis and drug cluster analysis to obtain the core formula of drug combination and invigorating spleen and kidney method for IMN treatment.3.Study 3: Carry out network pharmacology research on the core prescription of invigorating the spleen and kidney to treat IMN,find relevant compounds and action targets,find IMN disease targets at the same time,build the regulatory network of the core side to regulate IMN,build PPI network for the intersection targets,and enrich and analyze GO and KEGG pathways.Results:1.A total of 54 articles were included,with a total sample size of 3410 cases,including 1749 cases in the test group and 1661 cases in the control group.The analysis results showed that the traditional Chinese medicine decoction of invigorating spleen and kidney combined with conventional western medicine treatment group was superior to western medicine treatment alone in improving clinical symptoms,24-hour urine protein,serum albumin,triglyceride,low density lipoprotein,blood creatinine,urea nitrogen,etc.2.The analysis of 54 prescriptions of traditional Chinese medicine for the treatment of IMN by invigorating the spleen and kidney showed that the drugs with higher frequency were astragalus,poria cocos,atractylodes macrocephala,codonopsis pilosula,etc.The properties of the medicine are mostly warm and mild,and the taste of the medicine is mostly sweet and bitter.According to the analysis of association rules,the basic formula is Huangqi-Rehmannia glutinosa-Cornus officinalis-Poria cocos.3.In this network pharmacology study,a total of 59 active compounds and regulatory networks were selected from the core formula of Astragalus membranaceus-Rehmannia officinalis-Cornus officinalis-Poria cocos,a total of 67 overlapping targets,and 10 key core targets were selected as IL6,ESR1,HIF1 A,etc.67 intersection targets were analyzed.74 entries were obtained.KEGG obtained 127 pathways,and the significantly enriched pathways included chemical carcinogenesis-receptor activation,lipid and arteriosclerosis.Conclusion:This study discussed that the traditional Chinese medicine decoction of invigorating the spleen and kidney combined with conventional western medicine in the treatment of idiopathic membranous kidney disease is superior to western medicine alone in improving clinical symptoms and laboratory indicators.This paper analyzed the medication rules of the traditional Chinese medicine decoction for invigorating the spleen and kidney in the treatment of idiopathic membranous kidney disease,and preliminarily explored the effect of Astragalus membranaceus-Rehmannia officinalis-Cornus officinalis-Poria cocos in the treatment of idiopathic membranous kidney disease(IMN)based on network pharmacology through the effective components such as quercetin and stigmasterol acting on targets such as IL6,ESR1,HIF1 A,and the mechanism of this prescription may be related to the signal transduction pathways such as chemical carcinogenesis-receptor activation,lipid and arteriosclerosis.