Exploring The Prescription Rules Of Professor Gao Tianshu In The Diagnosis And Treatment Of Graves' Disease And Blood Proteomics Research Based On Data Minin

Purpose:Based on data mining technology,the compatibility law of Gao Tianshu’s treatment of Graves’disease was analyzed,and the potential mechanism of the recipe of nourishing Yin,reducing fire and dispersing knot with iodine-rich herbal medicines for Graves’disease was explored by blood proteomics technology.Material and method:The first part of our study collected 85 patients with Graves disease treated by Professor Gao Tianshu in the outpatient department of endocrinology of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from September2020 to October 2021.Input the cases’information into the software of"Traditional Chinese Medicine Inheritance Calculation Platform V3.0",process and analyze the data through the data statistics module of the platform,and then count the syndromes of 85 patients;The types of drugs in the prescription,four Qi,five flavors,and meridian tropism;Frequency of single drug use;Analyze the association rules between drugs and core prescriptions.The second part of the study continued to screen the patients with Graves disease according to the most common syndrome type obtained in the first part of the study,and treated the patients with simple traditional Chinese medicine compound for one month,collecting the basic information of the patients,the laboratory examination results before and after treatment and the results of thyroid ultrasound,The blood proteomics technology was used to compare and analyze the blood of patients before and after treatment,so as to evaluate the differential expression of blood protein after the intervention of the recipe of nourishing Yin,reducing fire and dispersing knot with iodine-rich herbal medicines.Results:1.The most common clinical syndromes of Graves’disease are Yin deficiency and fire burning with phlegm coagulation syndrome,followed by heart and liver fire burning syndrome and Qi and Yin deficiency syndrome.The top 5 kinds of TCM application frequency in descending order were clearing heat,resolving phlegm,relieving cough and relieving asthma,tonifying deficiency,calming liver and dispelling wind,promoting blood circulation and removing stasis.In the statistical frequency of four Qi drugs,"cold"drugs were the most frequently used,followed by"flat"drugs and"warm"drugs.In the classification of meridian,drugs entering liver meridian were the most frequently used.Lily,anemarrhena anemarrhena,Prunella subtilis,Hedyotis bungeana,rehmannia glutinosa,radix scrophulariae,Fritillaria thunbergii,oyster,seaweed and kelp were the classical rules of Gao Tianshu’s prescription for Graves’disease.2.After receiving the recipe of nourishing Yin,reducing fire and dispersing knot with iodine-rich herbal medicines for one month,the levels of serum FT₃,FT₄,TRAb,thyroid volumes and STA-PSV decreased significantly,the level of serum TSH increased significantly,and the levels of serum TGAb and TPOAb were not significantly different from those before treatment.3.Compared with NC group,106 proteins in V1 group were significantly over-expressed and93 proteins were significantly under-expressed by high-throughput quantitative blood proteomics.Compared with NC group,58 proteins were significantly higher and 45 proteins were significantly lower in V3 group.Compared with V1 group,36 proteins were significantly higher and 31 proteins were significantly lower.According to the results of the bioinformatics analysis differentially expressed proteins in biological process classification function mainly involves the cell process,biological process function regulation,stress reaction,multicellular organisms,positioning function,development process,signal transduction,immune and metabolic process,process of biofouling,multiple organ,cell migration,etc.;In cell composition classification,differentially expressed proteins are mainly located in cells,intracellular and protein-containing complexes.In molecular function classification,differentially expressed proteins mainly have the functions of protein binding,catalytic activity,molecular transduction activity,structural molecular activity,signal transduction activity and protein folding chaperone.COG/KOG results indicated that the functional classification of differential proteins mainly focused on signal transduction mechanism（13 differential proteins）,post-translational modification,protein transport,molecular chaperone（8 differential proteins）,cytoskeleton（5 differential proteins）,and energy production and conversion（5 differential proteins）.GO enrichment:The most significant enrichment in biological processes is the reactivity to cyclic adenosine phosphate（c AMP）,interleukin-6,negative regulation of intracellular transport,and testosterone.The concentration of proenzyme particles,polyribosomes,excitatory synapses and endoplasmic reticulum lumen were significant in cell composition.Steroid receptor binding,nuclear hormone receptor binding,hormone receptor binding,purine nucleoside triphosphate binding and so on were found to be significantly enriched in molecular functions.KEGG enrichment:The involvement of differentially expressed proteins in KEGG pathway is related to c AMP signaling pathway,epithelial cell signal transduction in Helicobacter pylori infection,gastric acid secretion,adrenergic signal transduction in cardiomyocytes,c GMP-PKG signaling pathway,and neuronal axonal orientation.Conclusion:1.Yin deficiency and fire burning with phlegm coagulation syndrome,heart and liver fire burning syndrome and Qi and Yin deficiency syndrome are the main syndromes among GD patients,and Yin deficiency and fire burning with phlegm coagulation syndrome is the most common one.Therefore,in clinical treatment,we should examine the evidence and seek the cause,and firmly grasp the treatment method of nourishing Yin,reducing fire and dispersing knot.2.The recipe of nourishing Yin,reducing fire and dispersing knot with iodine-rich herbal medicines can affect the occurrence and development of Graves’disease through multiple targets and pathways.Rap1b may be a potential target of the recipe.