Research On Professor Wang Chengxiang's Experience In Treating Pulmonary Nodules Based On Data Mining And Network Pharmacolog

Purpose and significance of the study:1 To summarize Professor Wang Chengxiang’s experience in the treatment of pulmonary nodules,such as his clinical ideas and commonly used combinations of Chinese medicine,and to refine the core prescription of Professor Wang Chengxiang in treating pulmonary nodules,so as to provide reference for the clinical diagnosis and treatment of pulmonary nodules,and then enrich the theoretical connotation of Chinese medicine in the treatment of pulmonary nodules;2 To explore the mechanism and targets of Professor Wang Chengxiang’s core prescriptions for the treatment of lung nodules by using network pharmacology methods,verify the effectiveness of the core prescriptions from the molecular level,so as to help the early diagnosis and treatment of lung cancer,with the aim of reducing the incidence and mortality of it.Methods:1 Data mining method was used to collect outpatient cases from September 2020 to September 2022 from the respiratory clinic of Prof.Wang,and after establishing a medical case database and standardizing it,the basic information of patients such as age and gender and disease information such as symptoms,tongue,pulse,past medical history and auxiliary examination data were counted using the ancient and modern medical case cloud platform(V2.3.5)to analyze the distribution of patients with pulmonary nodules and the information of four consultations;The attributes of the prescribed herbal medicines were statistically analyzed for their four qi,five tastes,attribution and efficacy information and bias;the prescribed herbal medicines were presented in a complex network.The high-frequency herbal medicines were subjected to systematic cluster analysis and dimensionality reduction factor analysis using IBM SPSS Statistics software,combined with IBM SPSS Modeler software to analyze the prescription drug information by association rules to derive high-frequency drug combinations and analyze the connotations of the dispensing.2.Network pharmacology method was adopted to retrieve core prescription chemical components and corresponding targets using databases such as TCMSP,and relevant targets related to pulmonary nodular disease were retrieved using databases such as Gene Cards.After the above target information was normalized by Uniprot database,the intersection targets of the two were selected for correlation analysis as follows:Cytoscape3.9.0 software was used to construct drug component target network and screen out core drug components.The drugdisease protein interaction network was constructed based on String database and Cytohubba plug-in,and HUB gene was screened.By means of Metascape gene function annotation analysis tool,GO function and KEGG pathway enrichment analysis were performed on potential targets of core prescription for pulmonary nodules,and their molecular functions and action pathways were verified.Finally,Cytoscape3.9.0 was used to construct the componenttarget-pathway network to visualize the mechanism of action of the core prescription in treating pulmonary nodules.Results:1 The data mining results showed that:For basic patient information and four consultation data:133 medical cases of pulmonary nodules were included,in which there are 133 visits and 304 consultations met.Among them,there were 50 male patients and 83 female patients,the maximum age of patients was 91 years old and the minimum age was 28 years old;87 kinds of clinical manifestations were involved,with a total frequency of 1362 occurrences and a total of 21 symptoms with a frequency of≥20,of which the top 10 were thirst,cough,little or no sputum,no special discomfort,chest tightness,insomnia,shortness of breath,pharyngeal discomfort,mouth bitterness,and weakness,in that order;16 kinds of tongue texture,tongue coating 25 types of tongue texture,23 types of tongue coating,23 types of pulse,and 21 disease mechanisms;In the prescriptions of Professor Wang Chengxiang for the treatment of pulmonary nodules,the four qi of Chinese medicine are mainly warm,followed by flat and cold;the five tastes are mainly bitter,followed by pungent and sweet;the main channels are the lung channel,followed by the spleen and stomach channels;the effects are mainly to clear heat and detoxify and dry dampness and resolve phlegm;the total frequency of use is 5,423 times,involving 155 kinds of drugs,The top ten in order are Licorice,pinellia,tangerine peel,Citrus aurantium,Poria,Party Ginseng,Fritillariae Thunbergii,Scrophularia,Dandelion and Coix seeds;the results of clustering and factor analysis of high-frequency Chinese medicine systems are roughly the same and the following four combinations were analyzed:Scrophularia-Fritillariae Thunbergiioyster-pinellia-Poria-tangerine peel-dandelion-prunella vulgaris-Sculellaria barbataOldenlandia diffusa-Coix seeds-Party Ginseng;Cyperus rotundus-Perilla stems;Dried Ginger-Coptis chinensis;Eustoma-Citrus aurantium-Licorice.2 The results of the network pharmacological study showed thatThe core prescription contains 104 active ingredients,262 targets corresponding to drug ingredients,1121 targets for pulmonary nodule diseases,and 118 targets for intersection of drugs and diseases.The 22 HUB genes were screened by the high intersection target frequency of CytoHubba algorithm,and further obtained 15 key HUB genes according to the ranking of MCC value,they are TNF,IL6,IL10,RELA,MAPK3,TP53,MAPK1,MAPK14,MYC,ESR1,NFKB1,HIF1 A,NFKBIA,AKT1 and CDKN1A;Based on the potential targets of core prescription for the treatment of pulmonary nodules,20 key active ingredients were screened based on degree centrality,proximity centrality and mesocentricity,among which,quercetin,lignocaine,kaempferol,baicalein,naringenin and luteolin were ranked in the top 8.GO function and KEGG enrichment results showed that the genes of core prescription for lung nodules were mainly enriched in cell migration,protein phosphorylation,and regulation of biological processes such as foreign body stimulation,inflammation,hypoxia,and trauma response,which were associated with cellular components such as membrane rafts,vesicle lumen,serine/threonine protein kinase complex,and Bcl-2 family protein complex enriched by GOCC,and GOMF The 188 enriched pathways can be divided into four major categories:lung cancer,prostate cancer and other cancer-related pathways;human cytomegalovirus infection,influenza A and other virus-related pathways;and PI3K-A pathways.The 188 enriched pathways can be divided into four major categories:cancer-related pathways such as lung cancer and prostate cancer;virus-related pathways such as human cytomegalovirus infection and influenza A;classical signaling pathways such as PI3K-Akt and IL-17;and other diseaserelated pathways such as hepatitis B,lipid and atherosclerosis.Conclusion:1 Professor Wang takes the Healthy-Qi Reinforcing and Phlegm-Resolving Method as the guiding principle to treat pulmonary nodules.while paying attention to the important role of the lung and spleen in the operation of qi,blood and fluids,using treatments such as resolving phlegm and dispersing nodules,clearing heat and detoxifying toxins,tonifying the lung and spleen,regulating qi and broadening the middle,and drying dampness and eliminating lumpiness to treat pulmonary nodules in a comprehensive manner.2 The core prescription may treat pulmonary nodules by modulating cancer-related pathways and delaying the progression of nodular transformation,and may also treat the causes of pulmonary nodules such as cancer,viruses and infections through PI3K/Akt,IL-17 and TNF signaling pathways to block the occurrence and development of pulmonary nodules,and its therapeutic effects at the molecular level have been clarified and can be further verified by animal experiments and clinical trials.