Network Pharmacology Analysis And Effectiveness Evaluation Of Erigeron Breviscapus In The Treatment Of Vascular Dementi

Erigeron breviscapus was first recorded in "Diannan Materia Medica",also known as Dengzhan Flower.Named after its flowers resembling lamps and roots resembling asarum,it is a dried whole herb of Erigeron breviscapus in the composite family.As a plant medicinal herb with special therapeutic effects in treating and preventing cardiovascular and cerebrovascular diseases,it has broad market prospects and high economic value.The 1977 edition of the Chinese Pharmacopoeia was included,and the 2005 edition was re included.At present,the main types of Erigeron breviscapus preparations include Erigeron breviscapus injection,Erigeron breviscapus tablets,Erigeron breviscapus granules,Erigeron breviscapus injection,Erigeron breviscapus tablets,Erigeron breviscapus dispersible tablets,Erigeron breviscapus phenol for injection,Erigeron breviscapus powder injection,and Erigeron breviscapus Shengmai capsules,which are compound preparations mainly composed of Erigeron breviscapus.The main component of Erigeron breviscapus is breviscapine,which is a flavonoid component isolated from it.It mainly contains breviscapine(4,5,6-trihydroxyflavone-7 glucuronide),a small amount of breviscapine,and other flavonoid components.Animal experiments show that breviscapine can reduce cerebrovascular resistance,increase cerebral blood flow,improve cerebral blood circulation,improve cerebral circulation and normal blood supply,while maintaining the normal level of arterial blood pressure.Rabbits caused microcirculatory damage with dextran.After injection of breviscapine,the blood flow in capillaries and venules gradually returned to a stagnant state,and the blood flow rate accelerated,gradually approaching normal.Breviscapine can improve the permeability of blood brain barrier,resist platelet aggregation and hyperviscosity caused by adenosine diphosphate,and inhibit thrombosis;Effectively reduce plasma viscosity,hematocrit,platelet aggregation rate,and fibrinogen in patients with cerebral infarction,and inhibit abnormal lipoprotein metabolism in patients with ischemic cerebrovascular disease.Traditional Chinese medicine syndrome differentiation found that the therapeutic effect of this medicine on dementia with "blood stasis syndrome" is significantly higher than that of the group without "blood stasis syndrome".When using Erigeron breviscapus injection in clinical practice,there have been occasional adverse reactions,including high fever,chills,palpitations,chest tightness,dizziness,headache,dry mouth,fatigue,skin itching,rash,skin flushing,limb contracture pain,etc.As early as the early 1980s,the World Health Organization announced that cerebrovascular diseases were the "first killer" of human health and ranked as the first cause of disease death.The increase in cerebrovascular patients has led to an increase in demand for such drugs.The sales of vascular drugs in China are second only to those for treating colds and gastrointestinal diseases,ranking third.So the demand for traditional Chinese medicine Erigeron breviscapus and its preparations in the pharmaceutical market is also growing.However,based on the small sample size of these studies,lack of long-term follow-up,and heterogeneity analysis between studies,evaluation and recommendations cannot be made.With the above questions in mind,this study conducted network pharmacology and evidence-based medicine research on the efficacy of Erigeron breviscapus in the treatment of vascular dementia,including the following parts:Research objectiveThis project aims to explore the active ingredients and target effects of Erigeron breviscapus in the treatment of vascular dementia through network pharmacology research,providing a theoretical basis for Erigeron breviscapus in the treatment of vascular dementia.This topic conducts a comprehensive and systematic qualitative evaluation of randomized controlled studies on the treatment of vascular dementia with Erigeron breviscapus through literature collection,organization,and statistical analysis.At the same time,quantitative analysis and comparison of eligible studies are conducted to provide reliable evidence-based medical basis for objectively evaluating the effectiveness and safety of Erigeron breviscapus in the treatment of vascular dementia.Research methodNetwork pharmacology analysis method:the compounds in Erigeron breviscapus were screened by using literature retrieval tools and the Chinese medicine Systems pharmacology database and analysis platform(TCMSP),and the corresponding targets and vascular dementia related targets of the compounds in Erigeron breviscapus were integrated from DrugBank,TTD,Genecards,OMIM,DisGeNET,KEGG,GAD and other databases,Utilize Metascape for GO functional enrichment analysis and KEGG pathway enrichment analysis,and finally construct a visualized signal pathway map related to traditional Chinese medicine disease targets.Meta analysis:A randomized controlled study was conducted by searching the China National Knowledge Infrastructure(CNKI),Wanfang Medical Database,VIP Information Chinese Science and Technology Journal Database,China Biomedical Literature Database(CBM),and Pubmed Database to screen for the treatment of vascular dementia from liver and kidney based on the inclusion criteria.After evaluating the quality of the included literature,the researchers extracted relevant information and used RevMan5.3 software for meta-analysis.Research resultsNetwork pharmacology:11 active ingredients and 45 vascular dementia related targets were screened from Erigeron breviscapus.The core genes used in the treatment of vascular dementia by Erigeron breviscapus mainly include TNF,KCNH2,RUNX1T1,ACACA,VCAM1,ACP3,PCOLCE,NCOA1,PYGM,LTA4H,CHRNA2,RXRG,PSMG1,PRKAB2,BAG1,CDK15,RPL11,RPL15,RPL3,GNMT,PRMT1,PAPSS1,ADCY1,AHCY,GABRA2,GABRA3,GABRA5 TUBA4A,CBR1 PRKAR2B,GABRB1,GABRB2,CCL8,ABCG1,TRPM7,ABCC4,RPL23A,ISYNA1,ESRRG,VCP,IMPDH2,RARG,GPBAR1,ADAM28,ABL2,etc.The GO functions involved in TCM disease targets mainly include aminobutyric acid signaling pathway,response to acidic chemicals,chronic inflammatory reaction,purine ribonucleoside metabolism,purine containing compound metabolism,ribosome large subunit assembly,intracellular lipid transport behavior,response to ketones,protein tetramerization,viral genome replication,vitamin metabolism,negative regulation of cell differentiation The signal transduction of mediators and the acquisition of energy through the oxidation of organic compounds.The KEGG pathway involved in TCM disease target mainly includes nicotine addiction pathway,glucagon signaling pathway,ribosome signaling pathway,adipocytokines signaling pathway,purine metabolism pathway,HTLV-I infection pathway,etc.Proved the characteristic of the "multi component,multi target" overall effect of Erigeron breviscapus on vascular dementia.Meta analysis:1173 references were included;After reading the title and abstract,44 articles were included in the initial screening;Further reading of the entire article resulted in the inclusion of 20 articles.The literature review has heterogeneity,using a random effects model and a funnel plot showing publication bias.Erigeron breviscapus can effectively improve the scores of the Simple Mental State Intelligence Scale(MMSE)in patients with vascular dementia(P<0.00001),indicating that Erigeron breviscapus is suspected to improve the dementia symptoms of patients;However,there was no statistically significant difference(P=0.95)in the results of the ADL scale for vascular dementia patients,and it is unknown whether it can improve the patient’s ability to live independently;The effective rate of treating vascular dementia is higher than that of the control group(P=0.003);The incidence of adverse reactions in the treatment of vascular dementia was not statistically significant compared to the control group(P=0.78),and there were no serious adverse reactions.The main symptoms were mild and generally improved on their own.Therefore,the preparation of Erigeron breviscapus can improve memory and cognitive function in patients with vascular dementia,which is statistically significant compared to the control group.However,whether it can improve self-care ability is still unknown,and there is no statistically significant difference between the experimental group and the control group.The two results are less affected by publication bias;Although there are side effects in the treatment of vascular dementia with Erigeron breviscapus,the symptoms are mild and generally do not affect continued medication treatment.Research conclusionThe molecular mechanisms of Erigeron breviscapus in treating vascular dementia are diverse,providing a theoretical basis for modern research on the treatment of vascular dementia with traditional Chinese medicine.Erigeron breviscapus has good clinical efficacy and minimal side effects in the treatment of vascular dementia,and is worthy of clinical recommendation.