Clinical Medication Mechanism of Traditional Chinese Medicine in Treatment of Diabetic Nephropathy with Qi and Yin Deficiency and Blood Stasis Based on Medication Network,Target Network,and Molecular Docking Technology
Objective:To analyze the prescription rules and specific pharmacological mechanisms of traditional Chinese medicine(TCM)in the treatment of diabetic nephropathy(DN)with Qi and Yin deficiency and blood stasis by integrating the medication network and target network,so as to provide a scientific basis for clinical treatment and reference for new drug research and development.Methods:"Diabetic nephropathy""Qi and Yin deficiency",and"blood stasis"were used as the theme words to extract prescriptions that met the criteria from the relevant literature in the databases of China National Knowledge Infrastructure(CNKI),China Science and Technology Journal Database,and Wanfang Medicine,and a prescription database was established.The ancient and modern medical case cloud platform was utilized to conduct data statistics and correlation analyses of the medication network to screen out core pairs and core prescriptions.The active chemical components and related targets of the core prescriptions and the targets of DN were screened by TCMSP,Genecards,OMIM,and TTD databases,and the intersecting targets were taken.Cytoscape 3.9.1 software and related plug-ins were used to construct the drug-active component-intersecting target-disease network and protein-protein interaction(PPI)network of intersecting targets.Cluster analysis,gene ontology(GO)function enrichment analysis,and Kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis were performed.Results:Finally,229 pieces of literature were included,and 172 prescriptions involving 379 TCM.Among the high-frequency drugs in the treatment of DN with Qi and Yin deficiency and blood stasis,the drugs were mostly plain,cold,slightly cold,and warm,and the tastes were mostly pungent,sweet,and bitter.The commonly used combinations were Salviae Miltiorrhiza Radix and Astragali Radix,Alismatis Rhizoma and Poria,and Angelicae Sinensis Radix and Astragali Radix.The core prescription in the treatment of DN with Qi and Yin deficiency and blood stasis was obtained from the analysis of the medication network as follows:Liuwei Dihuang Decoction combined with Danggui Buxue Decoction+Radix Salviae Miltiorrhiza+Rosae Laevigatae Fructus+Euryales Semen.The key components of the core prescription were quercetin,kaempferol,luteolin,alisol B,and formononetin,and the core targets were cytoskeletal actin(ACTB),Janus kinase(JAK2),intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM1),interleukin 4(IL-4),and other key protein targets,which may be involved in AGEs-RAGE signaling pathway,JAK-STAT signaling pathway,and so on.The molecular docking results showed that JAK2,ICAM-1,VCAM1,and IL-4 among the core targets predicted by network pharmacology were stably bound to the key active components.Conclusion:The core prescription of TCM for the treatment of DN with Qi and Yin deficiency and blood stasis can exert therapeutic effects through multiple active components,acting on multiple targets and pathways,which can provide a theoretical basis for the application and development of drugs for the clinical treatment of DN.
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