ABSTRACT
Objective:To analyze the effective active ingredients of Belamcandae Rhizoma and Ephedrae Herba couplet medicines(BREH)in the treatment of bronchial asthma based on network pharmacology, in order to predict their potential targets and explore the mechanism. Method:Active ingredients and predict their targets were collected from traditional Chinese medicine system pharmacology(TCMSP) database. Drugs-components-targets network and Proteins interations network were built by STRING database and Cytoscape software. ClusterProfiler and ClueGO was used to enrich the biological function and metabolic pathway of core targets. Finally, candidate targets were mapped onto the pictures of correlative pathways. Result:The 38 effectively active ingredients were screened out, including luteolin, stigmasterol, diosmetin, naringenin, quercetin, iristectorigenin A, isorhamnetin. There were 214 candidate targets relating to bronchial asthma, and 55 core ones were selected to be mainly studied, including RAC-alpha serine/threonine-protein kinase (Akt1), tumor necrosis factor (TNF), mitogen-activated protein kinase 1 (MAPK1), vascular endothelial growth factor A (VEGFA), interleukin-10 (IL-10), NF-kappa-B inhibitor alpha (NFKBIA), and a number of relevant gene ontology(GO) functions and Kyoto Encyclopedin of Genes and Genomes(KEGG) pathways were enriched. Conclusion:BREH may regulate the Th1, Th2 and Th17 cell differentiations, Asthma, IL-17, phosphatidylinositol-3-kinases(PI3K)/Akt, MAPK, NF-κB, VEGF signaling pathways, so as to interfere the process of cell metabolism, and inhibit gene expression of proinflammatory factor in the treatment of bronchial asthma.
ABSTRACT
The randomized controlled trials( RCTs) about modified Sanzi Yangqin Decoction in the treatment of patients with exacerbation of chronic obstructive pulmonary disease( AECOPD) were collected from 7 databases( PubMed,CNKI,etc.) till December25,2018 from their inception. All the studies searched were strictly evaluated and independently screened by two researchers according to the inclusion and exclusion criteria,and the methodological quality of included studies was evaluated. In order to systematically review the efficacy and safety of modified Sanzi Yangqin Decoction for treating AECOPD,the Meta-analysis and trial sequential analysis were conducted by using Stata/SE 14. 0 and TSA 0. 9. 5. 10 Beta,respectively. A total of 22 RCTs involving 2 012 patients were included. The results of Meta-analysis suggested that: as compared with the control group,the clinical symptoms in AECOPD patients were improved( RR = 1. 19,95%CI[1. 15,1. 24],P = 0); the pulmonary functions including forced expiratory volume in one second( FEV_1)( SMD= 0. 96,95%CI[0. 39,1. 52],P= 0. 001),the percentage of forced expiratory volume in one second( FEV_1%)( SMD =0. 80,95%CI[0. 20,1. 41],P = 0. 009),forced vital capacity( FVC)( SMD = 0. 69,95% CI[0. 06,1. 31],P = 0. 032),first seconds breathing volume percentage of forced vital capacity( FEV_1/FVC) were improved( SMD = 0. 81,95%CI[0. 64,0. 97],P = 0);the arterial oxygen partial pressure( PaO_2) was improved( SMD= 0. 87,95%CI[0. 41,1. 32],P= 0); the arterial partial pressure of carbon dioxide( PaCO_2) was decreased( SMD =-0. 91,95%CI[-1. 33,-0. 49],P = 0) in the trial group. In addition,the incidence of adverse reactions in the experimental group was low,and there were no serious adverse events. The trial sequential analysis( TSA) showed that the studies included in the improvement of clinical efficacy had passed the conventional and TSA threshold at the same time,further confirming the efficacy of trial group. This research showed that,conventional Western medicine treatment,combined with modified Sanzi Yangqin Decoction in treating acute exacerbation patients with chronic obstructive pulmonary disease could improve the clinical efficiency and pulmonary functions,improve the PaO_2,decrease the PaCO_2,with a high safety. However,the quality of existing research is low,requiring more high quality clinical trials for further validation.