Exploration of Medication Rules of ZHU Wenzong in Treating Neuropathic Insomnia Complicated with Anxiety and Its Mechanism Based on Data Mining and Network Pharmacology
Abstract: Objective: To explore the medication rules of Professor ZHU Wenzong in treating neuropathic insomnia complicated with anxiety and its mechanism by data mining technology and network pharmacology. Methods: The Chinese medicine prescriptions for patients with neuropathic insomnia complicated with anxiety by Professor ZHU at the Outpatient Department of Wenzhou Traditional Chinese Medicine Hospital of Zhejiang Chinese Medical University from February 2020 to December 2022 were collected, where the frequency of Chinese medicinals used was counted by the Traditional Chinese Medicine Inheritance Computing Platform V3.0,and association rule analysis for core medicinal groups was carried out by using the software IBM SPSS Modeler 18.0. The active components and corresponding targets of core medicinal groups were predicted on the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP); the disease-related targets were obtained by searching the DrugBank database, Genome Annotation Database Platform (GeneCards), Therapeutic Target Database (TTD), and Online Mendelian Inheritance in Man (OMIM). Using the software Cytoscape 3.9.1, the disease-core medicines-components-targets network was established by importing the active components and corresponding targets of core medicine and medicine-disease intersecting targets. The network analysis of protein-protein interaction (PPI) was conducted by importing the medicine-disease intersecting targets into the STRING database. The enrichment analysis of Gene Ontology (GO) function and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway was carried out by importing the medicinedisease intersecting targets into the Metascap database. Results: A total of 308 prescriptions were included and 174 Chinese medicinals were involved,with accumulated times of use of 4 064. Among them, a total of 20 Chinese medicinals were highly used for more than 60 times,and the top 5 were subsequently Glycyrrhizae Radix et Rhizoma, Pinelliae Rhizoma, Scutellariae Radix, Bupleuri Radix and Codonopsis Radix. The 174 Chinese medicinals were analyzed for their nature, flavor and channel entries, which showed that they were mainly warm, followed by neutral and slightly cold in nature; the majority was acrid, followed by bitter and sweet in flavor; the channel entries were mainly the lung and spleen, followed by the heart, liver and stomach. The association rules analysis and complicate network analysis showed that the core medicinal group was Pinelliae Rhizoma-Scutellariae Radix-Bupleuri Radix- Codonopsis Radix, which was given the network pharmacology analysis, and the results showed that there were 63 medicine-disease intersecting targets and active components, mainly including stigmasterol, quercetin and β-sitosterol. There were 15 core targets obtained by PPI network analysis, including vascular endothelial growth factor A (VEGFA), interleukin-8 (IL8), prostaglandin G/H synthase 2 (PTGS2), interleukin-1β (IL1β), amyloid- β precursor protein (APP), sodium-dependent dopamine transporter (SLC6A3), sodium-dependent serotonin transporter (SLC6A4), cytochrome P450 3A4 (CYP3A4), interleukin-6 (IL6), neuronal acetylcholine receptor subunit alpha-7 (CHRNA7), caspase-3 (CASP3), 5-hydroxytryptamine receptor 2C (HTR2C), estrogen receptor (ESR1), interleukin-10 (IL10), and tumor necrosis factor (TNF). The results of GO function enrichment analysis showed that the core medicine group may play a role by affecting synaptic membrane, dendrite, receptor complex and neurotransmitter receptor activity. The results of KEGG pathway enrichment analysis showed that the core medicine group may affect neuropathic insomnia complicated with anxiety by the neuroactive ligandreceptor interaction and pathways of multiple diseases-neurodegeneration. Conclusion: The treatment methods of Professor ZHU in treating neuropathic insomnia complicated with anxiety are mainly fortifying the spleen and regulating qi,and boosting qi and tonifying yin,supplemented with soothing the liver and harmonizing the stomach, and nourishing the heart and calming the mind. The commonly used core medicine group was Pinelliae Rhizoma,Scutellariae Radix,Bupleuri Radix and Codonopsis Radix,whose core active components may exert its curative effects by mainly acting on the synapses and protoplasmic dendrites of neurons, and affecting the activity of neurotransmitter receptors through neuroactive ligandreceptor interaction and other pathways, which fully presents the synergism of multiple components, targets and pathways in the treatment with Chinese medicine.