Title:Network Pharmacology Analysis and Retrospective Cohort Study Revealing the Effect of Qingyi Decoction on Intestinal Paralysis in Patients with Severe Acute Pancreatitis
Volume: 30
Issue: 42
Author(s): Shihan Du, Dinghuan Zhao, Kai Song, Yuan Zhang, Lina Wu, Bei Wang, Yan Li and Jianbo Yu*
Affiliation:
- Department of Anesthesiology and Critical Care Medicine, Tianjin Nankai Hospital, Tianjin Medical University, Tianjin, China
- Institute of Integrative Medicine for Acute Abdominal Diseases, Tianjin 300100, China
- Tianjin Key Laboratory of Acute
Abdomen Disease Associated Organ Injury and ITCWM Repair, Tianjin Nankai Hospital, Tianjin 300100, China
Keywords:
Severe acute pancreatitis, intestinal paralysis, Qingyi decoction, network pharmacology, molecular docking, inflammation.
Abstract:
Background: Intestinal dysfunction plays an important role in the clinical progress and prognosis
of severe acute pancreatitis (SAP). Qingyi decoction (QYD) has shown beneficial effects on intestinal function
recovery, but the prevention actions of the QYD on intestinal paralysis and its mechanism have not been fully
explored.
Methods: The possible molecular mechanism was unraveled by network pharmacology, including active ingredients
and potential target prediction, as well as GO, KEGG, and REATCOME pathway enrichment analyses.
The potential interactions between the main active ingredients of the QYD and core genes were explored by
molecular docking. A retrospective cohort study on 137 patients with SAP from Tianjin Nankai Hospital was
conducted to evaluate the preventive effect of QYD on intestinal paralysis.
Results: A total of 110 active ingredients in QYD were screened out, and 37 key targets were predicted by network
pharmacology. GO, KEGG, and REATCOME enrichment analyses showed that bioinformatics annotation
of the hub genes was mainly involved in intestinal epithelial functions and inflammatory response pathways.
The main components of QYD possessed good affinity with IL-6, TNF, CASP3, CXCL8, and CRP by
molecular docking. Patients who used QYD plus usual care seemed to have fewer intestinal paralysis rates,
lower risk of renal insufficiency, ARDS and blood purification therapy, and shorter hospital and ICU stays.
The multivariable regression analyses indicated that the mode of nasogastric and enemas administration of
QYD (P = 0.010) and timely intervention with QYD (P = 0.045) were the independent protective factors for intestinal
paralysis prevention in patients with SAP.
Conclusion: In conclusion, QYD can be used as an effective adjuvant procedure to prevent the occurrence and
development of intestinal paralysis in patients with SAP. The mechanisms may be involved in the anti-inflammatory
response and maintenance of intestinal epithelial function.
