Exploration of Medication Rules of Chinese Medicine in the Treatment of Rheumatic Heart Disease Based on Data Mining and Network Pharmacology Techniques and Its Mechanisms of Action
Abstract: Objective: To investigate the herbal medication rules and therapeutic mechanisms of Chinese medicine in the treatment of rheumatic heart disease (RHD) using data mining and network pharmacology techniques. Methods: Literature on RHD treatment was retrieved from databases including China National Knowledge Infrastructure(CNKI), Wanfang Data Knowledge Service Platform, China Science and Technology Journal Database (VIP), and China Biology Medicine disc (CBMdisc) to establish a prescription database. R language was employed to analyze Chinese herbal medicine using frequency,nature,flavor,channel entry,and association rules to identify core herbal combinations. Active components and targets of core Chinese herbal medicines were obtained from Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and Swiss Target Prediction platforms. RHD-related targets were collected from The Human Gene Database (GeneCards), Online Mendelian Inheritance in Man (OMIM),and DisGeNET. A protein-protein interaction (PPI) network was constructed and analyzed using STRING and Cytoscape 3.10.0, followed by topological analysis to screen core targets. Functional enrichment analysis of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways was performed using DAVID. Molecular docking was conducted to validate interactions between key active components and core targets. Results:A total of 99 prescriptions involving 189 Chinese herbal medicines were included. The Chinese herbal medicines are predominantly warm in property,sweet in flavor,and attributed to the lung,spleen,and heart meridians. Association rules revealed a core herbal combination: Poria-Cinnamomi Ramulus-Atractylodis Macrocephalae Rhizoma-Aconiti Lateralis Radix Praeparata -Salviae Miltiorrhizae Radix et Rhizoma. Network pharmacology identified 77 active components and 846 potential targets from the core herbal combination. Venn analysis revealed 237 overlapping targets between the 846 potential targets and 2 025 RHD-associated targets. Topological analysis of the PPI network highlighted 47 core targets, such as tumor necrosis factor (TNF), AKT serine/threonine kinase 1 (AKT1), etc. GO enrichment yielded 1 050 terms, and KEGG analysis revealed 170 signaling pathways. Molecular docking confirmed strong binding between key components and core targets. Conclusion:Chinese medicine in the treatment of RHD primarily follows the principles of invigorating the spleen and replenishing qi,warming yang to promote diuresis, as well as activating blood circulation to eliminate stasis. The core herbal combination of Poria- Cinnamomi Ramulus-Atractylodis Macrocephalae Rhizoma-Aconiti Lateralis Radix Praeparata -Salviae Miltiorrhizae Radix et Rhizoma exerts therapeutic effects of inhibiting oxidative stress, suppressing inflammation responses, and protecting cardiomyocytes by regulating atherosclerosis and TNF signaling pathways. The regulating effects are achieved through the action of key active components such as Deoxyandrographolide, Danshenol A, and Luteolin on targets including TNF,AKT1,epidermal growth factor receptor (EGFR),matrix metalloproteinase 9 (MMP9),and signal transducer and activator of transcription 3( STAT3)