Evaluation of the efficacy and potential mechanism of biyuan tongqiao granules in chronic sinusitis treatment based on Meta-analysis bridging network pharmacology
- JIANG Xuelian, ZHANG Jingyue, WEI Xudong
Journal of Otolaryngology and Ophthalmology of Shandong University. 2022, 36(3):
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Objective The efficacy of biyuan tongqiao granules and clarithromycin in the treatment of chronic rhinosinusitis was evaluated in this study. Based on Meta-analysis and network pharmacology, the potential mechanism of biyuan tongqiao granules and clarithromycin in chronic rhinosinusitis treatment was investigated. Methods Web of Science, PubMed, EMBASE, China journal full text database(CNKI), Vipers full text database(VIP), and Wanfang database literature(established since November 2021)were used to retrieve and screen the literature on chronic rhinosinusitis treatment using biyuan tongqiao granules. Randomized controlled trials(RCTs)were selected, and the quality of the literature that met the inclusion criteria was evaluated. Meta-analysis was performed for studies that met the quality criteria using RevMan 5.3 software. Target nasal abnormalities were screened using the TCMSP and BATMAN-TCM databases. Chronic sinusitis targets were screened using the GeneCards database, OMIM database, drug bank database, and PharmGKB database. Both targets, nasal abnormalities and chronic sinusitis, were screened using the FunRich software. The DAVID platform was used to conduct gene ontology biological processes, Kyoto gene, and genome encyclopedia pathway analysis on the shared targets of chronic rhinosinusitis. Key target screening was performed using the Cytoscape software. Results Eight original studies with a total of 1018 patients were included, among these 530 patients were in the treatment group and 488 patients in the control group. The clinical efficiency of biyuan tongqiao granules alone in the treatment group ［RR=1.15, 95%CI(1.05, 1.27］, Z=2.91, P=0.004)and the clinical efficiency of biyuan tongqiao granules combined with clindamycin in the treatment group ［RR=1.31. 95%CI(1.18, 1.45), Z=5.14, P<0.000 01］ were significantly different. The VAS scores(MD=-7.15, 95%CI(-8.22, -6.08), Z=13, P<0.000 01)in the treatment group for biyuan tongqiao granules combined with clindamycin and in the control group for clindamycin were also significantly different. The Lund-Kennedy score ［MD=-2.68, 95%CI(-4.64, -0.72), Z=2.68, P=0.007］ was significantly different. Network pharmacology identified a total of 48 targets and the KEGG-enriched pathways included the HIF-1 signaling pathway, Toll-like receptor signaling pathway, NOD-like receptor signaling pathway, and NF-kappa B signaling pathway. The key targets in the treatment of chronic sinusitis were TNF, IL6, AKT1, VEGFA, and PTGS2. Conclusion The combination of biyuan tongqiao granules with clarithromycin or biyuan tongqiao granules alone indicated that their therapeutic effects were better than those of clarithromycin alone. Due to the limitation of the quality of included studies, more high-quality studies are required to validate the above findings. Key targets for the effects of biyuan tongqiao granules in the treatment of chronic rhinosinusitis are TNF, IL6, AKT1, VEGFA, and PTGS2.