Background::In recent years, the incidence of rectal prolapse has increased significantly
due to the sedentary lifestyle and irregular eating habits of modern life. However, there is
a lack of clinical studies on the treatment of rectal prolapse with traditional Chinese medicine
(TCM) with a large sample size. Therefore, this study investigated the characteristics of rectal
prolapse treatment formulas and then studied the network pharmacology of their core therapeutic
drugs, which can help to provide a reference for the treatment and postoperative care of rectal
prolapse patients.
Objective::This study aimed to explore the prescription characteristics and the mechanism of
action of core drugs in the treatment of rectal prolapse in Chinese medicine through data mining
and bioinformatics techniques.
Methods::We collected the diagnosis and treatment information of patients with rectal prolapse
from January 2014 to September 2021 in the electronic case database of Nanjing Hospital of
TCM, mined the patient information and prescription features using R, screened the active ingredients
of the core pairs of drugs and disease drug intersection targets using TCMSP and
GnenCard databases, and constructed a Protein-protein interaction (PPI) network using
STRING and Cytoscape, and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes
(KEGG) enrichment analyses of the intersecting targets were performed using Metascape
and R.
Results::We found that prolapse is easy to occur in people over 50 years old, preferably in autumn
and winter. Commonly used therapeutic Chinese medicines include Glycyrrhiza glabra,
Radix angelicae sinensis, Radix astragali, Atractylodes macrocephala, and Pericarpium citri
reticulatae, which are mostly deficiency tonic medicines, warm in nature, and belong to spleen
meridian. The core therapeutic medicinal pair was “Bupleuri radix-Cimicifugae rhizoma”.
There were 190 common targets of Bupleuri radix and Cimicifugae rhizoma, and 71 intersection
targets of the drug pair and prolapse. The main components of the core drugs for the treatment
of prolapse may be quercetin, kaempferol, Stigmasterol, etc, and the core targets may be
CASP3, AKT1, HIF1A, etc. The total number of GO entries for the intersection targets of “Bupleuri
radix-Cimicifugae rhizoma” and diseases was 3495, among which the molecular functions
accounted for the largest proportion, mainly Pathways in cancer, IL-18 signaling pathway,
etc. KEGG enriched pathway analysis yielded 168 results, and the major pathways were pathways
in cancer, lipid and atherosclerosis, IL-17 signaling pathway, etc.
Conclusion::This study adopted real-world research methodology and used data mining and
bioinformatics technology to mine the medication law of rectal prolapse and its core drug action
mechanism from the clinical information of Chinese medicine.