The Efficacy and Mechanism of Xiaoqinglong Decoction in the Treatment of AECOPD based on Meta-analysis and Bridging Network Pharmacology

This study comprehensively evaluates the efficacy of Xiaoqinglong decoction combined with conventional treatment in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) based on Meta-analysis and network pharmacology, and preliminarily explores its potential action mechanism. Xiaoqinglong decoction combined with conventional treatment of randomized controlled trials for the treatment of AECOPD were collected by searching databases such as CNKI, Wanfang, VIP, PubMed, Cochrane Library and Web of Science; All literatures were screened based on inclusion and exclusion criteria and RevMan 5.4 software was used for Meta-analysis. The following steps were performed: The active components and their corresponding targets of Xiaoqinglong Decoction were searched and screened through tcmsp database; the Xiaoqinglong decoction compound target gene network was drawn; the key compounds were screened; the target genes related to COPD were searched in TTD database, genecards database, OMIM database and drugbank database; the intersection targets of chemical component targets and disease targets were screened by Excel, and the Wayne diagram was drawn; the intersection targets were imported into the string database to construct the PPI network and then the active ingredient targets of Xiaoqinglong decoction and the common targets of COPD were imported into the David 6.8 database for gene ontology (go) analysis and Kyoto Encyclopedia of genes and genomes (KEGG) analysis. The first 20 KEGG pathways were taken to draw the potential target pathway network diagram. Bioinformatics technology was used to analyze and preliminarily explore its mechanism. Meta-analysis included 34 articles and 2 948 patients totally. The results showed that Xiaoqinglong decoction combined with conventional treatment is superior to conventional treatment alone in terms of total effective rate, pulmonary function, arterial blood gas analysis, total score of TCM symptoms and signs, remission time of main symptoms and level of inflammatory factors. Network pharmacology has 157 components, 150 common targets and 130 related pathways, mainly involving HIF-1 signaling pathway, tumor necrosis factor signaling pathway, PI3K Akt signaling pathway, toll like receptor signaling pathway and other pathways, as well as major biological processes such as oxidation reaction and inflammatory reaction. Xiaoqinglong decoction combined with conventional western medicine is superior to conventional western medicine alone in clinical efficacy. Its potential mechanism may be to achieve the purpose of treating AECOPD through the process of anti-inflammatory and antioxidant stress.