Action mechanism of Zhitong Rushen Decoction in treating functional anorectal pain based on network pharmacology

Objective:Network pharmacology method was adopted in this study to screen the target of Zhitong Rushen Decoction of the treatment to Functional Anorectal Pain(FAP)and explore its mechanism of treatment.Methods:Chemical components and selected targets related to the ten traditional Chinese medicine(TCM)herbs were searched through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP).Through GeneCards database,OMIM database,disease targets of FAP were searched.R language was used to screen the common targets between drugs and disease,and then the interaction network diagram of the targets was constructed by String.Cytoscape3.7.0 was applied to construct the active ingredients-targets interacted network.GO enrichment analysis and KEGG enrichment analysis of targets were based on R language.Results:Four main chemical components including quercetin,wogonin,fisetin and kaempferol were screened,and four key targets including ESR1、NOS2、PGR and CHRM3 were identified.In GO enrichment analysis,66 molecular function entries,1040 biological process entries,26 cell component entries were obtained.KEGG pathway enrichment analysis showed that zhitong rushen decoction played a therapeutic role in functional anorectal pain by regulating AGE-RAGE signaling pathway in diabetic complications,Bladder cancer,Estrogen signaling pathway,HIF-1 signaling pathway.Conclusion:Zhitong rushen decoction for the treatment of functional anorectal pain may be related to its multi-component effect on multiple targets and multiple signaling pathways,providing theoretical basis for further study of active ingredients and mechanism of action.

电针董氏奇穴联合生物反馈治疗功能性肛门直肠痛的疗效评价

Objective:To investigate the clinical effect of electroacupuncture combined with biofeedback on functional anorectal pain.Methods:Sixty patients diagnosed functional anorectal pain were divided into three groups by random number table,namely electroacupuncture group,biofeedback group,and combination group,with 20 patients in each.In the electroacupuncture group,the electroacupuncture at Dong’s points Sānqí(三其穴),including Qímén(其门),Qíjiǎo(其角),and Qízhéng(其正),and Línggǔ(灵骨),Dàbái(大白),Chángmén(肠门)of both sides was given;in the Biofeedback group,the biofeedback therapy was adopted;in the combination group,the electroacupuncture and biofeedback therapy were used.All patients were treated once a day,30 min each time,10 consecutive treatments as one treatment course,and the therapeutic effect was evaluated after 3 treatment courses.The observation indexes after the intervention:Visual analogue Scale(VAS)score,SF-36 Quality of Life Scale score,Self-rating Anxiety Scale(SAS)score,Self-rating Depression Scale(SDS)score,Anorectal manometry,Clinical efficacy,and patients’adverse reactions.Results:After treatment,the pain of patients in the three groups was alleviated than that before treatment,VAS score,SAS score,SDS score,and anorectal pressure were decreased(P<0.05),and SF-36 Quality of Life Scale score was increased(P<0.05).After treatment,in the combination group,the VAS scores,SAS scores,SDS scores,and Anal-rectal pressure scores were lower than those in the other two groups(P<0.05),and SF-36 Quality of Life Scale scores were higher than those in the other two groups(P<0.05),the total effective rate was 80.0%(16/20),which was significantly higher than that of the electroacupuncture group(55.0%,11/20)and the biofeedback group(40.0%,8/20)(both P<0.05).No adverse reactions occurred in all three groups.Conclusion:Electroacupuncture at Dong’s points combined with biofeedback therapy has a significant effect on functional anorectal pain.The combined application of electroacupuncture and biofeedback therapy has a synergic action,and the analgesic effect is better than that of only using electroacupuncture or biofeedback therapy.