Identifying the Chinese Herbal Medicine Network and Core Formula for Allergic Rhinitis on a Real‐World Database

Abstract

Background and Purpose. Allergic rhinitis (AR) is a highly prevalent disease, and Chinese herbal medicine (CHM) is commonly used for treating AR. This study aims to demonstrate the CHM network for AR and possible molecular pathways. Materials and Methods. Patients with a primary diagnosis of AR (ICD-9-CM code: 477.9) in 2010 were included, and the National Health Insurance Research Database in Taiwan was used as the data source. Association rule mining and social network analysis were used to establish and explore the CHM network. Possible molecular pathways of the CHM network were summarized and compared with commonly used western medicine (WM) by conducting overrepresentation analysis in the Reactome pathway database. The potential proteins acted by CHMs were obtained from the CHM ingredient-protein databases, including STITCH, TCMSP, TCMID, and TCM@Taiwan. Results. There were 89,148 AR subjects found in 2010, and a total of 33,507 patients ever used CHM. On an average, 5.6 types of CHMs were utilized per prescription. Xin-Yi-Qing-Fei-Tang was used most frequently (25.5% of 222,279 prescriptions), while Xiao-Qing-Long-Tang with Xin-Yi-San was the most commonly prescribed CHM-CHM combination. Up to six distinctive clusters could be found among the CHM network, and core CHMs could be found for AR, such as Xiao-Qing-Long-Tang and Xin-Yi-Qing-Fei-Tang. A total of 140 molecular pathways were covered by the CHM network (2,432 ingredients from 31 kinds of CHMs), while 39 WMs covered 55 pathways. Among pathways responding to the immune system, WM mainly acted on cytokine signaling-related pathways, while CHM mostly acted on neutrophil/macrophage-related innate pathways and dendritic cell-related adaptive immunity pathways. Conclusion. Our study demonstrated and analyzed the CHM network for AR. Core CHM for AR and possible molecular pathways were presented as well, and this information is crucial for researchers to select candidates for CHM-related studies.

Deciphering the Efficacy and Mechanisms of Chinese Herbal Medicine for Diabetic Kidney Disease by Integrating Web-Based Biochemical Databases and Real-World Clinical Data: Retrospective Cohort Study

“…On the other hand, four types of WMs used for DKD were proposed in this study, including ACEis, ARBs, GLP-1 agonists, and SGLT2is. Other possible molecular pathways could be obtained based on these CHM clusters and WMs by connecting WMs and CHM clusters to online biomedical databases [40]. Since biomedical databases contained only information about SHs, every HF in the CMN was disassembled to SHs according to the compositions provided by the Department of Chinese Medicine and Pharmacy of the Ministry of Health and Welfare, Taiwan [60].…”

“…Potential survival benefits and molecular pathways present the potential complementary roles of CHMs in managing DKD. We previously proposed a framework to connect clinical databases to web-based biochemical and pathway databases to predict the efficacy of using CHM, and we reported the possible acting pathways of CHM for DKD with the same framework [40]. The different pathways among CHM and WM may have synergistic effects for DKD.…”

“…Additionally, the CHM prescriptions used for diseases are usually complicated in the clinical setting, and we previously found that the use of four to five kinds of CHMs in one prescription is not uncommon [39]. A comprehensive summary of the efficacy of CHM prescriptions becomes crucial to understand the effects of CHM for DKD [40,41].…”

“…In our previous findings, DKD patients who received all kinds of Traditional Chinese medicine (TCM) treatments, including CHM, acupuncture, and moxibustion, had a better prognosis, which raised our interest in CHM use for DKD patients and the possible effective biomedical pathways [41]. In our previous successful integration of the most up-to-date web-based biomedical databases and real-world prescription databases, we identified the synergistic effects of CHM and WM for allergic rhinitis [40]. This study aimed to analyze the outcomes of DKD patients with CHM-only management and elucidate the roles of CHM and WM for DKD using an integrative platform with clinical and web-based biomedical databases.…”

Acupuncture combined with traditional Chinese medicine for allergic rhinitis: A protocol for systematic review and meta-analysis

“…Traditional Chinese medicine has its own unique understanding of allergic rhinitis, which is mainly due to the de ciency of viscera. Traditional Chinese medicine treatment can be divided into internal treatment and external treatment, internal treatment is mostly Chinese patent medicine, external treatment is mostly acupuncture and moxibustion, but its remission of patients' symptoms does not last long, some studies have pointed out that if the combination of the two can greatly reduce patients' nasal congestion, runny nose and other symptoms, so that patients' life can be greatly improved (6)(7)(8)(9)(10)(11)(12)(13) . However, there is still a lack of systematic evaluation on the e cacy and safety of acupuncture combine with traditional Chinese medicine for AR in clinical practice.…”