Xuebijing and somatostatin against acute pancreatitis: A systematic review and network pharmacology

Background:Acute pancreatitis (AP) is a common pancreatic disease. Xuebijing injection (XBJ) combined with somatostatin in the treatment of AP is frequently used in clinical practice. There is, however, a lack of high-quality evidence-based evidence and network pharmacology to regard the therapeutic efficacy and pharmacological mechanisms. Purpose:The purpose of this study is to investigate the potential therapeutic targets and pharmacological mechanism of XBJ in AP using integrating evidence-based medicine and network pharmacology. Methods:PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Weipu, and Wanfang databases were searched. Randomized controlled trials of XBJ combined with somatostatin (experimental group) versus somatostatin alone (control group) in the treatment of AP were collected. After extracting data from the literature that meets the inclusion criteria, and using the Cochrane Scale to evaluate the quality of the literature, we used Rev Man 5.3.0 statistical software to perform meta-analysis of the effective rate, the disappearance time of abdominal pain and bloating, the recovery of gastrointestinal motility, serum-related indicators, inflammatory factors, ventilator evacuation time, and hospitalization time. A network pharmacology is used to analyze the potential active ingredients and related crucial targets of the XBJ in the treatment of AP, and we explored key regulatory pathways and potential biomarkers related to XBJ for AP with integrated bioinformatics analysis. Results:It was significant that the total effective rate in the study group was higher than that in the control group (P < .05). The time of recovery of gastrointestinal motility, serum-related indicators, inflammatory factors, ventilator withdrawal time, and hospitalization time were significantly lower than that of the control group. The differences were statistically significant (P < .05). Signal transducer and activator of transcription 3, tumor protein P53, interleukin 6, tumor necrosis factor, Jun Proto-Oncogene, SRC Proto-Oncogene, Heat Shock Protein 90 Alpha Family Class A Member 1, Vascular Endothelial Growth Factor A, Epidermal Growth Factor Receptor, and Mitogen-Activated Protein Kinase 1 were identified as the key hub of the protein-protein interaction network according to an analysis of network centrality. According to the Kyoto Encyclopedia of Genes and Genomes pathway analysis, the main pathways are involved in PI3K-Akt signaling pathway, HIF-1 signaling pathway, and tumor necrosis factor signaling pathway. Conclusions:The effectiveness of combination therapy of XBJ and somatostatin on AP is likely to be better than somatostatin. In addition, XBJ and somatostatin synergistically treated AP through a multi-pathway network.