Medication Rules and Mechanism of Topical Traditional Chinese Medicine for Meibomian Gland Dysfunction-Related Dry Eye Disease.

Objective: To summarize the use of traditional Chinese medicine in the treatment of meibomian gland dysfunction-related dry eye disease through data mining. Additionally, it aims to explore the signaling pathways and mechanisms of critical drugs used in the treatment of this condition through network pharmacology analysis. Methods: Clinical trial literature on the topical application of traditional Chinese medicine for meibomian gland dysfunction-related dry eye disease in the past 20 years was collected from Chinese academic databases (Zhiwang, Wanfang Data, and Weipu). Association rule analysis and clustering analysis were performed using IBM SPSS. Active ingredients and target sites of critical drugs were obtained from the TCSMP and BATMAN-TCM databases. Disease target sites were sourced from databases such as DrugBank and OMIM. The drug-disease intersecting target genes were used to construct a protein-protein interaction (PPI) network in the String database. Common target genes were subjected to GO function and KEGG signaling pathway enrichment analyses using the DAVID platform. The molecular docking of active ingredients and key targets was validated using AutoDock Vina (1.1.2). Results: A total of 93 Chinese herbal medicines in 56 prescriptions were collected. The critical drugs identified were flos chrysanthemi, flos lonicerae japonicae, fructus forsythiae, radix scrophulariae, radix rehmanniae recens, and radix ophiopogonis. There were 63 active ingredients and 905 potential targets. Key targets identified through PPI analysis included AKT1, TP53, TNF, EGFR, IL6, VEGFA, IL1B, INS, EGF, and CXCL8. GO function analysis revealed processes such as positive regulation of expression, positive regulation of cell proliferation, negative regulation of apoptosis, and inflammatory reactions. The main signaling pathways identified were the MAPK signaling pathway, PI3K-Akt signaling pathway, HIF-1 signaling pathway, calcium signaling pathway, and cytokine-cytokine receptor interactions. Molecular docking indicated relatively strong binding activity between the small molecules of the active ingredients and the target proteins. Conclusions: The critical drugs analyzed in this study potentially exert therapeutic effects on meibomian gland dysfunction-related dry eye disease by regulating related biological processes such as anti-inflammation and repairing the corneal epithelial barrier. These findings provide a theoretical basis for future research and development of new drugs and subsequent experimental investigations.