The prevalence of gastroesophageal reflux disease (GERD) is rapidly increasing due to the adoption of a Westernized lifestyle; at the same time, safe and efficient treatment is required due to the side effects and refractoriness of proton pump inhibitors (PPIs). The frequently used multi-compound treatment for GERD in the current traditional Korean medicine (TKM) clinical field comprises Crassostrea gigas Thunberg shell (CGTS), Bambusae Caulis in Taeniam (BCT), Ponciri Fructus Immaturus (PFI), Scutellaria baicalensis Georgi (SBG), medicated leaven (ML) and Glycyrrhizae Radix et Rhizoma (GRR). The current review was based on “Kun-Shin-Choa-Sa” theory and network analysis was conducted to explore the potential pharmacological activities, including efficacy and mechanisms of action of multi-compound treatment against GERD. Hypergeometric test results showed that the targets of multi-compound treatment are significantly associated with GERD gene sets, consistent with the literature review findings. In particular, the enrichment analysis indicated that the SBG targets are related to the IL-17 signaling pathway, bile secretion, small-cell lung cancer, and non-small cell lung cancer, corroborating the literature review, particularly concerning anti-inflammatory effect. In the literature review, CGTS and BCT, classified as “Kun,” play a role in anti-acid, anti-inflammatory, and anti-oxidative effects. The complementary “Shin” herbs, PFI and SBG, showed functions related to improving the prolonged gastric emptying rate, peristalsis, and a gastric cytoprotective effect. With the role of “Choa,” ML was suggested to inhibit H. pylori growth and diminish gastric acid secretion, consistent with the gastric acid secretion pathway in the enrichment analysis. However, the enrichment analysis did not show any significantly related pathways for CGTS and PFI, which may reflect the lack of information in the KEGG database in terms of the link between GERD, its mechanisms, and the abundance of minerals in CGTS. Despite the pharmacological potential of multi-compound treatment, this study should be corroborated by well-designed future experimental studies.

中文翻译：

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GERD 多化合物治疗药理活性的潜力：文献综述和基于网络药理学的分析

由于采用了西方化的生活方式，胃食管反流病 (GERD) 的患病率正在迅速增加；同时，由于质子泵抑制剂（PPI）的副作用和难治性，需要安全有效的治疗。目前传统韩药（TKM）临床领域常用的治疗GERD的多复合物包括巨牡蛎（CGTS）、竹笋（BCT）、枳实（PFI）、黄芩（SBG） 、药用酵素 (ML) 和甘草 (GRR)。本综述基于“Kun-Shin-Choa-Sa”理论和网络分析，以探索潜在的药理活性，包括多化合物治疗对 GERD 的疗效和作用机制。超几何测试结果表明，多化合物治疗的靶点与 GERD 基因集显着相关，与文献综述结果一致。特别是，富集分析表明 SBG 靶点与 IL-17 信号通路、胆汁分泌、小细胞肺癌和非小细胞肺癌相关，证实了文献综述，特别是关于抗炎作用。在文献综述中，归类为“坤”的CGTS和BCT具有抗酸、抗炎和抗氧化作用。互补的“Shin”草药，PFI 和 SBG，显示出与改善延长的胃排空率、蠕动和胃细胞保护作用相关的功能。由于“Choa”的作用，有人建议 ML 抑制 H. pylori 生长并减少胃酸分泌，与富集分析中的胃酸分泌途径一致。然而，富集分析并未显示 CGTS 和 PFI 的任何显着相关的途径，这可能反映了 KEGG 数据库中缺乏关于 GERD、其机制和 CGTS 中矿物质丰度之间联系的信息。尽管多化合物治疗具有药理学潜力，但该研究应得到精心设计的未来实验研究的证实。以及 CGTS 中丰富的矿物质。尽管多化合物治疗具有药理学潜力，但该研究应得到精心设计的未来实验研究的证实。以及 CGTS 中丰富的矿物质。尽管多化合物治疗具有药理学潜力，但该研究应得到精心设计的未来实验研究的证实。