Periodontitis is an oral disease caused by chronic inflammation, which affects 50% of adults due to poor dietary and oral hygiene habits, and the proportion is higher in the aging population(Eke et al., 2015; Zhang et al., 2014). Periodontitis damaged the supporting tissue structure and biological function of teeth leading to tooth loosening and loss eventually, affecting people chewing ability and quality of life(Slots, 2017). It was initially thought that periodontitis was only a localized problem, but later ponders have found that it is closely related to the event and advancement of a few systemic maladies such as cardiovascular malady, rheumatoid joint pain, diabetes and cancer(Genco & Van Dyke, 2010; X. Li, Kolltveit, Tronstad, & Olsen, 2000; Nibali et al., 2007; Whitmore & Lamont, 2014). The pathogenic microorganisms in the deep gingival tissue and periodontal pockets are the main factors for inducing periodontitis. The clinical treatment mainly adopts the mechanical treatment methods of supragingival scaling and subgingival scaling, in severe cases, periodontal surgery is required(Mira, Simon-Soro, & Curtis, 2017). However, this approach is time-consuming, painful, often with low patient compliance, and inability to access deep tissues (eg, the bottom of the periodontal pocket)(Nakajima, Tanner, Nakajima, Ibsen, & Mitragotri, 2021). In addition, antibiotics are used to intervene in some specific bacterial infections. However, some patients develop allergic reactions and drug resistance, which limits its wide-ranging clinical application(Oberoi, Dhingra, Sharma, & Sardana, 2015). Therefore, it is imminent to find an efficient and less toxic and side effect treatment method.
Chinese medicine culture is an important treasure of Chinese civilization. Traditional Chinese medicine scholars did not focus on a certain disease target or site in treating diseases but carried out comprehensive diagnosis and intervention on patients, which is also the biggest difference from our current medicine. In "The Origin and Syndrome of Diseases", it is recorded that "the kidney dominates the bone and produces the marrow, and the tooth is the bone which is the symbol of the kidney"(Zongkai et al., 2015). Traditional Chinese medicine believes that periodontitis is mainly caused by insufficient qi and blood and deficiency of kidney qi, forming the theory of "kidney deficiency and tooth gap"(Fangping, Hezhen, & Qiaoqun, 2016). Under the guidance of this theory, traditional Chinese medicine treatment of periodontitis pays more attention to the regulation of the kidney. Based on "Liuwei Dihuang Pill", Zhang Juzhi, a famous periodontologist in my country, developed a Chinese patent medicine especially used for periodontal disease - Bushen Guchi Pill(BGP)(Xiaoling, Xiaobo, & Xiaoqing, 2008). The main constituents of this side are Rehmanniae Radix Praeparata (Shudihuang, SDH), Rehmannia Glutinosa (Dihuang, DH), Spatholobus Suberectus Dunn (Jixueteng, JXT), Placenta Hominis (Ziheche, ZHC), Drynariae Rhizoma (Gusuibu, GSB), Rhapontici Radix (Loulu, LL), Radix Salviae (Danshen, DS), Radix Salviae (Wuweizi, WWZ), Rhizoma Dioscoreae (Shanyao, SY), Curcumae Radix (Yujin, YJ), Hedysarum Multijugum Maxim (Huangqi, HQ), Achyranthis Bidentatae Radix (Niuxi, NX), Chrysanthemi Indici Flos (Yejuhua, YJH), Poria Cocos (Schw.) Wolf (Fuling, FL), Lycii Fructus (Gouqizi, GQZ), Cortex Moutan (Mudanpi, MDP), Alisma Orientale (Sam.) Juz (Zexie, ZX) and Cinnanmomi Cortex (Rougui, RG). The study found that taking BGP after the basic treatment of periodontitis could significantly improve the clinical indicators of periodontitis such as gingival index (GI) and probe bleeding index (PBI) in patients with periodontitis(Yadi, Renhui, & Jun, 2013). And the expression of IL-1β, IL-6, and TNF-α in periodontal tissues can be reduced in patients with periodontitis after taking BGP(Caiyun, Yun, & Hongmei, 2018). In addition, oral administration of BGP after dental implants can reduce periodontal inflammation and promote the fusion of implants and bone tissue(F. Li & Yihan, 2015). Although the effect of BGP in the treatment of periodontitis has been described in some aspects, its specific mechanism of action still has to be illustrated.
Network pharmacology is derived from computer technology and biological research, and studies the relationship between drugs and disease targets. Network pharmacology is to further analyze and build a holistic network by finding the active ingredients of drugs and the therapeutic targets of diseases(Shi et al., 2021). The purpose of this study is to further elucidate the mechanism of action of BGP in the treatment of periodontitis and to provide valuable theoretical support for basic research and clinical application (Fig. 1).