Astragalus in Acute Pancreatitis: Insights from Network Pharmacology, Molecular Docking, and Meta-Analysis Validation.

(1) Backgroud Astragalus, a traditional Chinese medicine, demonstrates therapeutic effectiveness in acute pancreatitis (AP). Nevertheless, its precise pharmacological mechanism remains unclear, and clinical guidelines have not been established. This study aims to systematically elucidate the active compounds and molecular mechanisms underlying Astragalus' therapeutic effects in AP, and provide clinical evidence supporting its efficacy. (2) Methods: TCMSP and Swiss Target Prediction identified drug targets; GeneCards, DrugBank, and OMIM provided disease targets. Venny determined the therapeutic targets, while STRING constructed a protein-protein interaction network. Cytoscape 3.10.3 validated core targets. DAVID was used to conduct GO and KEGG pathway analyses, visualized via Bioinformatic platform. Cytoscape 3.10.3 was used to build a "drug-ingredients-targets-pathways-disease" network. AutoDock Vina 1.1.2 and AutoDockTools 1.5.7 was used to performed molecular docking, with PyMOL 3.0 visualizing the results. PubMed, Embase, Cochrane, Web of Science, CNKI, Wanfang, VIP, and CBMdisc were searched. The literature was screened, extracted, and evaluated, followed by a meta-analysis, using RevMan 5.4.1 and Stata 18. (3) Results: We identified 539 targets for the active ingredients of astragalus. Among 1974 disease-related targets, 232 were found to be therapeutic targets. The GO analysis yielded 589 entries, while the KEGG pathway enrichment analysis identified 147 relevant pathways. The top five active ingredients were quercetin, kaempferol, isorhamnetin, formononetin, and calycosin. Molecular docking analysis revealed potential synergistic effects between these components and core targets. The meta-analysis, comprising six randomized controlled trials, demonstrated a significantly higher total effective rate of clinical efficacy in the astragalus group compared to the control group. (4) Conclusions: Astragalus treats AP through the synergistic action of its components, targets, and pathways. Key active compounds, such as quercetin, kaempferol, isorhamnetin, formononetin, and calycosin, engage with pivotal targets, including TP53, AKT1, TNF, IL6, EGFR, CASP3, MYC, and HIF1A, within primary pathways, such as pathways in cancer, PI3K-Akt signaling pathway, and lipid metabolism, and atherosclerosis. Astragalus effectively treats AP and alleviates clinical symptoms by reducing the time for gas or defecation passage, the disappearance time of abdominal pain or distension, and the recovery time of bowel sounds.