Objective  To investigate the potential material basis, targets and molecular mechanisms of the Astragali Radix-Anemarrhenae Rhizoma herb pair in the treatment of chronic heart failure (CHF).

Methods  Formulas containing the Astragali Radix-Anemarrhenae Rhizoma herb pair were screened from the Encyclopedia of Traditional Chinese Medicine Prescriptions, and their compatibility rules were analyzed using the Apriori algorithm. Network pharmacology was used to screen active components, core targets, and key pathways of Astragali Radix-Anemarrhenae Rhizoma for CHF, and molecular docking was performed to assess the binding affinity between core components and key targets.

Results A total of 232 formulas containing Astragali Radix and Anemarrhenae Rhizoma were collected, of which 61 were consistent with the core pathogenesis of CHF. These formulas were mainly characterized by tonifying deficiency and clearing heat, and mostly distributed to the lung, spleen and kidney meridians. The core compatible herbs were Glycyrrhizae Radix et Rhizoma, Ginseng Radix et Rhizoma, Poria Cocos and Angelicae Sinensis Radix, which were consistent with the pathogenesis of qi, blood, yin and yang deficiency in CHF. Network pharmacology identified 28 active components of the herb pair and 214 overlapping targets between drugs and CHF. These targets mainly included AKT1, TNF, IL-6, etc., regulating pathways such as lipid and atherosclerosis, AGE-RAGE, IL-17 and TNF signaling pathways. GO and KEGG enrichment analyses indicated the above signaling pathways were involved in inflammatory response, negative regulation of apoptosis, response to hypoxia and other biological processes. Molecular docking further confirmed that core components including quercetin, kaempferol and diosgenin showed strong binding stability with key targets.

Conclusion The Astragali Radix-Anemarrhenae Rhizoma herb pair exerts therapeutic effects on CHF through anti-inflammatory, anti-apoptotic, vascular endothelial protective activities and improvement of cardiac function, which provides a theoretical basis for revealing its modern scientific connotation in treating CHF.

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