Abstract:Objective To investigate the potential mechanisms underlying the main Chinese medicines and their components in formulas for the successful treatment of ureteral calculus. Methods Two male cases of ureteral calculus who failed to undergo extracorporeal shock wave lithotripsy (ESWL) and were successfully drained by Chinese medicine treatment were reported. Network pharmacology was adapted to analyze the action mechanism of a combination of 10 Chinese herbs in prescriptions for treating ureteral calculus. Results Two men with ureteral calculus were successfully treated by Chinese medicine after the failure of ESWL, and the computer tomography (CT) reexaminations showed no ureteral calculus or hydronephrosis. Protein-protein interaction (PPI) network analysis found that the core proteins of 10 Chinese medicine herbs in the prescription involved ALB, MMP9, TLR4, EGF, IL-6, FN1, HSP90AA1, EGFR, AKT1, IL-10 and VEGFA. The enrichment analysis of the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway revealed that the 10 Chinese medicine herbs mainly involved PI3K/Akt, EGFR tyrosine kinase inhibition, TNF and HIF-1 signaling pathway. Conclusion Two cases of ureteral calculus with failed ESWL have been successfully drained by treatment with Chinese medicine. Network pharmacology shows that the combinations of 10 Chinese medicines have the effects of relaxing ureteral smooth muscle, anti-inflammatory, reducing ureteral endothelial damage, and diuresis. The analysis of calculus components and CT values suggests that Chinese medicine has therapeutic value for ureteral calculus, which is insensitive to ESWL.