摘要
目的探讨栀子豉汤合丹栀逍遥散化裁方用于治疗冠心病期室性前收缩治疗的临床疗效、物质基础及作用机制。方法2018年7月至2019年10月中国中医科学院广安门医院(南区)门诊97例冠心病室性期前收缩病人分为对照组与观察者,对照组45例应用比索洛尔治疗,观察组52例应用栀子豉汤合丹栀逍遥散化裁方治疗,观察服药4周后中医症状变化情况及临床疗效。依托中药系统药理学分析平台(TCMSP)检索并筛选栀子豉汤合丹栀逍遥散化裁方的有效成分和作用靶标,应用GeneGards数据库对冠心病期室性前收缩靶标进行检索,进而构建成分-靶点网络、构建蛋白互作(PPI)网络,并对靶标进行基因本体(GO)功能富集分析、京都基因与基因组百科全书(KEGG)通路富集分析,构建靶点-通路网络图。结果服药前对照组与观察组的中医症候积分为(17.65±1.67)和(17.72±1.51),用药四周后,两组的积分为(9.43±2.41)和(4.31±1.28),观察组服药4周后中医证候积分显著优于对照组,差异有统计学意义(P<0.001)。服药4周后,对照组与观察组总有效率为75.56%(34/45)和92.31%(48/52),观察组疗效显著优于对照组,具有统计学意义(P<0.05)。本研究共筛得到栀子豉汤合丹栀逍遥散化裁方82个活性成分及191个不同作用靶标,冠心病室性期前收缩2658个疾病作用靶标,方药与疾病重合靶标132个,GO及KEGG富集分析预测出与疾病相关的多条作用通路。结论栀子豉汤合丹栀逍遥散化裁是治疗冠心病室性期前收缩的有效方剂,能有效改善病人临床症状。本研究预测得到栀子豉汤合丹栀逍遥散化裁方治疗冠心病室性期前收缩的主要活性成分主要为黄酮类及甾醇类化合物,栀子与柴胡可能为其中起主要作用的药物;主要调节靶标是MAPK1、AKT1、RELA、MAPK8、MAPK10、JUN、MAPK14、RAF1、IL6、FOS,可能通过作用于PI3K-Akt、MAPK、Toll样受体信号通路等对冠心病室性期前收缩起到治疗作用。
Objective Xiaoyao decoction application treatment of premature ventricular contraction of coronary heart disease.Methods Ninety-seven outpatient patients with premature ventricular contraction of coronary heart disease in Southern Branch of Guang’anmen Hospital,China Academy of Chinese Medical Sciences from July 2018 to October 2019 were selected and assigned into control group and observer group.45 patients in the control group were treated with bisoprolol,while 52 patients in the observation group were treated with modified Zhizichi decoction and Danzhi Xiaoyao decoction.The changes of Traditional Chinese Medicine(TCM)symptoms and the clinical effect were observe at 4 weeks after taking the medicine.With Traditional Chinese Medicine Systems Pharmacology(TCMSP)retrieval and screening of the active components and target of modified Zhizichi decoction and Danzhi Xiaoyao decoction,the target of Premature ventricular contraction of coronary heart disease was retrieved from GeneGards database.Then the component-target network and the protein protein interaction(PPI)network were constructed,the target with Gene Ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG)were analyzed,and target-path network diagram was drawn.Results the control group and the observation group were(17.65±1.67)and(17.72±1.51),respectively.and the scores after four weeks of medication in the two groups were(9.43±2.41)and(4.31±1.28),respectively.The TCM syndrome scores of the observation group were significantly better than that of the control group after 4 weeks of medication,the difference was statistically significant(P<0.001).After 4 weeks of treatment,the total effective rate of the control group and the observation group was 75.56%(34/45)and 92.31%(48/52),thecurative effect of the observation group was significantly better than that of the control group,with statistical significance(P<0.05).There were 82 active components and 191 different action targets of the modified Zhizichi decoction and Danzhi Xiaoyao decoction inthis study,2658 targets were found in premature ventricular contraction of coronary heart disease,and there were 132 overlapping targets between TCM compounds and diseases.There are several disease-related pathways were obtained by GO and KEGG.Conclusion Modified Zhizichi decoction and Danzhi Xiaoyao decoction application is the effective prescription for the treatment of premature ventricular contraction of coronary heart disease,which can effectively improve the clinical symptoms of patients.In the research,the mainactive ingredient of modified Zhizichi decoction and Danzhi Xiaoyao decoction is predicted for the treatment of premature ventricularcontraction of coronary heart disease are Flavonoids and sterols.Gardeniae Fructus and Radix Bupleuri may be the main drugs.Themain regulatory targets are MAPK1,AKT1,RELA,MAPK8,MAPK10,JUN,MAPK14,RAF1,IL6,FOS.It may act on PI3 K-AKT,MAPK,toll-like receptor signaling pathway to treat premature ventricular contraction of coronary heart disease.
作者
钱伟
胡元会
郝志晔
李宛珊
关山月
龙峻标
QIAN Wei;HU Yuanhui;HAO Zhiye;Li Wanshan;Guan Shanyue;Long Junbiao(Intensive Care Unit,Southern Branch of Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 102600,China;Cross Infection Control Office,Southern Branch of Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 102600,China;Department of Cardiology,Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)
出处
《安徽医药》
CAS
2021年第7期1459-1463,I0002,I0003,共7页
Anhui Medical and Pharmaceutical Journal
基金
北京市科协金桥工程种子资金项目(ZZ19053)
本部专家学术经验传承(Y2018SC-01)。
关键词
冠心病
室性期前收缩
栀子豉汤
丹栀逍遥散
网络药理学
靶点
作用机制
Coronary heart disease
Premature ventricular contraction
Zhizichi decoction
Danzhi Xiaoyao decoction
Network pharmacology
Target
mechanism
