文章摘要
钱伟,胡元会,郝志晔,等.栀子豉汤合丹栀逍遥散化裁方治疗冠心病室性期前收缩 97例疗效与网络药理学研究[J].安徽医药,2021,25(7):1459-1463.
栀子豉汤合丹栀逍遥散化裁方治疗冠心病室性期前收缩 97例疗效与网络药理学研究
Efficacy and network pharmacology of modified Zhizichi decoction and Danzhi Xiaoyao decoction application treatment of 97 cases of ventricular premature contraction of coronary heart disease
  
DOI:10.3969/j.issn.1009-6469.2021.07.045
中文关键词: 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
英文关键词: Coronary heart disease  Premature ventricular contraction  Zhizichi decoction  Danzhi Xiaoyao decoction  Network pharmacology  Target  mechanism
基金项目: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)
作者单位E-mail
钱伟 中国中医科学院广安门医院南区重症医学科北京 102618  
胡元会 中国中医科学院广安门医院心血管科北京 100053  
郝志晔 中国中医科学院广安门医院 院感办北京 102618  
李宛珊 中国中医科学院广安门医院南区重症医学科北京 102618  
关山月 中国中医科学院广安门医院南区重症医学科北京 102618  
龙峻标 中国中医科学院广安门医院南区重症医学科北京 102618 546129971@qq.com 
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中文摘要:
      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)(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<0.0,01)。服药 4周后,对照组与观察组总有效和率为 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。
英文摘要:
      Objective To investigate the clinical effect, material basis and mechanism of modified Zhizichi decoction and DanzhiXiaoyao 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, ChinaAcademy of Chinese Medical Sciences from July 2018 to October 2019 were selected and assigned into control group and observergroup. 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 clinicaleffect were observe at 4 weeks after taking the medicine. With Traditional Chinese Medicine Systems Pharmacology (TCMSP) retrievaland screening of the active components and target of modified Zhizichi decoction and Danzhi Xiaoyao decoction,the target of Prematureventricular contraction of coronary heart disease was retrieved from GeneGards database. Then the component-target network and theprotein 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 TCM symptom scores before medication in 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 4weeks 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, 2 658 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 PI3K-AKT, MAPK, toll-like receptor signaling pathway to treat premature ventricular contraction of coronary heart disease.
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