基于网络药理学和临床试验探讨前列消汤对ⅢA型前列腺炎IL-17与Foxp3表达影响研究  

Study on the Effect of Qianliexiao Decoction on the Expression of IL-17 and Foxp3 in TypeⅢA Prostatitis Based on Network Pharmacology and Clinical Trials

作　　者：张泽朝 朱闽[1] 林泽森 买鹏宇 梁景辉 彭杰 时雪 Zhang Zechao;Zhu Min;Lin Zesen;Mai Pengyu;Liang Jinghui;Peng Jie;Shi Xue(Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine,Nanning 530000,China)

机构地区：[1]广西中医药大学附属瑞康医院,南宁530000

出　　处：《世界科学技术-中医药现代化》2021年第12期4519-4529,共11页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：国家自然科学基金委员会地区科学基金(81660796):前列消汤干预自身免疫性前列腺炎TGF-β1/Smads通路调控Th17、PrF细胞分化的研究,负责人:朱闽;广西壮族自治区自然科学基金委员会面上项目(2018GXNSFAA281081):基于IL-6-JAK2-STAT3信号通路探讨前列消汤调控自身免疫性前列腺炎CD4+T细胞凋亡的研究,负责人:朱闽;广西壮族自治区卫生厅中医药科技专项(GZLC14-16):前列消汤对ⅢA型前列腺炎Th17/Treg细胞分化平衡的临床研究,负责人:朱闽。

摘　　要：目的基于网络药理学进行前列消汤治疗慢性前列腺炎的预测,同时采用临床试验进行验证,证明前列消汤对ⅢA型前列腺炎患者的临床疗效及对前列腺液(Expressed Prostatic Secretion,EPS)中白细胞介素17(interleukin 17,IL-17)及双头叉转录因子p3(Forkhead box p3,Foxp3)表达的影响。方法采用网络信息学分析方法,筛选出前列消汤在ⅢA型前列腺炎治疗中发挥疗效的主要作用靶点,采用临床随机非盲法,将符合纳入标准的80例ⅢA型前列腺炎湿热下注证患者随机分为观察组和对照组各40例,观察组口服自拟前列消汤,对照组口服银花泌炎灵片。观察治疗前后两组的症状及证候评分情况、前列腺按摩液以及其IL17、Foxp3表达的差异。取40例正常男性前列腺液为正常对照。结果网络药理学分析结果提示IL17信号通路为前列消汤治疗慢性前列腺炎的重要通路之一,临床试验结果提示经治疗后观察组有效率达89.19%,较对照组的73.68%为优(P<0.05)。两组患者服药后的临床表现、前列腺按摩液WBC、症状及证候评分均存在明显改善。观察组和对照组IL-17水平较治疗前下降,Foxp3表达较治疗前升高(P<0.05)。观察组对降低IL-17表达和提升Foxp3表达上较对照组差异更大(P<0.05)。观察组治疗后与正常组IL-17和Foxp3水平比较差异较小(P>0.05)。结论网络药理学能一定程度上预测中药作用于疾病的相应靶点,前列消汤对ⅢA型前列腺炎湿热下注证患者的临床症状有明显改善作用,并能降低IL-17表达,对Foxp3表达有提升作用,在总有效率和对细胞因子的影响上较银花泌炎灵片组明显。Objective To predict the treatment of chronic prostatitis with Qianliexiao Decoction based on network pharmacology,and at the same time use clinical trials to verify the clinical efficacy of Qianliexiao Decoction on patients with typeⅢA prostatitis and effects on expression of interleukin 17(IL-17)and Forkhead box p3(Foxp3)in expressed prostatic secretion(EPS).Methods Using network informatics analysis methods,the main targets of Qianliexiao Decoction in the treatment of typeⅢA prostatitis were screened out.The clinical randomized and unblinded method was used to place 80 cases of typeⅢA prostatitis with damp and heat that met the inclusion criteria.Syndrome patients were randomly divided into observation group and control group,with 40 cases in each group.The observation group was given oral self-made Qianliexiao Decoction,and the control group was given Yinhua Miyanling tablets.We observed the differences in the symptoms and syndrome scores of the two groups before and after treatment,the prostate massage fluid,and the differences in the expression of IL17 and Foxp3.40 normal male prostate fluids were taken as normal controls.Results The results of network pharmacological analysis suggested that IL17 signaling pathway was one of the important pathways of Qianliexiao Decoction in the treatment of chronic prostatitis.The results of clinical trials suggested that the effective rate of the observation group after treatment reached 89.19%,which was superior to 73.68%of the control group(P<0.05).The clinical manifestations,prostate massage fluid WBC,symptoms and syndrome scores of the two groups of patients were significantly improved after taking the medicine.The level of IL-17 in the observation group and the control group was lower than before treatment,and the expression of Foxp3 was higher than before treatment(P<0.05).The observation group had greater differences in reducing IL-17 expression and increasing Foxp3expression than the control group(P<0.05).The levels of IL-17 and Foxp3 between the observation

关 键 词：慢性前列腺炎 中医药 前列消汤 IL-17 FOXP3 

分 类 号：R268[医药卫生—中医外科学]