基于“病-证-症-方”关联网络分析策略探讨祛风骨痛巴布膏的功效特点与作用机制  

Investigation of pharmacological characteristics and mechanisms of Qufeng Gutong Cataplasm based on a "disease-syndrome-symptom-formula" association network analysis

作　　者：张苏雅 毛霞[1] 陶雪莹 方罗昌婷 李涛[1] 刘毓东 杨菲[1] 苏晓慧[1] 陈卫衡 张彦琼 林娜[1] ZHANG Su-ya;MAO Xia;TAO Xue-ying;FANGLUO Chang-ting;LI Tao;LIU Yu-dong;YANG Fei;SU Xiao-hui;CHEN Wei-heng;ZHANG Yan-qiong;LIN Na(Institute of Chinese Materia Medica,China Academy of Chinese Medical Sciences,Beijing 100700,China;The Third Affiliated Hospital of Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院中药研究所,北京100700 [2]北京中医药大学第三附属医院,北京100029

出　　处：《药学学报》2023年第6期1412-1421,I0003,共11页Acta Pharmaceutica Sinica

基　　金：中国中医科学院科技创新工程项目(C12021A03808);中国中医科学院中药研究所技术研发项目(20211024);国家“重大新药创制”科技重大专项(2019ZX09731002)。

摘　　要：祛风骨痛巴布膏具有显著的镇痛效果,但其临床定位与作用机制尚不明确,采用“证症结合”的诊疗模式有利于突出中医药治疗的优势定位及疗效特点。因此,本研究基于“病-证-症-方”关联网络分析策略,整合临床表型组、转录组和生物网络挖掘技术,探析祛风骨痛巴布膏干预骨性关节炎(OA)、神经病理性疼痛(NP)、慢性炎症性疼痛(CIP)和肌筋膜疼痛综合征(MPS)的功效特点和作用机制。网络分析结果表明,祛风骨痛巴布膏所含3个功效组均与其减轻疼痛症状的作用环节相关,祛风散寒组、舒筋活血组与消肿止痛组的作用可分别概括为散寒止痛、活血止痛、消肿止痛,三组共同发挥祛邪止痛之效;在纠正机体代谢水平紊乱方面,祛风散寒组与消肿止痛组的作用分别概括为祛风散寒除湿和行气消肿止痛;在矫正机体“免疫-炎症-血管轴”失衡方面,舒筋活血组的作用概括为疏肝行气、活血化瘀。进一步基于“病-证-症-方”关联网络分析策略,祛风骨痛巴布膏干预OA、NP、CIP与MPS致病基因互作网络的关键网络靶标可能通过矫正疾病发生和进展中的“神经-内分泌-免疫”失衡系统,发挥缓解痛觉过敏和感觉异常等症状的治疗作用。综上所述,祛风骨痛巴布膏可改善风寒湿痹证典型关联疾病的疼痛等相关症状,其作用机制可能与其通过调节机体“神经-内分泌-免疫”系统,发挥中枢镇痛、纠正内分泌紊乱、矫正“免疫-炎症”失衡的药理作用相关。相关结果将为祛风骨痛巴布膏的临床合理定位提供网络分析依据,也为进一步的临床和实验验证提供基础和方向。Growing clinical evidence shows that Qufeng Gutong Cataplasm may exert a significant analgesic effect.However,the pharmacological characteristics and mechanisms underlying this prescription are still unclear.In the current study,a"disease-syndrome-symptom-formula"association network analysis was performed to explore the pharmacological characteristics and mechanisms of Qufeng Gutong Cataplasm against osteoarthritis(OA),neuropathic pain(NP),chronic inflammatory pain(CIP)and myofascial pain syndrome(MPS)by integrating clinical phenomics data,transcriptomics data and biological interaction network mining.As a result,the three functional modules(Qufeng Sanhan-QFSHG,Shujin Huoxue-SJHXG and Xiaozhong Zhitong-XZZTG)enriched by the drug network targets were all related to the pharmacological effects of Qufeng Gutong Cataplasm,including dispersing cold and relieving pain,activating blood and relieving pain,reducing swelling and relieving pain.In addition,the main pharmacological effects of QFSHG and XZZTG were dispelling wind and dispersing cold and dehumidifying,promoting Qi and reducing swelling and relieving pain,respectively.In terms of reversing the imbalance of"immune-inflammation-vascular axis",the main pharmacological effects of SJHXG were regulating the liver and promoting Qi,activating blood circulation and removing stasis.Mechanically,the key network targets of Qufeng Gutong Cataplasm against OA,NP,CIP and MPS may play a therapeutic role in relieving hyperalgesia and paresthesia by reversing the"neuro-endocrine-immune"imbalance system during the occurrence and progression of diseases.In conclusion,our data indicate that Qufeng Gutong Cataplasm may relieve the pain and wind-cold-dampness arthralgia syndrome related symptoms by regulating the"neuro-endocrine-immune"system,neurological and endocrine disorders and reversing the imbalance of"immunity-inflammation".The relevant results may provide a network-based evidence for clinical positioning of Qufeng Gutong Cataplasm,and offer a direction for further clinical a

关 键 词：祛风骨痛巴布膏 风寒湿痹证 “病-证-症-方”关联网络 功效特点 作用机制 

分 类 号：R966[医药卫生—药理学]