瓜蒌皮注射液治疗高同型半胱氨酸颈动脉粥样硬化的效果及机制研究  

Clinical and experimental research of trichosanthis peel extract injection in treating of hyperhomocysteinemia carotid atherosclerosis

作　　者：甄庆强 朱冬霞 刘永昌 孙岩 ZHEN Qing-qiang;ZHU Dong-xia;LIU Yong-chang(Department of Hepatobiliary and Vascular Surgery,Jinan People's Hospital,Jinan,271100,China)

机构地区：[1]济南市人民医院肝胆血管外科,山东济南271100 [2]济南市人民医院中医科,山东济南271100 [3]山东第一医科大学附属省立医院血管外科,山东济南250021

出　　处：《中国中西医结合外科杂志》2024年第1期112-118,共7页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：山东省中医药科技发展计划(2019-0303);山东省医药卫生科技发展计划(2018WS273);济南市卫生健康委员会科技计划项目(2020-4-124)。

摘　　要：目的:探讨瓜蒌皮注射液治疗高同型半胱氨酸颈动脉粥样硬化的效果和潜在机制。方法:选取2019年1月—2021年1月济南市人民医院收治的高同型半胱氨酸颈动脉粥样硬化患者120例,采用随机数字表法分为观察组(60例)和对照组(60例)。观察组采用他汀类药物联合瓜蒌皮注射液治疗,对照组采用他汀类药物治疗,比较两组患者治疗前后血脂水平、同型半胱氨酸水平和颈动脉内膜中层厚度。利用网络药理学和生物信息学思路挖掘瓜蒌皮干预颈动脉粥样硬化的潜在机制,设计动物实验加以验证。结果:瓜蒌皮注射液可显著降低患者总胆固醇、甘油三酯、低密度脂蛋白胆固醇和血清同型半胱氨酸水平,减小颈动脉内中膜厚度,效果优于单独使用他汀类药物。网络药理学和实验研究证实,瓜蒌皮注射液可抑制高同型半胱氨酸动脉粥样硬化模型大鼠腹主动脉肿瘤坏死因子-α(TNF-α)、核转录因子-κB p65、基质金属蛋白酶-9(MMP-9)和血管细胞黏附因子-1(VCAM-1)水平。结论:瓜蒌皮注射液可降低高同型半胱氨酸颈动脉粥样硬化患者血脂水平,延缓病情的进展。瓜蒌皮注射液可调控TNF/NF-κB信号通路,发挥抗高同型半胱氨酸颈动脉粥样硬化的作用。Objective To investigate the effect of trichosanthis peel extract injection in the treatment of hyperhomocysteinemia carotid atherosclerosis and potential mechanism.Methods 120 patients with hyperhomocysteinemia carotid atherosclerosis who were hospitalized in Jinan People's Hospital from January 2019 to January 2021 were included and randomly divided into observation group(60 cases)and control group(60 cases)using random number table method.The observation group was treated with statins combined with trichosanthis peel extract,and the control group was treated with statins.The lipid level,homocysteine level and carotid artery intima-media thickness were compared before and after treatment in both groups.The network pharmacology and bioinformatics were used to explore the mechanism of trichosanthis peel extract injection treating carotid atherosclerosis.The experimental study was performed to validate the mechanism.Results Trichosanthis peel extract injection could significantly reduce the level of total cholesterol,triglycerides,low density lipoprotein cholesterol,homocysteine and the carotid artery intima-media thickness.The treatment effect was better than using statins alone.Network pharmacology and experimental study showed that the trichosanthis peel extract injection could reduce the expression of tumor necrosis factorα,nuclear factorκB p65,matrix metalloprotein 9 and vessel cell adhesion molecule 1 in abdominal aorta of hyperhomocysteinemia atherosclerosis rats.Conclusion Trichosanthis peel extract injection can reduce lipid levels and slow down the progression of disease in patients with hyperhomocysteinemia carotid atherosclerosis.Trichosanthis peel extract injection could treat hyperhomocysteinemia atherosclerosis by regulating TNF/NF-κB signaling pathway.

关 键 词：颈动脉粥样硬化 高同型半胱氨酸 瓜蒌皮注射液 网络药理学 生物信息学 

分 类 号：R654.4[医药卫生—外科学]