“黄芪-白术”药对在肝癌临床应用的组方规律及最适配伍比例  

Formulation regularity and optimal compatibility ratio of“Huangqi-Baizhu”drug pairs for treating liver cancer

作　　者：严毅超 张露蓉[1,2] YAN Yichao;ZHANG Lurong(Central Laboratory,Affiliated Suzhou TCM Hospital,Nanjing University of Chinese Medicine,Jiangsu Suzhou 215009,China;Suzhou Academy of Wumen Chinese Medicine,Research&Development Department of Traditional Chinese Medicine,Jiangsu Suzhou 215009,China)

机构地区：[1]南京中医药大学附属苏州市中医医院中心实验室,江苏苏州215009 [2]苏州市吴门医派研究院中药研究与开发部,江苏苏州215009

出　　处：《中国医院药学杂志》2024年第10期1123-1131,共9页Chinese Journal of Hospital Pharmacy

基　　金：苏州市姑苏卫生人才科研项目(编号:GSWS2022078);苏州市科技计划项目(编号:SKJY2021132);江苏省卫生健康委医学科研项目(编号:M2020004);江苏省研究生科研创新计划(编号:KYCX23_2059)。

摘　　要：目的:探索临床应用于肝癌治疗的含“黄芪-白术”药对中药方剂的组方规律及最适配伍比例,为黄芪-白术在抗肝癌的临床合理应用提供证据。方法:以中国知网、万方、维普数据库为来源,筛选符合条件处方,提取药物信息,建立数据汇总表。使用Excel 2019、SPSS Modeler 18.0、SPSS Statistics 24.0、中医传承辅助平台V2.50、RevMan 5.3统计软件进行组方分析和临床疗效评价;运用细胞增殖实验和肝癌小鼠生存期实验探讨黄芪-白术治疗肝癌的最佳比例。结果:(1)黄芪-白术是治疗肝癌的常用药对。(2)组方分析显示与黄芪-白术药对配伍使用频次排名前5位的中药依次为茯苓、甘草、薏苡仁、麦芽、柴胡;药物类别以补虚药最多,其次是清热药、活血化瘀药和利水渗湿药。(3)Meta分析显示所有纳入文章偏倚不大,运用含黄芪-白术中药处方的治疗组,其对瘤体近期疗效的有效率显著高于对照组,OR=2.31,95%CI(1.80,2.97),P<0.0001。(4)肝癌细胞增殖实验显示黄芪-白术比例为1∶1、2∶1、1∶2时IC50接近,分别为64.71、68.40、69.08 mg·mL^(–1);肝癌小鼠生存期实验显示黄芪-白术比例为1∶2时生存率最高,为62.5%,且抑瘤率最高,为35.97%。结论:“黄芪-白术”药对在肝癌临床治疗中应用广泛,黄芪-白术及其组方符合肝癌治疗的临床原则,具有良好的治疗作用;同时黄芪-白术比例为1∶2时,肝癌小鼠生存率最高,为临床合理组方配比提供依据。OBJECTIVE To explore the composition regularity and optimal compatibility ratio of traditional Chinese medicine(TCM)formulas containing Huangqi-Baizhu(HB)for treating liver cancer(LC)and provide rationales for rational clinical application of HB for LC.METHODS The databases of China National Knowledge Infrastructure(CNKI),Wanfang and VIP were employed as prescription sources for selecting suitable prescriptions and extracting drug information.Excel 2019,SPSS Modeler 18.0,SPSS Statistics 24.0,TCM Inheritance Auxiliary Platform V2.50 and RevMan5.3 statistical software were employed for grouping analysis and clinical efficacy evaluations.Optimal ratio of Huangqi-Baizhu for treating LC was assessed by cell proliferation and murine survival assays.RESULTS Composition analysis showed that Top 5 traditional Chinese medicines in terms of compatibility frequency with HB were Poria cocos,licorice,Coix seed,malt and Bupleurum chinense.The most common types of medications were of tonifying deficiency followed by those of clearing heat,promoting blood circulation and resolving blood stasis and promoting water and dampness.Meta-analysis demonstrated not much bias among all included articles.Treatment group of HB achieved a significantly higher effective rate in short-term treatment than control group[OR=2.31,95%CI(1.80,2.97),P<0.0001].LC cell proliferation assay indicated that,at a ratio of Huangqi-Baizhu of 1∶1,2∶1 and 1∶2,the values of half maximal inhibitory concentration(IC50)were 64.71,68.40 and 69.08 mg·mL^(–1) respectively.And survival assay revealed that the highest survival rate was 62.5%at a ratio of 1∶2.Tumor inhibition rate peaked at 35.97%.CONCLUSION HB pair is widely applied for clinical treatment of LC.HB and its combination accord well with the clinical therapeutic principles of LC and offer excellent therapeutic outcomes.At the same time,at a formulation ratio of 1∶2,survival rate is the highest for LC mice.Thus it provides rationales for clinical rational formulation of HB.

关 键 词：黄芪-白术 组方规律 META分析 配伍比例 原发性肝癌 

分 类 号：R285[医药卫生—中药学]