黄芩咳喘散治疗支气管哮喘临床研究和网络药理学效应机制探讨  

Clinical Study and Network Pharmacology Mechanism Explorationof Huangqin Kechuan San in the Treatment of Bronchial Asthma

作　　者：许伟英[1] 孙永宁[1] 王子杨 刘美志 屠艳婕 曹燕[1] 折哲[1] XU Weiying;SUN Yongning;WANG Ziyang;LIU Meizhi;TU Yanjie;CAO Yan;ZHE Zhe(Affiliated Municipal Hospital of Traditional Chinese Medicine of Shanghai University of Chinese Medicine,Shanghai 200071,China;Graduate School of Shanghai University of Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属市中医医院,上海200071 [2]上海中医药大学研究生院,上海201203

出　　处：《现代中医药》2024年第5期51-61,共11页Modern Chinese Medicine

基　　金：上海市卫生健康委员会科研课题(202040261)。

摘　　要：目的基于网络药理学研究黄芩咳喘散防治支气管哮喘的有效性及其效应物质探讨。方法选取符合纳入标准的患者共94例,随机分为治疗组和对照组各47例。所有患者均接受常规药物治疗。治疗组给予黄芩咳喘散三伏贴,对照组给予其模拟剂三伏贴。对比两组患者治疗前后中医症候积分评分情况、ACT评分、半年内疾病发作次数、血清嗜酸性粒细胞(EOS)等情况。基于网络药理学和分子对接等探讨黄芩咳喘散与支气管哮喘可能的效应物质及作用机制。结果数据显示:①治疗组患者临床治疗总有效率高于对照组(P<0.05);②治疗组患者咳嗽气促、喘息咯痰、食少便溏、神疲乏力单项症状评分、ACT评分、半年内疾病发作次数均低于对照组(均P<0.05);③两组患者EOS水平均降低,且治疗组各指标值明显低于对照组(均P<0.05);④网络药理学筛选黄芩咳喘散有效活性成分潜在作用靶点与支气管哮喘的交集靶点26个,关键有效成分包括四羟基黄酮、亚油酸乙酯、棕榈酸等,涉及核心靶点包括SIRT1、STAT3、ESR1、PPARA等,可能涉及免疫、脂肪酸代谢、激素类反应、细胞坏死因子反应等生物过程。⑤分子对接显示黄芩咳喘散中有效活性成分四羟基黄酮(5,7,2′,6′-Tetrahydroxyflavone)通过氢键分别与支气管哮喘关键靶点SIRT1的氨基酸ILE411、GLU410、LYS408、SER370、LYS375,与STAT3的氨基酸ASP334、LYS574,与ESR1的氨基酸LEU346及PPARA的氨基酸MET320、LEU331、THR334结合。结论黄芩咳喘散治疗支气管哮喘肺脾气虚证患者具有可靠的临床疗效,在改善临床症状、减少疾病发作次数等具有积极作用。经网络药理学分析黄芩咳喘散可能通过SIRT1、STAT3、ESR1等靶点作用于PI3K-Akt、JAK-STAT、NF-κB等通路从减轻气道炎症反应、抑制气道重塑等方面发挥治疗作用,进一步分子对接后提示该药的有效活性成分四羟基黄酮与哮喘疾病Objective Based on network pharmacology,this study aims to investigate the effectiveness of Huangqin Kechuan San in preventing and treating bronchial asthma,as well as to explore its effective substances.Methods A total of 94 patients who met the inclusion criteria were randomly divided into a treatment group and a control group,with 47 patients in each group.All patients received routine medication treatment.The treatment group was given Huangqin Kechuan San Sanfu Paste,while the control group was given its analog Sanfu Paste.Compare the TCM symptom score,ACT score,frequency of disease attacks within six months,and serum eosinophil count(EOS)between two groups of patients before and after treatment.Exploring the possible effector substances and mechanisms of Huangqin Kechuan San in relation to bronchial asthma based on network pharmacology and molecular docking.Results The data showed that:①The total effective rate of clinical treatment in the treatment group was higher than that in the control group(P<0.05);②The single symptom scores,ACT scores,and frequency of disease attacks within six months in the treatment group were lower than those in the control group(all P<0.05),including cough,shortness of breath,wheezing,phlegm production,reduced appetite,loose stools,and fatigue.The EOS levels of both groups of patients decreased,and the values of various indicators in the treatment group were significantly lower than those in the control group(both P<0.05);④Network pharmacology screening identified 26 potential targets of active ingredients in Huangqin Kechuan San that intersect with bronchial asthma.Key active ingredients include tetrahydroxyflavonoids,ethyl linoleate,palmitic acid,etc.Core targets include SIRT1,STAT3,ESR1,PPARA,etc.,which may involve biological processes such as immunity,fatty acid metabolism,hormone reactions,and cell necrosis factor reactions.⑤Molecular docking showed that the effective active ingredient tetrahydroxyflavone(5,7,2′,6′-Tetrahydroxyflavone)in Huangqin Kechuan San was h

关 键 词：黄芩咳喘散 支气管哮喘 临床疗效 网络药理学靶点 分子对接 

分 类 号：R256.11[医药卫生—中医内科学]