基于网络药理学和临床检测探讨苦参洗剂治疗混合痔的作用机制  

Exploration based on network pharmacology and clinical testing for mechanism of action of Sophora flavescens lotion in treatment of mixed hemorrhoids

作　　者：钟杭燕 刘海琴 王菁[3] Zhong Hangyan;Liu Haiqin;Wang Jing(Anorectal Department,Shanghang County Traditional Chinese Medicine Hospital,364200 Longyan,China;Shanghai Seventh People's Hospital,Shanghai 200137,China;Department of Proctology,People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350004,China)

机构地区：[1]上杭县中医院肛肠科,龙岩364200 [2]上海市第七人民医院,上海200137 [3]福建中医药大学附属人民医院肛肠科,福州350004

出　　处：《国际医药卫生导报》2024年第19期3197-3202,共6页International Medicine and Health Guidance News

基　　金：福建省中医肛肠与肛周创面修复临床医学研究中心(闽科社[2023]3号)。

摘　　要：目的探讨苦参洗剂治疗混合痔的作用机制。方法在网络药理学数据库中筛选出药物主要活性成分和疾病靶点,并进行富集分析和分子对接;采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测上杭县中医院肛肠科2023年1月1日至12月31日收治的100例混合痔患者苦参洗剂治疗前后血清白细胞介素-6(interleukin-6,IL-6)、转化生长因子-β(transforming growth factor-β,TGF-β)水平。采用t检验。结果苦参洗剂主要活性成分为槲皮素、木犀草素、β-谷甾醇、豆甾醇、山奈酚。苦参洗剂与混合痔相互作用核心靶点为蛋白激酶B(protein kinase B,AKT1)、白细胞介素-1β(interleukin-1β,IL-1β)、IL-6、肿瘤坏死因子(tumor necrosis factor,TNF)、基质金属蛋白酶-9(matrix metalloproteinase 9,MMP9)、TGF-β。主要有效成分能与核心靶点有效结合。富集分析显示,主要与晚期糖基化产物-晚期糖基化终末产物受体(advanced glycation end product-receptor of advanced glycation end product,AGE-RAGE)、磷脂酰肌醇三激酶-蛋白激酶B(phosphatidylinositol 3 kinase-v-akt murine thymoma viral oncogene homolog,PI3K-Akt)等信号通路有关。ELISA检测结果显示,治疗后,血清IL-6水平低于治疗前[10.15(3.80,14.48)mg/L比19.30(8.68,27.00)mg/L],血清TGF-β水平高于治疗前[0.8(0.6,1.0)mg/L比0.4(0.2,0.6)mg/L](均P<0.05)。结论苦参洗剂有效活性成分与核心靶点结合,通过AGE-RAGE、PI3K-Akt等信号通路调节炎症因子的表达,进而发挥治疗作用。这可能是苦参洗剂治疗混合痔的主要作用机制。Objective To explore the mechanism of action of Sophora flavescens lotion in the treatment of mixed hemorrhoids.Methods The drugs'main active ingredients and disease targets were screened from online pharmacology databases;enrichment analysis and molecular docking were conducted;enzyme-linked immunosorbent assay(ELISA)was used to detect the serum levels of interleukin-6(IL-6)and transforming growth factor-β(TGF-β)in 100 patients with mixed hemorrhoids before and after the treatment with Sophora flavescens lotion at Shanghang County Traditional Chinese Medicine Hospital from January 1 to December 31,2023.t test was used.Results The main active ingredients of Sophora flavescens lotion are quercetin,luteolin,β-sitosterol,stigmasterol,and kaempferol.Sophora flavescens lotion interacts with the core targets of mixed hemorrhoids,such as protein kinase B(AKT1),interleukin-1β(IL-1β),IL-6,tumor necrosis factor(TNF),matrix metalloproteinase-9(MMP9),and TGFβ.The main active ingredients can effectively bind to the core targets.The enrichment analysis showed that it is mainly related to signaling pathways such as advanced glycation end product-receptor of advanced glycation end product(AGE-RAGE),phosphatidylinositol 3 kinase-v-akt murine thymoma viral oncogene homolog(PI3K-Akt),etc.The results of ELISA showed that the serum IL-6 level was lower after than before the treatment[10.15(3.80,14.48)vs(19.30(8.68,27.00)mg/L)mg/L],and the TGFβlevel was higher after than before the treatment[0.8(0.6,1.0)mg/L vs.0.4(0.2,0.6)mg/L](both P<0.05).Conclusions The effective active ingredients of Sophora flavescens lotion bind to the core targets,and exert therapeutic effects regulating the expression of inflammatory factors through signaling pathways such as AGE-RAGE and PI3K-Akt.This may be the main mechanism of Sophora flavescens lotion in treating mixed hemorrhoids.

关 键 词：混合痔 苦参洗剂 网络药理学 作用机制 

分 类 号：R285.6[医药卫生—中药学]