参乌益智胶囊治疗卒中后认知障碍的临床疗效及网络药理学机制研究  

Clinical Efficacy of Shen Wu Yizhi Capsule in the Treatment of Post-Stroke Cognitive Impairment and Its Network Pharmacological Mechanism

作　　者：郭灿 班文明 杜姜 赵莉莉 孙媛媛 孙悦 陈佳宁 GUO Can;BAN Wenming;DU Jiang;ZHAO Lili;SUN Yuanyuan;SUN Yue;CHEN Jianing(The First Clinical Medical School of Anhui University of Chinese Medicine,Hefei 230000 Anhui,China;Taihe Traditional Chinese Medicine Hospital Affiliated to Anhui University of Chinese Medicine,Taihe 236000 Anhui,China)

机构地区：[1]安徽中医药大学第一临床医学院,安徽合肥230000 [2]安徽中医药大学附属太和中医院,安徽阜阳236000

出　　处：《广州中医药大学学报》2025年第2期328-336,共9页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：安徽省中医药管理局科研项目(编号:2022CCYB16);安徽省高等学校科学研究项目(编号:2022AH050476);安徽中医药大学临床科研项目(编号:2023LCTH01)。

摘　　要：【目的】运用网络药理学方法及临床试验验证,探讨参乌益智胶囊治疗卒中后认知障碍(PSCI)的作用机制。【方法】前瞻性纳入2022年8月~2024年2月安徽中医药大学附属太和中医院收治的90例PSCI患者,采用随机数字表法将患者随机分为对照组和试验组,每组各45例。对照组予以PSCI常规治疗,试验组在对照组的基础上加用参乌益智胶囊治疗,疗程为28 d。观察2组患者治疗前后简易精神状态检查量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分及血清肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)等炎症因子的变化情况,并记录2组患者不良事件发生情况,评价2组治疗方案的安全性。基于网络药理学方法,运用TCMSP及查阅文献获得参乌益智胶囊有效活性成分,运用GeneCards等数据库得到PSCI疾病靶点,将共同靶点输入至STRING数据库构建PPI网络,通过Cytoscape 3.9.0构建参乌益智胶囊-PSCI-靶点网络图,运用DAVID进行GO及KEGG通路富集分析,再通过分子对接验证结合活性。【结果】(1)临床研究方面,治疗28 d后,2组患者的MMSE、MoCA评分均较治疗前升高(P<0.05),且试验组的升高幅度均明显优于对照组(P<0.05);血清TNF-α、IL-6水平均较治疗前降低(P<0.05),且试验组的降低幅度均明显优于对照组(P<0.05);同时,2组患者在试验过程中均未见明显不良反应,具有较高的安全性。(2)网络药理学方面,参乌益智胶囊活性成分共92个,靶点803个,疾病靶点5209个,交集靶点556个,核心靶点为AKT1、TNF、IL-6、TP53、IL-1B,关键化合物为脱氧三尖杉酯碱、洋川芎醌、芫花素等,富集得到1812个GO条目,其中细胞成分(CC)154个,生物学过程(BP)1332个,分子功能(MF)326个,富集到195条KEGG信号通路;分子对接结果显示,参乌益智胶囊关键化合物与核心靶点间具有良好的结合活性。【结论】参乌益智胶囊治疗PSCI临床疗效显著,多成分可能通过AKT1、TNF、IL-6等�Objective To investigate the therapeutic mechanism of Shen Wu Yizhi Capsule in the treatment of poststroke cognitive impairment(PSCI)by using network pharmacology methods and clinical trial validation.Methods A prospective trial was carried out in 90 cases of patients with PSCI admitted to Taihe Traditional Chinese Medicine Hospital Affiliated to Anhui University of Chinese Medicine from August 2022 to February 2024.The patients were randomly divided into the control group and the trial group by random number table method,with 45 cases in each group.The control group was treated with conventional treatment for PSCI,and the trial group was treated with Shen Wu Yizhi Capsule orally on the basis of treatment for the control group.The treatment course for the two groups covered 28 days.The changes of Mini-Mental State Examination(MMSE)score,Montreal Cognitive Assessment(MoCA)score,and the serum levels of inflammatory factors such as tumor necrosis factorα(TNF-α)and interleukin 6(IL-6)in the patients of the two groups were observed before and after treatment.Moreover,the incidences of adverse events in the two groups were recorded,thus to evaluate the safety of the treatment regimens in the two groups.And then the network pharmacological research was performed.TCMSP and literature review were used to obtain the active ingredients of Shen Wu Yizhi Capsule,GeneCards and other databases were used to obtain the PSCI disease targets,and the common targets were inputted into the STRING database to construct the PPI network.Cytoscape 3.9.0 was used to construct the network diagram of Shen Wu Yizhi Capsule-PSCI-targets,DAVID was used to perform GO and KEGG pathway enrichment analysis,and then molecular docking was used to verify the binding activity.Results(1)The results of clinical trial showed that after 28 days of treatment,the MMSE and MoCA scores of patients in the two groups were increased compared with those before treatment(P<0.05),and the increase of the scores in the trial group was significantly superior to that

关 键 词：参乌益智胶囊 卒中后认知障碍 网络药理学 分子对接 核心靶点 炎症因子 

分 类 号：R277.7[医药卫生—中医学]