Meta分析-网络药理学的芪明颗粒治疗糖尿病视网膜病变的疗效评价及机制探析  

The efficacy evaluation and mechanism analysis of Qiming granules in the treatment of diabetic retinopathy based on Meta-analysis and network pharmacology

作　　者：陈鑫钰 张大铮[1,7,8,9] 刘敏 黄莉红 周静 蔡晓彤[1,2,7,8,9] 谢涛 林见知 马志睿 钱柯宏 刘穆颉鑫 钟娟 CHEN Xinyu;ZHANG Dazheng;LIU Min;HUANG Lihong;ZHOU Jing;CAI Xiaotong;XIE Tao;LIN Jianzhi;MA Zhirui;QIAN Kehong;LIU Mujiexin;ZHONG Juan

机构地区：[1]都江堰市人民医院,四川成都611830 [2]成都中医药大学,四川成都610072 [3]成都市妇女儿童中心医院,四川成都610073 [4]成都中医大银海眼科医院,四川成都610084 [5]北京中医药大学,北京100105 [6]都江堰市第五人民医院,四川都江堰611130 [7]都江堰市青少年近视防治中心,四川都江堰611843 [8]都江堰市青城中医研究院,四川都江堰611830 [9]都江堰市中医博士后工作室,四川都江堰611830

出　　处：《中医临床研究》2024年第33期38-48,共11页Clinical Journal Of Chinese Medicine

摘　　要：目的:借助Meta分析和网络药理学方法观察芪明颗粒治疗糖尿病视网膜病变(Diabetic Retinopathy,DR)的临床疗效,探讨潜在治疗机制。方法:检索中英文数据库中芪明颗粒治疗DR的随机对照试验(Randomized Controlled Trial,RCT)文献,根据纳入、排除标准和数据的完整程度筛选文献,采用Review Manage 5.4对纳入文献进行Meta分析。基于网络药理学筛选芪明颗粒有效成分、疾病靶点,对潜在作用靶点进行基因本体论(GO)和京都基因与基因组百科全书(KEGG)富集分析,探讨芪明颗粒治疗DR的潜在机制。结果:共纳入10项RCT研究。Meta分析显示,在总有效率、视力、血清炎症细胞因子[白细胞介素(Interleukin,IL)-6、肿瘤坏死因子(Tumor Necrosis Factor,TNF)-α]含量、视网膜中央动脉阻力指数(Resistance Index,RI)、眼底出血指标(微血管瘤数量、出血灶面积)方面,治疗组效果优于对照组,两组不良反应差异无统计学意义。运用网络药理学方法,通过数据库检索,共收集到187个药物活性成分、1870个药物靶点和2238个疾病靶点,最终获得588个潜在靶点。主要有效成分为花生四烯酸、异鼠李素、大黄酸、山柰酚、槲皮素,度值居前5位的靶点为肿瘤蛋白p53(Tumor Protein p53,TP53)、SRC原癌基因(SRC Proto-Oncogene,SRC)、组蛋白乙酰基转移酶P300(EP300)、丝裂原活化蛋白激酶1(Mitogen-Activated Protein Kinases 1,MAPK1)、丝氨酸/苏氨酸蛋白激酶1(Akt Serine/Threonine Kinase 1,AKT1),主要涉及晚期糖基化终末产物(Advanced Glycation End-product,AGE)与其受体(Receptor for Advanced Glycation End Products,RAGE)、磷脂酰肌醇3激酶-蛋白激酶B(Phosphatidylinositol 3-kinase-Akt,PI3K-Akt)、腺苷酸活化蛋白激酶(AMP-activated Protein Kinase,AMPK)等多条信号通路。结论:芪明颗粒有效化学成分通过多途径、多通路减轻炎症、改善视网膜中央动脉RI、减少眼底出血,提高视力,安全性良好。Objective:To observe the clinical efficacy of Qiming granules(芪明颗粒)in the treatment of diabetic retinopathy,and to explore the potential therapeutic mechanism by means of Meta-analysis and network pharmacology.Methods:Randomized controlled trials of Qiming granules in the treatment of diabetic retinopathy in Chinese and English databases were searched,to screen the relevant literature according to the inclusion criteria and exclusion criteria and the completeness of the data.Meta-analysis was performed on the included literature by Review Manage 5.4.The active ingredients and disease targets of Qiming granules were screened based on network pharmacology,and the potential targets were enriched by GO and KEGG to explore the potential mechanism of the in the treatment of diabetic retinopathy.Results:A total of 10 RCTs were included.Meta-analysis showed that the treatment group was better than the control group in total effective rate,visual acuity,serum inflammatory cytokines(IL-6,TNF-α)content,central retinal artery resistance index,fundus bleeding indexes(number of microhemangioma,bleeding focus area),and there was no statistical difference in adverse reactions between the two groups.A total of 187 drug active ingredients,1870 drug targets and 2238 disease targets were collected through the database search and the network pharmacology method,and 588 potential targets were obtained.

关 键 词：芪明颗粒 糖尿病视网膜病变 荟萃分析 网络药理学 潜在机制 

分 类 号：R587.1[医药卫生—内分泌]