中药联合化疗治疗中晚期非小细胞肺癌的系统评价和中药有效成分筛选及其机制研究  

Systematic Evaluation of Traditional Chinese Medicine Combined with Chemotherapy in the Treatment of Advanced Non-small Cell Lung Cancer and Screening of Effective Components of Traditional Chinese Medicine and Its Mechanism

作　　者：唐乾[1,2] 先正平 唐钰 曹洪玉 王立皓[2,3] 佟昊聪 杜亚男 郑学仿[2,3] Tang Qian;Xian Zhengping;Tang Yu;Cao Hongyu;Wang Lihao;Tong Haocong;Du Yanan;Zheng Xuefang(College of Life and Healthy,Dalian University,Dalian 116622,China;College of Environmental and Chemical Engineering,Dalian University,Dalian 116622,China;Liaoning Key Laboratory of Bio-organic Chemistry,Dalian University,Dalian 116622,China)

机构地区：[1]大连大学生命健康学院,辽宁大连116622 [2]大连大学环境与化学工程学院,辽宁大连116622 [3]辽宁省生物有机化学重点实验室,大连大学,辽宁大连116622

出　　处：《南京师大学报(自然科学版)》2025年第2期47-61,共15页Journal of Nanjing Normal University(Natural Science Edition)

基　　金：国家自然科学基金项目(21571025、21601024、21601025、21601023);大连大学学科建设专项-学科交叉项目(DLUXK-2023-YB-007);大连大学学科平台项目(202101ZD01).

摘　　要：中药不论在直接抑制肿瘤生长,还是辅助西医治疗肿瘤方面都发挥着不容忽视的作用.本文经检索中国知网、万方、维普、Pubmed、Web of Science等数据库,纳入中药汤剂联合化疗治疗非小细胞肺癌(NSCLC)的随机对照试验,通过Meta、用药规律、网络药理学和细胞实验等分析方法系统评价中药联合化疗治疗NSCLC的疗效、安全性及作用机制,最终纳入56篇文献进行统计分析,共4992例患者、57首处方、172味中药.结果显示,中药联合化疗治疗组的1年生存率、肝功能损伤、总有效率、胃肠道不良反应等方面均优于单纯化疗组.用药频次>20的有7味:药味以甘苦为主,药性以寒温为主,主要归为肺经和肝经.得到5个高频药物聚类,关联规则分析得到置信度最高的4条药物组合为:天花粉-麦冬、玉竹-麦冬、北沙参-玉竹-麦冬、白术-黄芪-党参.收集到核心中药成分潜在作用靶点与NSCLC交集靶点126个;PPI分析得到3个核心靶点:AKT1、EGFR、SRC;KEGG分析表明关键通路为PI3K-Akt信号通路;筛选得到3个关键成分:木犀草素、槲皮素、山柰酚;分子对接结果表明关键成分和核心靶点均能稳定结合.细胞实验结果表明,木犀草素可有效抑制A549细胞的增殖、活力和迁移,诱导其发生凋亡,并使其形态发生变化.本文结果表明,中药联合化疗治疗NSCLC可以提高其临床疗效、降低化疗的毒副作用;黄芪、麦冬、党参、北沙参等核心中药多种成分可通过多靶点、多途径协同治疗NSCLC;关键中药的核心成分木犀草素可抑制A549细胞的增殖、活力和迁移,并可诱导其发生凋亡.Traditional Chinese medicine plays an important role in both directly inhibiting tumor growth and assisting western medicine in the treatment of tumors.In this paper,the study searched CNKI,Wanfang,VIP,Pubmed,Web of Science and other databases to include randomized controlled trials of traditional Chinese medicine decoction combined with chemotherapy in the treatment of NSCLC.The efficacy,safety and mechanism of traditional Chinese medicine combined with chemotherapy in the treatment of non-small cell lung cancer(NSCLC)were systematically evaluated by Meta,medication rules,network pharmacology and cell experiments.The efficacy,safety and mechanism of traditional Chinese medicine combined with chemotherapy in the treatment of non-small cell lung cancer were systematically evaluated by Meta,medication rules,network pharmacology and other analytical methods.Finally,56 articles were included for statistical analysis,a total of 4992 patients,57 prescriptions,and 172 Chinese medicines.The results showed that the total effective rate,liver function injury,gastrointestinal reaction and 1-year survival rate of the combined treatment group were better than those of the chemotherapy group.There were 7 flavors with medication frequency>20,the flavor of the medicine was mainly sweet and bitter,the medicinal properties were mainly cold and warm,mainly classified as lung meridian and liver meridian,5 high-frequency drug clusters were obtained,4 drug combinations with the highest confidence obtained by association rule analysis,that were Trichosanthis Radix-Ophiopogon japonicus,Polygonatum odoratum-Ophiopogon japonicus,Glehniae Radix-Polygonatum odoratum-Ophiopogon japonicus,Atractylodes-Astragali Radix-Codonopsis Radix.A total of 126 potential targets of core Chinese medicine components and NSCLC intersection targets were collected.Three core targets were obtained by PPI analysis:AKT1,EGFR and SRC.KEGG analysis showed that the key pathway was PI3K-Akt signaling pathway.Three key components were screened,that were luteolin,querc

关 键 词：非小细胞肺癌 中药 Meta分析 用药规律 网络药理学 分子对接 生物学验证 

分 类 号：O641[理学—物理化学] O622[理学—化学] R273[医药卫生—中西医结合]