中药复方治疗突发性聋的疗效和可能机制:一项结合网络药理学研究的回顾性临床分析  

Protective effect of Chinese herbal medicine on sudden sensorineural hearing loss: a retrospective analysis and network pharmacology

作　　者：王鑫[1] 原晶晶 郝鹏鹏 闫占峰[2] 刘建华[2] 钟利群[1] 刘思溟[2] 吴薇 赵晓阳 张莹[2] WANG Xin;YUAN Jingjing;HAO Pengpeng;YAN Zhanfeng;LIU Jianhua;ZHONG Liqun;LIU Siming;WU Wei;ZHAO Xiaoyang;ZHANG Ying(Department of Encephalopathy,Dongzhimen Hospital,Beijing University of ChineseMedicine,Beijing 100700,China;Department of Otolaryngology,Dongzhimen Hospital,Beijing University of ChineseMedicine,Beijing 100700,China)

机构地区：[1]北京中医药大学东直门医院脑病科,北京100700 [2]北京中医药大学东直门医院耳鼻喉科,北京100700

出　　处：《山东大学耳鼻喉眼学报》2025年第2期6-17,共12页Journal of Otolaryngology and Ophthalmology of Shandong University

基　　金：北京市自然科学基金(7214290)。

摘　　要：目的 探讨中药(traditional Chinese medicine, TCM)治疗突发性聋(sudden sensorineural hearing loss, SSNHL)的疗效和可能机制,为临床应用和下一步研究提供参考。方法 通过回顾性临床研究总结SSNHL患者的基本信息,获取TCM治疗SSNHL的频率,并通过症状和纯音测听结果分析疗效。利用网络药理学技术,在TCMSP和BATMAN-TCM平台获取前20味TCM的有效成分、靶点,在GeneCards和OMIM数据平台得到疾病靶点,取交集靶点后基于String和Metascape平台分析蛋白-蛋白相互作用、核心靶点和通路。结果 SSNHL患者平均年龄为51岁,患耳中左耳占59.05%,右耳占39.05%,双耳听力下降占1.9%。临床总有效率为72.90%,治疗后耳鸣、耳闷、眩晕症状的缓解程度不同。网络药理学研究得出,前20味中药治疗SSNHL涉及多靶点、多通路、多机制,其中核心靶点包括MAPK1、AKT1、JUN、TP53、EGFR等,关键通路有Pathways in cancer、Lipid and atherosclerosis、Proteoglycans in cancer、MAPK signaling pathway、Human cytomegalovirus infection等,机制部分有炎症机制、血流动力学等方面。结论 中西医结合治疗SSNHL具有积极的治疗作用,对改善听力损失、耳鸣、耳闷和眩晕有一定的作用。此外,中药的药物机制与糖皮质激素相似,通过抗炎和抗凋亡机制作用于耳蜗、前庭器官和听神经,保护内耳听觉功能。Objective To explore the curative effect and possible mechanism of traditional Chinese medicine(TCM)in the treatment of sudden sensorineural hearing loss(SSNHL),and to provide reference for clinical application and further research.Methods The basic information of patients with SSNHL was summarized through retrospective study,and the frequency of TCM treatment of SSNHL was obtained,and the curative effect was analyzed by symptoms and pure tone audiometry.The effective ingredients and targets of the top 20 TCMs were obtained from TCMSP and BATMAN-TCM platforms using network pharmacology technology,and disease targets were obtained from GeneCards and OMIM data platforms.After taking intersection targets,protein-protein interactions,core targets,and pathways were analyzed based on String and Metascape platforms.Results The mean age of SSNHL patients was 51 years 59.05%of the affected ears were left ear,39.05%were right ear,and 1.9%were binaural hearing loss.The total effective rate of treating SSNHL was 72.90%,among which symptoms of aural fullness,tinnitus,and vertigo were different after treatment.Network pharmacological study show that the treatment of SSNHL by the top 20 TCM involves multiple targets,pathways and mechanisms,among which the core targets include MAPK1,AKT1,JUN,TP53,EGFR,etc.The key pathways are pathways in cancer,lipid and atherosclerosis,proteoglycans in cancer,MAPK signaling pathway,human cytomegalovirus infection,and other aspects.Conclusion Application of CHM in the cases of SSNHL provides positive therapy and some contributions to improving hearing loss,tinnitus,aural fullness,and vertigo.Moreover,CHMs produce glucocorticoid-like effects and act on the cochlea,vestibular organ,and auditory nerve through an anti-inflammatory and anti-apoptotic mechanism,which can protect the auditory function of inner ear.

关 键 词：中药 突发性聋 网络药理学 疗效 

分 类 号：R764.437[医药卫生—耳鼻咽喉科]