| 庞敬涛 苑宇楷? 李昱乔 刘晓婷 刘珊 袁辉 王振华 张伟潍坊市中医院 山东潍坊 261041 |
| Exploring the mechanism of action of Zishui Liver Clearing Drink in the treatment of posterior circulation ischaemic vertigo based on clinical efficacy observation and network pharmacology |
| DOI： |
| 中文关键词: 滋水清肝饮 网络药理学 后循环缺血性眩晕 临床疗效观察 |
| 英文关键词: |
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| 中文摘要: |
| 目的 分析滋水清肝饮治疗后循环性眩晕的临床效果,通过网络药理学探讨其作用机制。方法 选取 2022 年 1 月—2023年12月潍坊市中医院收治的 220例风阳上扰型眩晕病患者。根据随机数字表法,将患者分为对照组(110例)和试验组(110 例)。两组均应用甲磺酸倍他司汀片口服,试验组加用滋水清肝饮治疗。分别在治疗前、治疗两周后进行中医证候积分、眩晕障碍量表(DHI)、眩晕评定量表评分系统(DARS)评分,TCMSP和文献中筛选滋水清肝饮的化学成分,利用Disgenet和Genecards数据库分析滋水清肝饮治疗后循环缺血性眩晕的分子靶点。在筛选出共同靶点后,用 Cytoscape3.10软件、Disgenet、Genecards、UniProtString、STRING、David数据库中分别绘制化合物和靶蛋白的网络图、构建蛋白相互作用(PPI)网络和基因本体论(GO)功能及京都基因和基因组百科全书(KEGG)信号通路富集分析。结果 治疗后,试验组 中医症候积分、DHI、DARS评分均低于对照组(P<0.05)。最终得到滋水清肝饮活性成分潜在靶点693个,疾病相关靶点930个,药物与疾病的交集靶点229个；进行分析得出Degree值前20的靶点,其中包括PIK3C、HRAS、SRC等。并进一步在STRING数据库中构建PPI网络图展示各靶点之间作用关系,使用上一步所得的交叉靶点根据P值,GO分析的BP的重要项目是酶结合、蛋白质结合、细胞膜等；初步推断滋水清肝饮与后循环缺血性眩晕治疗中的酶和蛋白结合与细胞膜相关。根据P值,KEGG分析共筛选出多条通路,包括癌症途径、糖尿病并发症中的AGE-RAGE信号通路、表皮生长因子受体(EGFR)酪氨酸激酶抑制剂抗性、脂质和动脉粥样硬化、乙型肝炎化等。讨论 综上所述,本研究通过中医症候评分和DHI、DARS评分证明了滋水清肝饮在中西医结合的背景下对于后循环缺血性眩晕有显著改善效果。构建了滋水清肝饮“活性成分-靶点-通路-疾病”网络,为临床中西医治疗后循环缺血性眩晕提供了参考,为滋水清肝饮的临床应用提供了理论基础。 |
| 英文摘要: |
| Objective To analyse the clinical effect of Nourishing Water Clearing Liver Drink in treating post-circulatory vertigo, and to explore its mechanism of action through network pharmacology. METHODS 220 cases of vertigo patients with wind-yang upturned type admitted to Weifang Hospital of Traditional Chinese Medicine from January 2022 to December 2023 were selected. According to the random number table method, the patients were divided into the control group (110 cases) and the experimental group (110 cases). Both groups were treated with oral administration of betahistine mesylate tablets, and the experimental group was treated with Zishui Liver Cleansing Drink. Before and after two weeks of treatment, the patients were screened for the chemical components of Zishui Qinglian Drink in TCMSP and the literature, and the molecular targets of Zishui Qinglian Drink in the treatment of posterior circulation ischemic vertigo were analysed using the Disgenet and Genecards databases. After screening the common targets, the network diagrams of compounds and target proteins, the construction of protein-protein interaction (PPI) network and gene ontology (GO) function and Kyoto genes and genomes were mapped using Cytoscape 3.10 software, Disgenet, Genecards, UniProtString, STRING, and David databases, respectively. Encyclopedia (KEGG) signalling pathway enrichment analysis. Results After treatment, the TCM symptom scores, DHI and DARS scores of the test group were lower than those of the control group (P<0.05). Finally, 693 potential targets of active ingredients of Zishui Liver Cleansing Drink were obtained, 930 disease-related targets, and 229 targets of drug-disease intersection; the analysis was performed to derive the top 20 targets of Degree value, which included PIK3C, HRAS, SRC, etc. The results were further analyzed in the STRING database, which was used for the analysis of the DHI and DARS scores of the test group. And further construct a PPI network diagram in STRING database to show the role relationship between the targets, using the intersecting targets obtained in the previous step according to the P value, the important items of BP analysed by GO were enzyme binding, protein binding, cell membrane, etc.; initially, it was deduced that the enzyme and protein binding in Zishui Liver Cleansing Drink and posterior circulation ischemic vertigo treatment was related to the cell membrane. Based on the P-value, KEGG analysis screened a total of several pathways, including cancer pathway, AGE-RAGE signalling pathway in diabetic complications, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor resistance, lipid and atherosclerosis, and hepatitis Bification. DISCUSSION In conclusion, this study demonstrated that Zishui Liver Cleansing Drink has a significant improvement effect on posterior circulation ischemic vertigo in the context of combining Chinese and Western medicine, as evidenced by the TCM symptom scores and the DHI and DARS scores. The ‘active ingredient-target-pathway-disease’ network of Zishui Liver-cleansing Drink has been constructed, which provides a reference for the clinical treatment of posterior circulation ischemic vertigo with Chinese and Western medicine, and a theoretical basis for the clinical application of Zishui Liver-cleansing Drink. |
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