基于网络药理学探讨安宫牛黄丸治疗脓毒症相关性脑病的作用机制OA

Objective To investigate the therapeutic effect of Angong Niuhuang pill on sepsis-associated encephalopathy(SAE)and its underlying mechanism based on network pharmacology and clinical verification.Methods Network pharmacology techniques were employed to screen the active ingredients of Angong Niuhuang pill and potential targets associated with SAE.Cytoscape 3.5.1 software was utilized to construct the"active ingredient-target-pathway"network.Concurrently,40 SAE patients admitted to the Second People's Hospital of Hefei from June 2024 to December 2025 were enrolled.They were randomly divided into a control group and an observation group,with 20 cases in each.Both groups received routine Western medicine treatment,including anti-infection and symptomatic support.On the basis of routine treatment,the observation group was administered Angong Niuhuang pill orally at a dose of 3 g once daily.The differences in Glasgow coma scale(GCS)scores,platelet count(PLT),D-dimer,and interleukin-6(IL-6)levels,Montreal cognitive assessment(MoCA)scores were compared between the two groups after treatment to analyze the clinical efficacy of Angong Niuhuang pill combined with routine Western medicine in the treatment of SAE.Results Network pharmacology screening identified 134 active ingredients and 990 corresponding targets for Angong Niuhuang pill,with 104 common targets shared with SAE.The main active ingredients of Angong Niuhuang pill included Quercetin,Berberine,Epiberberine,β-sitosterol,and Stigmasterol.Angong Niuhuang pill exerts therapeutic effects byregulating key targets such as IL-6,tumor necrosis factor(TNF),IL-1β,tumor protein p53(TP53),signal transducer and activator of transcription 3(STAT3),matrix metallopeptidase-9(MMP-9),CXC chemokine ligand 8(CXCL8),and IL-10,and enriching signaling pathways including advanced glycosylation end product-receptor for advanced glycation endproduct(AGE-RAGE),lipid and atherosclerosis,and fluid shear stress and atherosclerosis.Clinical validation results showed that neurological function and biochemical indicators improved significantly in both groups after treatment compared to baseline.The observation group demonstrated significantly higher GCS scores(10.37±2.66 vs.8.58±3.20)and MoCA scores(27.50±5.96 vs.23.23±4.25)than the control group(all P<0.05).Conversely,levels of PLT,D-dimer,and IL-6 were significantly lower in the observation group than in the control group[PLT(×109/L):63.00±8.94 vs.66.23±10.47,IL-6(ng/L):90.70±14.96 vs.140.72±18.09,D-dimer(mg/L):0.55±0.19 vs.0.59±0.06],with differences being statistically significant(all P<0.05).Conclusions Network pharmacology predicts that Angong Niuhuang pill intervenes in SAE via a"multi-component,multi-target,multi-pathway"mechanism.Clinical studies corroborate this prediction and demonstrate that the drug significantly improves patients'neurological and biochemical indicators.