基于网络药理学和临床试验探讨加味小承气汤对肝癌轻微型肝性脑病的临床治疗OA

Objective:To predict the mechanism of modified Xiaochengqi Decoction(小承气汤)in the treatment of mild hepatic encephalopathy in liver cancer based on network pharmacology,and to verify its improving effect on symp-toms of mild hepatic encephalopathy in liver cancer by clinical experiments.Methods:The core targets and pathways of treating mild hepatic encephalopathy by retention enema with modified Xiaochengqi Decoction were studied by network pharmacology analysis.Patients with hepatocellular carcinoma diagnosed by pathology in the Department of Oncology at Sichuan Integrative Medicine Hospital from June 2024 to October 2025 were selected,who tested positive on both the number connection test-A(NCT-A)and digit symbol test(DST)and were diagnosed with mild hepatic encephalopathy in liver cancer.They were equally divided into a control group and an experimental group by using a prospective random-ized controlled design and employing the block randomization method.The patients in both groups were given convention-al treatment during the study period.Modified Xiaochengqi Decoction was used for retention enema in the experimental group,while lactulose was adopted for retention enema in the control group.After 2 weeks of treatment,the efficacy rates of both groups were compared.The serum levels of inflammatory factors(tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-1β(IL-1β))and the content and activities of liver function indicators(blood ammonia,as-partate transaminase(AST),alanine transaminase(ALT),and total bilirubin(TBIL))were detected.The cognitive function of the two groups was evaluated by DST and NCT-A,and the improvement of clinical symptoms was evaluated by traditional Chinese medicine(TCM)syndrome score.Results:The network pharmacology analysis showed that there were 1007 therapeutic targets corresponding to the 108 active ingredients in modified Xiaochengqi Decoction,950 targets related to hepatic encephalopathy,and 289 overlapping targets.By GO and KEGG enrichment analysis,2667 function en-tries and 234 significant signal pathways were obtained(P<0.05).Key signaling pathways such as MAPK and NF-κB were the molecular basis for the therapeutic effects.After treatment,compared with the control group,the experimental group showed reduced serum levels of TNF-α,IL-6,IL-1β,and blood ammonia(P<0.05),an increase in the number of correct responses on the DST(P<0.05),a decrease in the completion time of NCT-A(P<0.05),and an obviously re-duced TCM syndrome score(P<0.05).Conclusion:The modified Xiaochengqi Decoction is effective in the treatment of mild hepatic encephalopathy in liver cancer,which can effectively regulate the levels of inflammatory factors,reduce the level of blood ammonia,shorten the recovery time of cognitive function,and improve liver function.Its mechanism may involve reducing inflammatory factor levels and promoting blood ammonia metabolism through MAPK,NF-κB,and other signaling pathways.