基于网络药理学、分子对接与临床观察探讨痛风丸干预痛风性关节炎的作用机制OA
Study on the mechanisms of the Tongfeng pill in treating gouty arthritis based on network pharmacology,molecular docking and clinical observation
目的 采用网络药理学、分子对接研究我院经验方痛风丸治疗痛风性关节炎(GA)的潜在作用机制,并结合临床观察验证其抗炎镇痛疗效.方法 通过网络药理学筛选出痛风丸的活性成分、核心靶点及关键通路,利用 Autodock Tools 开展分子对接.临床疗效研究共纳入 80 例 GA 患者,两组患者均进行饮食、生活方式非药物指导治疗,对照组予口服双氯芬酸钠缓释片 0.1g,1 次/日,大黄散 10g+金黄散 10g 外敷于红肿关节处,疗程 3d.治疗组在上述基础上加服痛风丸13g,3次/日,疗程3d.分析两组临床疗效及治疗前后关节疼痛视觉模拟评分(VAS)、相关炎症指标等.结果 痛风丸治疗 GA 的活性成分有 β-蜕皮甾酮、吴茱萸次碱、掌叶二蒽酮 A、山奈酚、鞣花酸等,核心靶点有 TNF、BCL2、JUN、PPARG、CASP3、SRC.KEGG 富集主要涉及 PI3K-Akt、NF-κB、NOD 样受体信号通路等.分子对接显示核心靶点与痛风丸活性成分均有良好的结合能力.临床观察显示,治疗后两组各项指标均较治疗前显著改善,但组间比较:治疗组总有效率 95%vs 对照组 90%(P>0.05),VAS 评分及 CRP、WBC、NEU、ESR 改善程度两组间均无统计学差异(P>0.05).结论 痛风丸治疗 GA 具有多成分、多靶点、多通路的特点,其机制或与调控 PI3K-Akt、NF-κB、NOD 样受体信号通路,抑制炎症反应有关.临床观察虽未发现西医炎症指标的统计学优势,但结合中医证候改善趋势,提示痛风丸可能通过调节湿热蕴结证的整体状态发挥治疗价值.
Objective To investigate the potential mechanism of our hospital's empirical formula Tongfeng Pill in the treatment of gouty arthritis(GA)using network pharmacology and molecular docking,and to verify its anti-inflammatory and analgesic efficacy through clinical observation.Methods The active ingredients,core targets and pathways of the Tongfeng pill in the treatment of GA were screened by network pharmacology technology,and molecular docking was carried out using Autodock Tools.80 patients with GA were included in the clinical efficacy study.Both groups of patients received non pharmacological guidance on diet and lifestyle.The control group was treated with oral administration of Diclofenac Sodium Sustained-release Tablets 0.1g once daily,combined with external application of Dahuang Powder 10g and Jinhuang Powder 10g on the swollen and red joints for 3 days.The treatment group was additionally given Tongfeng Pill 13g orally three times daily for 3 days.The clinical efficacy,Visual Analogue Scale(VAS)score for joint pain and related inflammatory markers were analyzed before and after treatment.Results The active ingredients of Tongfeng Pill in treating GA included β-ecdysterone,rutaecarpine,Palmidin A,kaempferol and ellagic acid,etc.The core targets included TNF,BCL2,JUN,PPARG,CASP3,and SRC.KEGG enrichment mainly involved the PI3K-Akt,NF-κB,and NOD-like receptor signaling pathway.Molecular docking showed good binding affinity between core targets and active ingredients of the Tongfeng pill.Clinical observation showed that after treatment,all indicators in both groups were significantly improved compared with before treatment.However,intergroup comparison revealed no statistically significant differences in the total effective rate(95%in treatment group vs 90%in control group,P>0.05),or in the improvement of VAS score,CRP,WBC,NEU,and ESR between the two groups(P>0.05).Conclusion Tongfeng Pill exhibits multi-component,multi-target,and multi-pathway characteristics in treating GA,and its mechanism may be related to the regulation of PI3K-Akt,NF-κB,and NOD-like receptor signaling pathways and inhibition of inflammatory responses.Although the clinical observation did not demonstrate statistical advantages in conventional Western medicine inflammatory indicators,combined with the improvement trend of TCM syndromes,it suggests that Tongfeng Pill may exert therapeutic value by regulating the overall state of damp-heat accumulation pattern.
夏海越;谢涛;胡斌;廖晓莉;陈艳英
成都第一骨科医院,四川 成都 610031成都第一骨科医院,四川 成都 610031成都第一骨科医院,四川 成都 610031成都第一骨科医院,四川 成都 610031成都第一骨科医院,四川 成都 610031
医药卫生
痛风丸痛风性关节炎网络药理学分子对接临床观察
Tongfeng pillGouty arthritisNetwork pharmacologyMolecular dockingClinical observation
《四川中医》 2026 (7)
48-56,9
四川省中医药管理局中医药科研专项面上项目(2024MS472).
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