论乙肝、肝硬化、肝癌治疗的中医核心方剂及其作用机制

StephenW

论乙肝、肝硬化、肝癌治疗的中医核心方剂及其作用机制
王振东 1 , 张勇 2 , 张秋云 3 , 强傲 4 , 罗昌永 5 , 王伯川 1 , 陈白 1 , 学艺阁 6 , 王雨涵 1 , 王靖 5 , 应倩 3 , 何雨 1 , 顾晓红1
隶属关系
隶属关系

    1
    北京中医药大学中医学院，北京，中国。
    2
    【作者单位】： 山东省中医院肝病科;
    3
    首都医科大学，北京，中国。
    4
    北京天成药业有限公司，北京，中国。
    5
    北京中医药大学东方医院;
    6
    山东中医药大学，济南，中国。

    PMID：36193202 PMCID：PMC9525786 DOI：10.1155/2022/5300523

抽象的

背景：作为癌症患者常见的死亡原因，肝癌通常发生在乙型肝炎和肝硬化中。在中国，中国人一直在使用中医药治疗各种慢性肝病，可以有效改善症状，减缓肝病的进展。但由于中药方剂规则复杂，其作用机制尚不清楚，可能会影响有效方剂的推广。本研究旨在确定治疗乙型肝炎、肝硬化和肝癌的核心中药，以阐明核心中药网络的作用机制。

方法：本研究共收集慢性肝病处方1673张，其中肝B类处方854张，肝硬化530张，肝癌289张。首先通过描述性分析解释本草的基本特征，然后通过关联规则分析本草的核心组方，最后借助系统的网络药理学和TCMIP等数据库，探索核心组方的作用机制。 、HERB、OMIM、GeneCards、KEGG 以及 RStudio 和 Cytoscape 等软件。

结果：本案核心方剂以寒温兼用为主，以寒性苦药为主。补虚、清热、活血化瘀是三种肝病的共同治疗原则。乙肝治疗中，以姜黄（郁金）、白芍（白芍）、柴胡（柴胡）、丹参（丹参）、黄芪（黄芪）最多，以健脾疏肝。黄芪（黄芪）、茯苓（茯苓）、白术（白术）、黄芪（水红花子）、莪术（莪术）在肝硬化治疗中最常用于补气活血。百花蛇草草、半枝莲、莪术、豆蔻，常用于解癌解毒、健脾活血。这些核心药材主要通过信号转导和免疫系统途径发挥作用，其中PI3K-Akt途径起关键作用。肝硬化核心方比乙肝方调节的内分泌系统通路更多，肝癌方调节的神经系统相关通路更多。

结论：确定了乙肝、肝硬化、肝癌治疗的3个核心方，主要通过信号转导和免疫系统途径调节免疫和细胞生长，参与炎症抑制，其中肝癌方调节的途径较多，尤其是比其他两个更多的神经系统相关途径。

版权所有 © 2022 王振东等。
利益冲突声明

作者声明他们没有利益冲突。

StephenW

On the Core Prescriptions and Their Mechanisms of Traditional Chinese Medicine in Hepatitis B, Liver Cirrhosis, and Liver Cancer Treatment
Zhendong Wang  1 , Yong Zhang  2 , Qiuyun Zhang  3 , Qiang Ao  4 , Changyong Luo  5 , Bochuan Wang  1 , Chen Bai  1 , Xueyi Ge  6 , Yuhan Wang  1 , Jing Wang  5 , Ying Qian  3 , He Yu  1 , Xiaohong Gu  1
Affiliations
Affiliations

    1
    School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
    2
    Liver Disease Branch, Shandong Hospital of Traditional Chinese Medicine, Jinan, China.
    3
    Capital Medical University, Beijing, China.
    4
    Beijing Tcmages Pharmaceutical Co., Ltd., Beijing, China.
    5
    Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.
    6
    Shandong University of Traditional Chinese Medicine, Jinan, China.

    PMID: 36193202 PMCID: PMC9525786 DOI: 10.1155/2022/5300523

Abstract

Background: As a frequent cause of death in cancer patients, liver cancer usually occurs in hepatitis B and cirrhosis. In China, Chinese people have been using traditional Chinese medicine (TCM) in treating various chronic liver diseases, which could effectively improve the symptoms and slow down the progression of liver diseases. However, due to the complexity rules of TCM prescription, their action mechanisms are still not clearly understood, which may affect the popularization of effective prescriptions. This study aims to identify the core TCM herbs in the treatment of hepatitis B, liver cirrhosis, and liver cancer so as to clarify the mechanism of action of the core herb networks.

Methods: There were 1,673 prescriptions for chronic liver diseases collected in this study, of which 854 were hepatic B prescriptions, 530 were for liver cirrhosis, and 289 were for liver cancer. The basic characteristics of herbal medicine were firstly explained via descriptive analysis, then the core prescriptions of herbal medicine were analyzed through association rule, and finally, the mechanism of core prescriptions was explored with the help of systematic network pharmacology and by applying such databases as TCMIP, HERB, OMIM, GeneCards, KEGG, and software like RStudio and Cytoscape.

Results: The rule of the core prescriptions in these cases was characterized by the application of herbs with both cold and warm properties, in which bitter herbs with cold property took priority. Tonifying deficiency, clearing heat, and activating blood circulations to remove stasis were common treatment principles for the three liver diseases. Turmeric Root Tuber (YuJin), White Peony Root (BaiShao), Bupleurum (ChaiHu), Salvia miltiorrhiza (DanShen), and Astragali Radix (HuangQi) were prescribed the most in hepatitis B treatment to invigorate the spleen and soothe the liver. Astragali Radix (HuangQi), Tuckahoe (FuLing), Atractylodis Macrocephalae Rhizoma (BaiZhu), Fructus Polygoni Orientalis (ShuiHongHuaZi), and Curcumae Rhizome (EZhu) were most frequently applied in liver cirrhosis treatment to replenish qi and activate blood. Oldenlandia (BaiHuaSheSheCao), Bearded Scutellaria (BanZhiLian), Curcumae Rhizome (EZhu), and Cardamom (DouKou) were most frequently prescribed to eliminate cancer toxin, invigorate the spleen, and activate blood. These core herbs mainly act through signal transduction and immune system pathways, in which the PI3K-Akt pathway plays a key role. The core prescription for liver cirrhosis regulated more endocrine system pathways than the hepatitis B prescription, and liver cancer prescription regulated more nervous system-related pathways.

Conclusion: Three core prescriptions for hepatitis B, liver cirrhosis, and liver cancer treatment were identified, which acted mainly through signal transduction and immune system pathways to regulate immunity and cell growth and participate in inflammation inhibition, in which liver cancer prescription regulated more pathways, especially more nervous system-related pathways than the other two.

Copyright © 2022 Zhendong Wang et al.
Conflict of interest statement

The authors declare that they have no conflicts of interest.

StephenW

https://downloads.hindawi.com/journals/jo/2022/5300523.pdf

lancas

不知道不定期调理会对病情有没帮助呢~