玉屏风散治疗慢性肾小球肾炎的临床疗效评价及作用机制研究

doi:10.5246/jcps.2023.12.081

中国药学(英文版) ›› 2023, Vol. 32 ›› Issue (12): 1006-1026.DOI: 10.5246/jcps.2023.12.081

玉屏风散治疗慢性肾小球肾炎的临床疗效评价及作用机制研究

李雅静¹^,²^,^#, 白雅雯¹^,^#, 杜宇²^,³, 严长宏⁴^,^*(), 麻春杰¹, 孙丽宁², 卜凤跃⁵, 严昊阳⁶

1. 内蒙古医科大学中医学院, 内蒙古呼和浩特 010110
2. 包头市第八医院肾内科, 内蒙古包头 014040
3. 包头医学院第一附属医院肾内科, 内蒙古包头 014017
4. 包头市中心医院中医科, 内蒙古包头 014040
5. 克什克腾旗蒙医中医医院，内蒙古赤峰 025378
6. 湖南中医药大学中医学院, 湖南长沙 410208

收稿日期:2023-06-23 修回日期:2023-07-12 接受日期:2023-08-30 出版日期:2024-01-04 发布日期:2023-12-31
通讯作者: 严长宏
作者简介:
+ Tel.: +86-13084721121, E-mail: yan13084721121@163.com
基金资助:
National Natural Science Foundation of China (Grant No. 82260979) and Natural Science Foundation of Inner Mongolia (Grant No. 2023LHMS08075).

Yu Ping Feng Powder for chronic glomerulonephritis treatment: A meta-analysis and network pharmacology study

Yajing Li¹^,²^,^#, Yawen Bai¹^,^#, Yu Du²^,³, Changhong Yan⁴^,^*(), Chunjie Ma¹, Lining Sun², Fengyue Bu⁵, Haoyang Yan⁶

1 Traditional Chinese Medicine College, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia, China
2 Department of Nephrology, Baotou Eighth Hospital, Baotou 014040, Inner Mongolia, China
3 Department of Nephrology, The First Affiliated Hospital of Baotou Medical College, Baotou 014017, Inner Mongolia, China
4 Department of Traditional Chinese Medicine, Baotou Central Hospital, Baotou 014040, Inner Mongolia, China
5 Keshiketeng Banner Hospital of Mongolian Medicine and Traditional Chinese Medicine, Chifeng 025378, Inner Mongolia, China
6 College of Traditional Chinese Medicine, Hunan University of Traditional Chinese Medicine, Changsha 410208, Hunan, China

Received:2023-06-23 Revised:2023-07-12 Accepted:2023-08-30 Online:2024-01-04 Published:2023-12-31
Contact: Changhong Yan
About author:
# Yajing Li and Yawen Bai contributed equally to this work.

摘要/Abstract

摘要：

本研究通过meta分析评价玉屏风散(YPF)治疗慢性肾小球肾炎(CGN)的临床疗效, 并利用网络药理学和分子对接探讨其作用机制。检索国内外数据库CNKI、维普、中国生物医学、万方、PubMed和Cochrane建库至2023年5月YPF治疗CGN临床随机对照试验, 根据纳入和排除标准, 纳入研究。运用RevMan5.4软件进行质量评估和meta分析, 使用TSA Beta软件对主要结局指标进行序贯分析。通过TCMSP、GeneCards、OMIM、TTD数据库检索YPF的有效成分及CGN靶点, 利用Venny2.1.0获取两者交集靶点, 运用DAVID数据库进行GO和KEGG富集分析。通过AutoDock Vina1.5.6软件进行分子对接。共纳入14项研究, 1072名患者。meta分析结果显示, YPF在治疗CGN的临床总有效率[OR = 6.99, 95% CI (4.68, 10.44)], 证候改善率[OR = 3.16, 95%CI (1.43, 6. 98)], 降低24小时尿蛋白[SMD = –1.90, 95% CI (–2.54, –1.25)]、血清肌酐[SMD = –0.38, 95% CI (–0.57, –0.19)], 尿素氮[SMD = –0.46, 95% CI (–0.63, –0.30)], 均具有统计学意义(P < 0.05)。序贯分析结果表明, 本次meta结果是可靠的, YPF治疗CGN的总有效率优于单纯西药治疗。网络药理学共筛选出槲皮素、山奈酚、汉黄芩素等45种有效成分, 关键靶点有TNF、AKT1、IL-6和VEGF等, 涉及AGE-RAGE、TNF、PI3K-AKT等信号通路。分子对接显示, 槲皮素、山奈酚、汉黄芩素等与关键靶点可稳定结合, 结合能均≤ –6.0 kJ/mol。结果发现, YPF对CGN是一种积极的治疗措施, 其作用机制可能与多种成分、多个靶点、多条信号通路产生的免疫调节、抗炎、抗氧化和抗纤维化有关。

关键词: 玉屏风散, 慢性肾小球肾炎, Meta分析, TSA, 网络药理学, 分子对接

Abstract:

Chronic glomerulonephritis (CGN) is a common kidney disease and the leading cause of renal failure. This not only affects the quality of life of patients but also places a significant burden on their families. The objective of this study was to evaluate the clinical efficacy of Yu Ping Feng Powder (YPF) in treating CGN through meta-analysis and trial sequential analysis (TSA). Additionally, network pharmacology and molecular docking were employed to explore the mechanisms of YPF. We conducted a comprehensive search of the China National Knowledge Infrastructure (CNKI), VIP Database, Sinomed, WanFang, PubMed, and Cochrane Library up until May 2023. Quality assessment and meta-analysis were performed using the RevMan 5.4 software. TSA of key outcome indicators was conducted using TSA Beta software. The active ingredients of YPF were obtained from the TCMSP database, while the CGN targets were sourced from the GeneCards, OMIM, and TTD databases. The shared targets between YPF and CGN were identified using the STRING database and analyzed using Cytoscape 3.7.2 software. GO and KEGG analyses were employed to predict potential pathways affected by YPF in CGN. Finally, molecular docking techniques were utilized to investigate the interactions between core components and targets. The results of the meta-analysis revealed that YPF-based treatment for CGN significantly improved total clinical effectiveness, evidence-based outcomes, and reductions in 24-h urine protein, serum creatinine, and urea nitrogen compared to conventional treatment. Network pharmacology analysis identified TNF, AKT1, IL-6, and VEGFA as key targets for CGN treatment. Molecular docking predicted that the most active ingredients in YPF for CGN were quercetin, kaempferol, and wogonin. YPF demonstrated positive effects in treating CGN through multiple signaling pathways, leading to immunomodulatory, anti-inflammatory, antioxidant, and anti-fibrotic effects.

Key words: Yu Ping Feng Powder, Chronic glomerulonephritis, Meta-analysis, TSA, Network pharmacology, Molecular docking

Supporting:

李雅静, 白雅雯, 杜宇, 严长宏, 麻春杰, 孙丽宁, 卜凤跃, 严昊阳. 玉屏风散治疗慢性肾小球肾炎的临床疗效评价及作用机制研究[J]. 中国药学(英文版), 2023, 32(12): 1006-1026.

Yajing Li, Yawen Bai, Yu Du, Changhong Yan, Chunjie Ma, Lining Sun, Fengyue Bu, Haoyang Yan. Yu Ping Feng Powder for chronic glomerulonephritis treatment: A meta-analysis and network pharmacology study[J]. Journal of Chinese Pharmaceutical Sciences, 2023, 32(12): 1006-1026.

图/表 25

Table 1. General information on the included literature.

Table 2. Other outcomes.

Table 3. Main active ingredients in YPF.

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玉屏风散治疗慢性肾小球肾炎的临床疗效评价及作用机制研究

Yu Ping Feng Powder for chronic glomerulonephritis treatment: A meta-analysis and network pharmacology study

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