Gao Jin, Pan Yujing, Zhao Yuxi, Li Haoyang, Mi Zishuo, Chen Hao, Tan Xiaodong
School of Integrated Chinese and Western Medicine, Nanjing 210023, China.
School of Acupuncture and Massage, Nanjing University of Chinese Medicine, Nanjing 210023, China.
Evid Based Complement Alternat Med. 2021 Dec 20;2021:3574321. doi: 10.1155/2021/3574321. eCollection 2021.
Coronary heart disease is characterized by the formation of arterial plaque. If not taken seriously, it will cause serious consequences such as myocardial infarction and heart failure. Zhishi Xiebai Guizhi Decoction first appeared in "Synopsis of Prescriptions of the Golden Chamber" and is a representative prescription for the treatment of coronary heart disease. This study aims to explain the mechanism of Zhishi Xiebai Guizhi Decoction in the treatment of coronary heart disease through network pharmacology and clinical trials.
We first identified the core compounds of Zhishi Xiebai Guizhi Decoction and their potential targets through TCMSP. Then, We analyzed the molecular targets of Zhishi Xiebai Guizhi Decoction in coronary heart disease with OMIM and GeneCards databases. After the common targets were screened out, we manage to figure out the pathways of these target genes through STRING. Finally, we verify the treatment results in clinical trials.
Through network pharmacology analysis, we discovered that several core compounds of Zhishi Xiebai Guizhi Decoction have anti-inflammatory effects and are of great significance to treatment of cardiovascular diseases. The mechanism may be closely related to PPAR, inflammation, TNF signaling pathway, AMPK signaling pathway, and PI3K-Akt signaling pathway. Clinical trials have also proved the key role of inflammation.
Zhishi Xiebai Guizhi Decoction may play a role in treating coronary heart disease by activating PPAR. TNF signaling pathway, AMPK signaling pathway, and PI3K-Akt signaling pathway are potential mechanisms as well. The application of network pharmacology can provide a novel method for the research of Chinese herbal medicine. We hope that Zhishi Xiebai Guizhi Decoction will be recognized as a complementary or alternative treatment for coronary heart disease.
冠心病以动脉斑块形成为特征。若不加以重视，会导致心肌梗死和心力衰竭等严重后果。枳实薤白桂枝汤首载于《金匮要略》，是治疗冠心病的代表方剂。本研究旨在通过网络药理学和临床试验阐释枳实薤白桂枝汤治疗冠心病的作用机制。
我们首先通过中药系统药理学数据库与分析平台（TCMSP）确定枳实薤白桂枝汤的核心化合物及其潜在靶点。然后，利用在线人类孟德尔遗传数据库（OMIM）和基因卡片数据库（GeneCards）分析枳实薤白桂枝汤在冠心病中的分子靶点。筛选出共同靶点后，通过STRING数据库明确这些靶基因的通路。最后，在临床试验中验证治疗效果。
通过网络药理学分析，我们发现枳实薤白桂枝汤的几种核心化合物具有抗炎作用，对心血管疾病的治疗具有重要意义。其机制可能与过氧化物酶体增殖物激活受体（PPAR）、炎症、肿瘤坏死因子（TNF）信号通路、腺苷酸活化蛋白激酶（AMPK）信号通路和磷脂酰肌醇-3激酶-蛋白激酶B（PI3K-Akt）信号通路密切相关。临床试验也证实了炎症的关键作用。
枳实薤白桂枝汤可能通过激活PPAR发挥治疗冠心病的作用。TNF信号通路、AMPK信号通路和PI3K-Akt信号通路也是潜在机制。网络药理学的应用可为中药研究提供一种新方法。我们希望枳实薤白桂枝汤能成为冠心病的补充或替代治疗方法。
