Department of Pharmacy, Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China.
Intensive Care Unit, Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine Xiaoshan Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China.
Medicine (Baltimore). 2023 Feb 3;102(5):e32846. doi: 10.1097/MD.0000000000032846.
Accumulating evidence supported the clinical efficacy of Danhong injection (DHI) on chronic obstructive pulmonary disease (COPD). It is urgent to summarize the effects of DHI on various outcomes in COPD patients and to elucidate the molecular mechanisms of DHI in treating COPD.
Eligible studies were retrieved from 6 databases including China national knowledge infrastructure, Wangfang, VIP, web of science, PubMed, and Embase. The heterogeneity across studies was tested using the I2 statistic and the quality of studies was assessed. The pooled evaluation of outcomes was calculated using a fix- or random-effect model according to the heterogeneity. The underlying mechanism of DHI in treating COPD was analyzed using network pharmacology.
A total of 34 eligible studies with a general medium quality were included in the meta-analysis. The pooled data showed that DHI intervention significantly increased clinical efficacy as compared to routine treatment. Meanwhile, our data also revealed that the addition of DHI markedly improved hemorheological indicators, lung function index, arterial blood gas index, and as well as blood coagulation functions. However, the current meta-analysis lacked sufficient data to support the significant effect of DHI on prothrombin time and activated partial thromboplastin time. Network pharmacology found 59 candidate targets of DHI in treating COPD, and enrichment analysis found these targets were associated with lymphocyte proliferation and activation, glucocorticoid receptor signaling, TREM1 signaling, IL-12 signaling and production in macrophages, and aryl hydrocarbon receptor signaling. Multiple core targets including AKT1, TNF, and IL1B, etc. Were identified and might play an important role in the action of DHI against COPD.
Taken together, this study suggested that DHI could ameliorate hemorheological indicators, lung function, arterial blood gas, and as well as coagulation functions of COPD patients and elucidate the underlying mechanism of DHI against COPD.
越来越多的证据支持丹红注射液（DHI）在慢性阻塞性肺疾病（COPD）中的临床疗效。总结 DHI 对 COPD 患者各种结局的影响，阐明 DHI 治疗 COPD 的分子机制迫在眉睫。
从中国知网、万方、维普、Web of Science、PubMed 和 Embase 6 个数据库中检索符合条件的研究。采用 I2 统计量检验研究间的异质性，并用固定或随机效应模型根据异质性对结局进行汇总评价。采用网络药理学分析 DHI 治疗 COPD 的潜在作用机制。
共纳入 34 项研究，总质量中等。汇总数据显示，与常规治疗相比，DHI 干预可显著提高临床疗效。同时，我们的数据还表明，DHI 的加入显著改善了血液流变学指标、肺功能指标、血气指标和凝血功能。然而，目前的荟萃分析缺乏足够的数据来支持 DHI 对凝血酶原时间和活化部分凝血活酶时间的显著影响。网络药理学发现 DHI 治疗 COPD 的 59 个候选靶点，富集分析发现这些靶点与淋巴细胞增殖和激活、糖皮质激素受体信号、TREM1 信号、巨噬细胞中 IL-12 信号和产生以及芳香烃受体信号有关。鉴定出 AKT1、TNF 和 IL1B 等多个核心靶点，它们可能在 DHI 治疗 COPD 的作用中发挥重要作用。
综上所述，本研究表明 DHI 可改善 COPD 患者的血液流变学指标、肺功能、血气和凝血功能，并阐明了 DHI 治疗 COPD 的潜在作用机制。
