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基于网络药理学和Meta分析探索中药对腹泻型肠易激综合征患者焦虑抑郁的作用机制

Exploration of the mechanism of Traditional Chinese Medicine for anxiety and depression in patients with diarrheal irritable bowel syndrome based on network pharmacology and meta-analysis.

作者信息

Bai Chen, Wang Junyi, Wang Yifan, Liu Haoqi, Li Jiaxiu, Wang Siyi, Bai Zhen, Guo Rongjuan

机构信息

Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China.

Department of Medical Equipment, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.

出版信息

Front Pharmacol. 2024 May 21;15:1404738. doi: 10.3389/fphar.2024.1404738. eCollection 2024.

DOI:10.3389/fphar.2024.1404738
PMID:38835657
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11148253/
Abstract

BACKGROUND: The efficacy of Chinese herbal medicine (CHM) in managing irritable bowel syndrome with diarrhea (IBS-D) accompanied by anxiety and depression remains uncertain. Thus, a systematic review was carried out employing meta-analysis and network pharmacology to ascertain the efficacy and underlying mechanisms of CHM therapy. METHODS: By conducting a systematic review, including literature search, screening, and data extraction, we identified 25 randomized controlled trials to assess CHM's effectiveness in treating irritable bowel syndrome alongside anxiety and depression. Network pharmacology was utilized to scrutinize the metabolite utility of CHM in addressing this condition. Potential primary mechanisms were synthesized using information sourced from the PubMed database. RESULTS: Twenty-five studies, including 2055 patients, were analyzed, revealing significant treatment efficacy for IBS-D in the trial group compared to controls [OR = 4.01, 95% CI (2.99, 5.36), I = 0%] Additionally, treatment for depression [SMD = -1.08, 95% CI (-1.30, -0.86), < 0.00001, I = 68%; SDS: SMD = -1.69, 95% CI (-2.48, -0.90), < 0.0001, I = 96%] and anxiety [HAMA: SMD = -1.29, 95% CI (-1.68, -0.91), < 0.00001, I = 89%; SAS: SMD = -1.75, 95% CI (-2.55, -0.95), < 0.00001, I = 96%] significantly improved in the trial group. Furthermore, the trial group exhibited a significantly lower disease relapse rate [OR = 0.30, 95% CI (0.20, 0.44), < 0.00001, I = 0%]. CHM treatment consistently improved IBS severity (IBS-SSS) and symptom scores. Network pharmacology analysis identified key chemical metabolites in traditional Chinese medicine formulations, including Beta-sitosterol, Stigmasterol, Quercetin, Naringenin, Luteolin, Kaempferol, Nobiletin, Wogonin, Formononetin, and Isorhamnetin. Utilizing the STRING database and Cytoscape v3.9.0 software, a protein-protein interaction (PPI) network revealed the top eight key targets: IL-6, TNF, PPARG, PTGS2, ESR1, NOS3, MAPK8, and AKT1, implicated in anti-inflammatory responses, antioxidant stress modulation, and neurotransmitter homeostasis maintenance. CONCLUSION: Chinese Herbal Medicine (CHM) offers a promising and safe treatment approach for patients dealing with Diarrheal Irritable Bowel Syndrome (IBS-D) accompanied by anxiety and depression; thus, indicating its potential for practical implementation. The most active metabolites of CHM could simultaneously act on the pathological targets of IBS-D, anxiety, and depression.The diverse scope of CHM's therapeutic role includes various aspects and objectives, underscoring its potential for broad utilization.

摘要

背景：中药治疗腹泻型肠易激综合征（IBS-D）伴焦虑抑郁的疗效尚不确定。因此，本研究采用荟萃分析和网络药理学进行系统评价，以确定中药治疗的疗效及潜在机制。 方法：通过系统评价，包括文献检索、筛选和数据提取，我们纳入了25项随机对照试验，以评估中药治疗肠易激综合征伴焦虑抑郁的有效性。利用网络药理学研究中药在治疗该病中的代谢物作用。通过PubMed数据库获取的信息综合分析潜在的主要机制。 结果：共分析了25项研究，涉及2055例患者，结果显示试验组治疗IBS-D的疗效显著优于对照组[OR = 4.01，95%CI（2.99，5.36），I² = 0%]。此外，试验组治疗抑郁[SMD = -1.08，95%CI（-1.30，-0.86），P < 0.00001，I² = 68%；SDS：SMD = -1.69，95%CI（-2.48，-0.90），P < 0.0

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引用本文的文献

[1]
Based on Proteomics Data Revealing the Potential of Traditional Chinese Medicine in Treating Irritable Bowel Syndrome.

Mediators Inflamm. 2025-7-23

[2]
Association between dietary flavonoid intake and anxiety: data from NHANES 2017-2018.

BMC Public Health. 2025-4-22

[3]
The emerging role of honeysuckle flower in inflammatory bowel disease.

Front Nutr. 2025-3-28

[4]
The Role of Gut Microbiome in Irritable Bowel Syndrome: Implications for Clinical Therapeutics.

Biomolecules. 2024-12-21

本文引用的文献

[1]
Gastrointestinal and brain barriers: unlocking gates of communication across the microbiota-gut-brain axis.

Nat Rev Gastroenterol Hepatol. 2024-4

[2]
Kaempferol Improves Breast Cancer-Related Depression through the COX-2/PGE2 Pathway.

Front Biosci (Landmark Ed). 2023-11-28

[3]
Luteolin Attenuates Oxidative Stress and Colonic Hypermobility in Water Avoidance Stress Rats by Activating the Nrf2 Signaling Pathway.

Mol Nutr Food Res. 2024-1

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Kaempferol-3-O-sophoroside (PCS-1) contributes to modulation of depressive-like behaviour in C57BL/6J mice by activating AMPK.

Br J Pharmacol. 2024-4

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The monoaminergic pathways are involved in the antidepressant-like effect of quercetin.

Naunyn Schmiedebergs Arch Pharmacol. 2024-4

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Enhanced antidepressant effects of BDNF-quercetin alginate nanogels for depression therapy.

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Unraveling the Potential of Isorhamnetin as an Adjuvant in Depression Treatment with Escitalopram.

Curr Issues Mol Biol. 2023-9-21

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CNS Neurosci Ther. 2024-3

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