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血必净与生长抑素治疗急性胰腺炎的系统评价与网络药理学

Xuebijing and somatostatin against acute pancreatitis: A systematic review and network pharmacology.

作者信息

Cao Ji-Ping, Piao Xiang-Hua, Zhu Long-Xun, Feng Pan-Feng

机构信息

Department of Pharmacy, Affiliated Hospital 2 of Nantong University, And First People's Hospital of Nantong City, Nantong, Jiangsu Province, P.R. China.

Department of Pharmacy, Jiangwan Hospital of Shanghai Hongkou District, Shanghai, P.R. China.

出版信息

Medicine (Baltimore). 2024 Dec 13;103(50):e40964. doi: 10.1097/MD.0000000000040964.

Abstract

BACKGROUND

Acute pancreatitis (AP) is a common pancreatic disease. Xuebijing injection (XBJ) combined with somatostatin in the treatment of AP is frequently used in clinical practice. There is, however, a lack of high-quality evidence-based evidence and network pharmacology to regard the therapeutic efficacy and pharmacological mechanisms.

PURPOSE

The purpose of this study is to investigate the potential therapeutic targets and pharmacological mechanism of XBJ in AP using integrating evidence-based medicine and network pharmacology.

METHODS

PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Weipu, and Wanfang databases were searched. Randomized controlled trials of XBJ combined with somatostatin (experimental group) versus somatostatin alone (control group) in the treatment of AP were collected. After extracting data from the literature that meets the inclusion criteria, and using the Cochrane Scale to evaluate the quality of the literature, we used Rev Man 5.3.0 statistical software to perform meta-analysis of the effective rate, the disappearance time of abdominal pain and bloating, the recovery of gastrointestinal motility, serum-related indicators, inflammatory factors, ventilator evacuation time, and hospitalization time. A network pharmacology is used to analyze the potential active ingredients and related crucial targets of the XBJ in the treatment of AP, and we explored key regulatory pathways and potential biomarkers related to XBJ for AP with integrated bioinformatics analysis.

RESULTS

It was significant that the total effective rate in the study group was higher than that in the control group (P < .05). The time of recovery of gastrointestinal motility, serum-related indicators, inflammatory factors, ventilator withdrawal time, and hospitalization time were significantly lower than that of the control group. The differences were statistically significant (P < .05). Signal transducer and activator of transcription 3, tumor protein P53, interleukin 6, tumor necrosis factor, Jun Proto-Oncogene, SRC Proto-Oncogene, Heat Shock Protein 90 Alpha Family Class A Member 1, Vascular Endothelial Growth Factor A, Epidermal Growth Factor Receptor, and Mitogen-Activated Protein Kinase 1 were identified as the key hub of the protein-protein interaction network according to an analysis of network centrality. According to the Kyoto Encyclopedia of Genes and Genomes pathway analysis, the main pathways are involved in PI3K-Akt signaling pathway, HIF-1 signaling pathway, and tumor necrosis factor signaling pathway.

CONCLUSIONS

The effectiveness of combination therapy of XBJ and somatostatin on AP is likely to be better than somatostatin. In addition, XBJ and somatostatin synergistically treated AP through a multi-pathway network.

摘要

背景

急性胰腺炎(AP)是一种常见的胰腺疾病。血必净注射液(XBJ)联合生长抑素治疗AP在临床实践中经常使用。然而,缺乏高质量的循证医学证据和网络药理学研究来阐明其治疗效果和药理机制。

目的

本研究旨在运用循证医学与网络药理学相结合的方法,探讨XBJ治疗AP的潜在治疗靶点和药理机制。

方法

检索PubMed、Embase、Cochrane图书馆、中国知网、维普和万方数据库。收集XBJ联合生长抑素(试验组)与单纯生长抑素(对照组)治疗AP的随机对照试验。从符合纳入标准的文献中提取数据,并用Cochrane量表评估文献质量,然后使用Rev Man 5.3.0统计软件对有效率、腹痛腹胀消失时间、胃肠动力恢复情况、血清相关指标、炎症因子、呼吸机撤离时间和住院时间进行Meta分析。运用网络药理学分析XBJ治疗AP的潜在活性成分和相关关键靶点,并通过综合生物信息学分析探索与XBJ治疗AP相关的关键调控通路和潜在生物标志物。

结果

研究组总有效率高于对照组,差异有统计学意义(P < 0.05)。胃肠动力恢复时间、血清相关指标、炎症因子、呼吸机撤离时间和住院时间均显著低于对照组,差异有统计学意义(P < 0.05)。通过网络中心性分析,确定信号转导和转录激活因子3、肿瘤蛋白P53、白细胞介素6、肿瘤坏死因子、原癌基因Jun、原癌基因SRC、热休克蛋白90α家族A类成员1、血管内皮生长因子A、表皮生长因子受体和丝裂原活化蛋白激酶1为蛋白质-蛋白质相互作用网络的关键枢纽。根据京都基因与基因组百科全书通路分析,主要通路涉及PI3K-Akt信号通路、HIF-1信号通路和肿瘤坏死因子信号通路。

结论

XBJ联合生长抑素治疗AP的疗效可能优于生长抑素。此外,XBJ和生长抑素通过多途径网络协同治疗AP。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76c0/11651499/58999984e20a/medi-103-e40964-g001.jpg

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