基于干预细胞因子风暴文献挖掘的中医药治疗重症新型冠状病毒肺炎探讨

Traditional Chinese medicine for treatment of COVID-19 based on literature mining of targeting cytokine storm

新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)临床以发热、乏力、干咳为主要表现,少部分患者可因"细胞因子风暴"在中低热甚至无明显发热病程中快速进展为急性呼吸窘迫综合征、脓毒性休克、代谢性酸中毒和凝血功能障碍,甚至多器官功能衰竭而导致重症患者死亡。遗体微创病理检查发现COVID-19与2003年的严重急性呼吸综合征(SARS)和2015年国内的中东呼吸综合征(MERS)有相似之处。从中医药干预细胞因子风暴治疗SARS重症文献分析入手,运用数据挖掘和网络药理学方法,探讨中医药治疗重症COVID-19与干预细胞因子风暴密切相关的作用路径和潜在的机制靶点,以期为临床针对"细胞因子风暴"这一关键病理过程,进行精准的组方潜药、科学的联合用药、靶向的筛选新药提供参考,有效地遏制COVID-19患者细胞因子风暴的发生和发展,促进其良好的临床转归。

The primary clinical manifestations of coronavirus disease 2019(COVID-19)are fever,fatigue and dry cough.Several clinical studies reported that some patients with low or medium fever,or even without obvious symptom,rapidly progressed to severe or critical illness,including severe acute respiratory syndrome,septic shock,coagulation disorders and intractable metabolic acidosis.These patients were usually associated with significant elevated serum levels of a profile of cytokines,which is similar to SARS-2003 and MERS-2015,indicating the occurrence of cytokine storm.In the present review,we summarized previous advances in the treatment of severe cases of SARS by using traditional Chinese medicines(TCM),especially those TCM targeting cytokine storm,based on literature mining.By using data mining and network pharmacology,we also investigated underlying mechanisms and biological pathways involved in the inhibitory effects of TCM against cytokine storm.This review not only provides novel insights in the precise application of TCM,appropriate integrative use of TCM in combination with western medicine,but also contributes to the discovery of novel drugs or new therapeutic strategies targeting cytokine storm to suppress progression of COVID-19 and to improve clinical prognosis and outcomes.