灯盏细辛胶囊治疗卒中后疲劳疗效及机制研究

Therapeutic Effect and Mechanism of Erigeron Breviscapus Capsule on Post-stroke Fatigue

目的观察灯盏细辛胶囊治疗卒中后疲劳(PSF)的效果,利用网络药理学探讨其机制。方法52例PSF患者按照随机数字表法分为观察组(灯盏细辛胶囊,0.54 g/次,3次/日;维生素C片,0.1 g/次,3次/日)及对照组(维生素C片,0.1 g/次,3次/日),每组26例,两组疗程均为60日。观察患者治疗前后疲劳严重程度量表(FSS)评分、Fugl-Meyer量表(FMA)、脑卒中专用生活质量量表(SS-QOL)及视觉模拟量表(VAS)评分和hs-CRP、IL-6水平变化。采用TCMSP等检索灯盏细辛胶囊的活性成分对应的靶点,检索PSF相关靶点,建立活性成分-靶点-通路网络模型。使用METASCAPE对两者取交集的26个靶点进行GO注释分析和KEGG通路分析。结果与本组治疗前比较,观察组治疗后FSS评分、VAS评分、hsCRP、IL-6降低(P<0.05),SS-QOL、FMA评分升高(<0.05);对照组治疗FSS评分、hs-CRP、IL-6降低(P<0.05),FMA评分升高(P<0.05)。与对照组同期比较,观察组治疗后FSS评分、VAS评分、hsCRP、IL-6降低(P<0.05),SS-QOL、FMA评分升高(P<0.05)。灯盏细辛胶囊可能通过黄芩素、槲皮素、毛地黄黄酮、山柰酚、芒柄花黄素作用MMP2、SERPINE1、VCAM1以及补体和凝血级联通路等多个通路治疗PSF。结论灯盏细辛胶囊可减轻PSF患者的疲劳症状,其机制主要涉及26个相关基因和4个信号通路。

Objective To observe the effect of Erigeron breviscapus Capsule on post-stroke fatigue(PSF) and explore its mechanism by network pharmacology.Methods Totally 52 patients with PSF were randomly assigned to observation group(Erigeron breviscapus Capsule,0.54 g each time,thrice daily;vitamin C tablets,0.1 g each time,thrice daily) and control group(vitamin C tablets,0.1 g each time,thrice daily),26 patients in each group,the therapeutic course for all was 60 days.The changes of Fatigue Severity Scale(FSS),Fugl-Meyer Assessment of Motor Function(FMA) Scale,Stroke-Specific Quality of Life(SS-QOL)Scale,Visual Analogue Scale(VAS),hs-CRP and IL-6 levels were observed before and after treatment.TCMSP was used to retrieve the target of the active ingredient of Erigeron breviscapus Capsule,PSF related target was retrieved,and the active ingredient target pathway network model was established.GO annotation analysis and KEGG pathway analysis were performed on 26 targets intersected by METASCAPE.Results Compared with before treatment,the FSS score,VAS score,hs-CRP and IL-6 in the observation group decreased significantly after treatment(P <0.05),meanwhile the SS-QOL and FMA scores increased significantly(P <0.05);the FSS score,hs-CRP and IL-6 in the control group decreased significantly after treatment(P <0.05),the FMA scores increased significantly(P<0.05).Compared with the control group after treatment,the FSS score,VAS score,hs-CRP,IL-6 in the observation group decreased significantly(P <0.05),meanwhile the SS-QOL and FMA scores increased significantly(P<0.05).Erigeron breviscapus Capsule may treat PSF through baicalein,quercetin,Radix Rehmanniae flavonoids,kaempferol,aristoxanthin,MMP2,SERPINE1,VCAM1 complement and coagulation cascade pathways.Conclusion Erigeron breviscapus Capsule can alleviate fatigue symptoms in patients with PSF,and its mechanism mainly involves 26 related genes and 4 signaling pathways.