柴丹泻血方治疗肝郁血瘀证原发性血小板增多症科学论证

Scientific Evidence of Chaidan Xiexue Decoction(柴丹泻血方)in Treating Essential Thrombocythemia of Liver Depression and Blood Stasis Syndrome

目的论证柴丹泻血方治疗肝郁血瘀证原发性血小板增多症(essential thrombocythemia,ET)的科学性。方法基于ET的发病机制以及治疗现状,分析中医药治疗ET的优势;基于其中医病因病机,分析柴丹泻血方的组方用药特点;基于柴丹泻血方组方药物及其活性成分的现代药理学研究,探讨柴丹泻血方治疗肝郁血瘀证ET的机制;基于柴丹泻血方的网络药理学研究,揭示柴丹泻血方治疗肝郁血瘀证ET的关键通路与靶点。结果 ET的发病及血栓形成与JAK2V617F突变及JAK-STAT通路活化关系密切,但现有治疗方法存在不良反应不能耐受及药物抵抗等问题,部分中药有降血小板和抗凝的作用,但尚无特效中药;柴丹泻血方基于该病肝郁血瘀的核心病机,具有疏肝化瘀的功效;现代药理学研究表明柴丹泻血方组方及其活性成分具有抑制JAK-STAT通路和炎性因子、抗血小板聚集与抗凝血的作用;网络药理学研究显示该方可以抑制JAK-STAT信号通路,具有抑制巨核系增殖和防治血栓形成的作用。结论柴丹泻血方疏肝化瘀,组方科学,成分清楚,机制明确,治疗肝郁血瘀证ET具有科学性。

Objective The aim of this study is to demonstrate the scientific validity of Chaidan Xiexue Decoction(柴丹泻血方)in treating essential thrombocythemia(ET)of liver depression and blood stasis syndrome.Methods Based on the pathogenesis and treatment status of ET,the advantages of Chinese medicine(TCM)in treating ET were analyzed.Based on the TCM etiology and pathogenesis of the disease,the prescription regularity of Chaidan Xiexue Decoction were analyzed.According to the modern pharmacology of the drugs and active ingredients of Chaidan Xiexue Decoction,the mechanism of Chaidan Xiexue Decoction in treating ET was analyzed.Based on the network pharmacology,the key pathway and target of Chaidan Xiexue Decoction in treating ET were revealed.Results The pathogenesis and thrombosis of ET are closely related to the JAK2V617F mutation and activation of the JAK-STAT pathway,but there are problems with existing treatments such as intolerable adverse effects and drug resistance.Some traditional Chinese medicine has antiplatelet and anticoagulant effects,but there are no specific herbs available.Based on the core pathogenesis of liver depression and blood stasis syndrome,Chaidan Xiexue Decoction has the liver-dredging and stasis-dispersing effects.Modern pharmacological studies have shown that Chaidan Xiexue Decoction and its active ingredients have the effects of inhibiting JAK-STAT pathway,inflammatory factors,platelet aggregation and coagulation.Network pharmacology shows that this formula can inhibit the JAK-STAT signalling pathway,which has the effect of inhibiting the proliferation of megakaryocytosis and preventing thrombosis.Conclusion Chaidan Xiexue Decoction has the function of soothing the liver and transforming stasis.Its composition is scientific and its mechanism is distinct.