Meta分析结合网络药理学的肾复康胶囊治疗慢性肾小球肾炎的疗效评价及其潜在作用机制研究

Study on Efficacy Evaluation and Potential Mechanism of Shenfukang Capsule in Treatment to Chronic Glomerulonephritis by Meta Analysis and Network Pharmacology

目的 结合meta分析与网络药理学研究策略,评价肾复康胶囊(Shenfukangcapsule,SKC)治疗慢性肾小球肾炎(chronicglomerulonephritis,CGN)的临床疗效,并初步探索其作用机制。方法 全面检索SKC治疗CGN随机对照试验(randomized controlled trials,RCTs)研究的中英文文献,基于纳、排标准,确定定量文献,采用Review Manager对纳入数据meta分析。基于网络药理学方法,筛选SKC的化学成分及其作用靶点、疾病靶点、共有靶点等相关信息,随后基于生物信息学技术,进行关键通路的相关注释,探讨SKC干预CGN潜在机制。结果 共纳入11项RCTs,合计938例受试者。Meta分析显示,在有效率、淋巴细胞亚群(CD4、CD4/CD8升高,CD8下降)、纤溶系统以及肾功能指标方面,治疗组均优于对照组(P<0.05)。通过在线数据库共得到27个化学成分和97个潜在靶标干预的CGN关系极为密切,主要涉及AGE/RAGE通路、脂质和动脉粥样硬化、TNF信号通路、IL-17信号通路等多条信号通路等分子过程。结论 SKC干预CGN是多成分、多靶点、多环节的整合效应,其机制可能通过调控自身免疫、氧化应激、炎症反应等途径而达到治疗目的。

OBJECTIVE To investigate clinical efficacy evaluation and potential mechanism of Shenfukang capsule(SKC)in treatment to chronic glomerulonephritis(CGN) based on integration meta analysis and network pharmacology research strategy.METHODS The Chinese and English literature of the randomized controlled trials(RCTs) about SKC in treatment on CGN were comprehensively searched.The quantitative literature was determined based on the criteria of inclusion and exclusion.The meta analysis of the included data was carried out by the Review Manager.The chemical components and the target of action,disease targets,common targets,and other related information of SKC were screened based on network pharmacology.The key pathway was annotated,and the potential mechanism of SKC intervention in CGN was explored based on bioinformatics technology.RESULTS A total of 11 RCTs were included,which were involving 938 patients.Meta analysis showed that the effective rate,lymphocyte subsets(CD4,CD4/CD8 increased and CD8 decreased),fibrinolytic system,and renal function indexes in the therapy group were superior to those in the control group(P<0.05).A total of 27 chemical components and 97 potential targets extremely closely related to CGN were obtained through the online database,which was related to AGE/RAGE pathway,lipid and atherosclerosis,TNF signaling pathway,IL-17 signaling pathway,and other molecular processes.CONCLUSION SKC intervention in CGN is an integration effect of multi-component,multi-target,multi-links integration effect,mainly through the regulation of autoimmunity,oxidative stress,inflammatory response,and other ways to achieve therapeutic purposes.