三痹颗粒治疗类风湿性关节炎的临床观察及网络药理学研究

Clinical Observation and Network Pharmacology Study on the Treatment of Rheumatoid Arthritis with Sanbi Granule

目的观察三痹颗粒治疗类风湿性关节炎(RA)的临床疗效,并采用网络药理学对其作用机制进行初探。方法选取2021年1月-2022年12月娄底市中医医院收治的RA患者96例,随机分为研究组(48例)和对照组(48例),对照组给予常规药物治疗,研究组在此基础上给予三痹颗粒治疗,比较两组治疗2个月后临床疗效及血清指标[红细胞沉降率(ESR)、C-反应蛋白(CRP)、类风湿因子(RF)、抗环瓜氨酸肽抗体(ACPA)及白细胞介素-6(IL-6)]。另基于网络药理学方法,首先利用TCMSP数据库数据库筛选三痹颗粒的有效成分和作用靶点,将结果在Gene Cards数据库中检索抗RA相关靶点,求交集获得关键核心靶点;其次,借助STRING数据库进行蛋白互作分析,通过DAVID数据库进行基因本体论(GO)功能和基因组百科全书(KEGG)通路富集分析;最后,利用Cytoscape 3.6.1软件构建蛋白互作和“活性成分-靶点-通路”网络。结果治疗组总有效率为96.50%,高于对照组的68.75%(P<0.05);治疗组治疗后2个月后ESR、CRP、RF、ACPA、IL-6水平优于对照组(P<0.05)。网络药理学研究分析得到21个关键活性成分和27个潜在靶点,主要通过10条关键信号通路发挥抗RA作用。结论三痹颗粒治疗RA具有多成分、多靶点、多通路的协同干预作用特点,能有效改善RA患者临床症状,临床效果确切。

Objective To observe the clinical efficacy of Sanbi Granules in the treatment of rheumatoid arthritis(RA),and to explore its mechanism of action by network pharmacology.Methods A total of 96 patients with RA treated in the Loudi Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were selected and randomly divided into study group(48 patients)and control group(48 patients).The control group was given conventional drug treatment,and the research group was given Sanbi granules on the basis of this treatment.The clinical efficacy and serum indexes[erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),rheumatoid factor(RF),anti-cyclic citrullinated peptide antibody(ACPA)and interleukin-6(IL-6)]were compared between the two groups after 2 months of treatment.Based on the network pharmacological method,first,the effective components and targets of Sanbi granules were screened with TCMSP database,the key core targets were obtained by intersection of the results and the anti-RA related targets retrieved from Gene Cards databases.Secondly,STRING database was used for protein interaction analysis,protein interaction and active components-targets-pathway network was constructed by Cytoscape 3.6.1.Finally,gene ontology(GO)function and KEGG pathway enrichment analysis were performed by DAVID database,and the above results were verified by molecular docking technique.Results The total effective rate of the treatment group was 96.50%,which was higher than 68.75%of the control group(P<0.05).The levels of ESR,CRP,RF,ACPA and IL-6 in the treatment group were better than those in the control group 2 months after treatment(P<0.05).Through network pharmacology analysis,21 key active components and 27 potential targets were obtained,which mainly played an anti-RA role through 10 key signaling pathways.Conclusion Sanbi granules have the characteristics of multi-component,multi-target and multi-pathway synergistic intervention in the treatment of RA,which can significantly improve the clinical symptoms of RA patients and the clinical effect is remarkable.