Efficacy of Shugan Lidan Decoction in Treating Acute Calculous Cholecystitis and Analysis of Its Mechanism Based on Network Pharmacology

Wei-long QU; Nan QIAO; Chi ZHANG; Song LIN

doi:10.13422/j.cnki.syfjx.20210118

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Efficacy of Shugan Lidan Decoction in Treating Acute Calculous Cholecystitis and Analysis of Its Mechanism Based on Network Pharmacology

Clinic | 更新时间：2021-03-05

- Efficacy of Shugan Lidan Decoction in Treating Acute Calculous Cholecystitis and Analysis of Its Mechanism Based on Network Pharmacology
- Chinese Journal of Experimental Traditional Medical Formulae Vol. 27, Issue 6, Pages: 76-81(2021)
- 作者机构：
  
  南京中医药大学南通附属医院，江苏南通 226001
- 作者简介：
- 基金信息：
- DOI：10.13422/j.cnki.syfjx.20210118
  CLC： R675.4+1;R285;R289;R22;R2-031
- Received：17 September 2020，
  
  Published Online：30 November 2020，
  
  Published：20 March 2021
- 稿件说明：
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屈卫龙,乔楠,张弛等.疏肝利胆汤治疗急性结石性胆囊炎的疗效及网络药理学机制[J].中国实验方剂学杂志,2021,27(06):76-81.

QU Wei-long,QIAO Nan,ZHANG Chi,et al.Efficacy of Shugan Lidan Decoction in Treating Acute Calculous Cholecystitis and Analysis of Its Mechanism Based on Network Pharmacology[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(06):76-81.
屈卫龙,乔楠,张弛等.疏肝利胆汤治疗急性结石性胆囊炎的疗效及网络药理学机制[J].中国实验方剂学杂志,2021,27(06):76-81. DOI： 10.13422/j.cnki.syfjx.20210118.

QU Wei-long,QIAO Nan,ZHANG Chi,et al.Efficacy of Shugan Lidan Decoction in Treating Acute Calculous Cholecystitis and Analysis of Its Mechanism Based on Network Pharmacology[J].Chinese Journal of Experimental Traditional Medical Formulae,2021,27(06):76-81. DOI： 10.13422/j.cnki.syfjx.20210118.

摘要

目的

探讨疏肝利胆汤（SLD）联合腹腔镜胆囊切除术对急性结石性胆囊炎（ACC）的临床疗效，并采用网络药理学探讨其作用机制。

方法

回顾性分析121例ACC患者，分为腹腔镜胆囊切除术+SLD组（观察组）68例和单纯腹腔镜胆囊切除术组（对照组）53例。比较两组患者术后恢复情况（首次排气时间、体温恢复时间、抗生素使用时间及住院时间），血清炎性因子水平［白细胞计数（WBC），C反应蛋白（CRP），白细胞介素-6（IL-6）］，免疫指标水平［白细胞分化抗原（CD）3

，CD4

/CD8

，免疫球蛋白M（IgM）］以及安全性。利用TCMSP，BATMAN-TCM及TCMIP数据库平台筛选方中药物有效化合物及作用靶点；利用OMIM，GeneCard数据库搜索ACC相关靶点，取交集得到SLD治疗ACC的潜在作用靶点。利用STRING数据库平台分析作用靶点蛋白质-蛋白质相互作用（PPI）网络；利用Bioconductor软件包对作用靶点进行京都基因与基因组百科全书（KEGG）通路富集分析。

结果

观察组患者首次排气时间、抗生素使用时间及住院时间均低于对照组，差异具有统计学意义（

0.05）。经治疗，两组患者术后WBC，CRP，IL-6，CD4

/CD8

和IgM均低于治疗前，术后CD3

高于治疗前，差异均具有统计学意义（

0.05）。治疗后，观察组术后WBC，CRP，IL-6，CD4

/CD8

和IgM均低于对照组，术后CD3

高于对照组，差异均具有统计学意义

（P

0.05）。两组不良反应无统计学差异。筛选得到SLD治疗ACC的关键靶点为IL-6，血管内皮生长因子A（VEGFA），胰岛素（INS）和表皮生长因子受体（EGFR）等，关键通路为低氧诱导因子-1（HIF-1）信号通路和EGFR受体酪氨酸激酶抑制剂等。

结论

疏肝利胆汤可能作用于IL-6，VEGFA，INS，EGFR等靶点调控HIF-1通路等信号通路，从而降低急性结石性胆囊炎患者术后炎症因子，提高免疫功能，促进术后康复。

Abstract

Objective

To explore the clinical efficacy of Shugan Lidan decoction（SLD） combined with laparoscopic cholecystectomy on acute calculous cholecystitis（ACC），and explore its mechanism based on network pharmacology.

Method

In a retrospective analysis， 121 patients with ACC were divided into laparoscopic cholecystectomy+SLD group （observation group， 68 cases） and laparoscopic cholecystectomy group（control group，53 cases）. The postoperative recovery of the patients （time to first exhaust，time to temperature recovery，antibiotic use time and hospitalization time），serum inflammatory factor levels ［white blood cell count（WBC），C-reactive protein（CRP），interleukin-6（IL-6）］，immune index levels［claster of differentiation（CD）3

，CD4

/CD8

，immunoglobulin M（IgM）］ and safety were compared between these two groups. The TCMSP，BATMAN-TCM and TCMIP databases were used to collect all chemical components and targets of SLD. GeneCard and OMIM databases were combined to search ACC-related targets，and then the intersection ones of SLD-related targets and ACC-related targets were extracted to obtain the potential action targets of SLD for treatment of ACC. The STRING database platform was used to establish and analyze the protein-protein interaction （PPI） network，and Bioconductor software package was used for Kyoto encyclopedia of genes and genomes（KEGG） pathway enrichment of the targets.

Result

The time to first exhaust，antibiotic use time and hospitalization time of observation group were shorter than those of control group，and the differences were statistically significant（

0.05）. After treatment，the postoperative WBC，CRP，IL-6，CD4

/CD8

and IgM in the two groups of patients were lower than those before treatment，and the postoperative CD3

was higher than that before treatment，with statistically significant differences（

0.05）. The postoperative WBC，CRP，IL-6，CD4

/CD8

and IgM in the observation group were lower than those in control group，and the CD3

was higher than that of control group，with statistically significant differences（

0.05）. There was no statistical difference in adverse reactions between the two groups. Totally 159 components in SLD were screened，which acted synergistically on key targets such as IL-6，vascular endothelial growth factor A（VEGFA），insulin（INS），and epidermal growth factor receptor（EGFR），and participated in the regulation of HIF-1 signaling pathway，EGFR tyrosine kinase inhibitor resistance and PI3K-Akt signaling pathway in the treatment of ACC.

Conclusion

SLD may regulate HIF-1 pathway and other signaling pathways by acting on IL-6，VEGFA，INS，EGFR and other targets，thereby reducing postoperative inflammatory factors，improving immune function，and promoting postoperative recovery in patients with ACC.

关键词

Keywords

references

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