犀角地黄汤治疗寻常型银屑病的网络药理学分析及临床验证

目的探讨犀角地黄汤治疗寻常型银屑病的物质基础、作用机制及临床效果。方法利用网络药理学方法检索、筛选犀角地黄汤治疗银屑病的靶点,并对其进行生物学功能和 KEGG通路分析。选取 2020年 12月至 2021年 12月广东医科大学附属医院皮肤性病科就诊的寻常型银屑病病人 89例,采用随机数字法分为对照组和治疗组,对照组常规治疗,治疗组在常规治疗基础上口服犀角地黄汤,观察两组疗效、银屑病皮损面积及严重程度指数( PASI)评分、皮肤病生活质量指数( DLQI)评分、中医证候评分以及血清一氧化氮( NO)含量。结果共获得犀角地黄汤治疗银屑病 28种化学成分, 65个靶点,并发现该方可能通过 NO的生物合成等多种途径发挥治疗银屑病作用。两组受试者 PASI评分、 DLQI评分、中医证候评分、血清 NO含量均有改善(P<0.01),且治疗组优于对照组( P<0.05),治疗过程中未见不良事件的发生。结论犀角地黄汤治疗银屑病具有多成分、多靶点、多途径协同干预的特点,能显著改善银屑病病人临床症状及生活质量,并初步验证银屑病在中医与“血”密切相关的理论及犀角地黄汤通过影响 NO合成治疗银屑病的机制。

Network pharmacological analysis and clinical verification of Xijiao Dihuang decoction in the treatment of psoriasis vulgaris

Objective To explore the material basis and mechanism of Xijiao Dihuang decoction (XJDHD) in the treatment of psoria- sis vulgaris and its clinical verification.Methods The chemical targets of XJDHD in the treatment of psoriasis vulgaris were retrievedand screened via network pharmacology, and its biological function and KEGG pathway were analyzed. A total of 89 patients with psori-asis vulgaris from the department of dermatology and venereology, the Affiliated Hospital of Guangdong Medical University from De-cember 2020 to December 2021 were selected, they were randomly assigned into control and treatment group. The control group re-ceived conventional treatment, and the treatment group received oral XJDHD on the basis of conventional treatment. The clinical ef-fects, psoriasis area and severity index (PASI), dermatology life quality index (DLQI), traditional Chinese medicine (TCM) syndromescores and the level of serum nitric oxide (NO) were observed in the two groups.Results In this study, a total of 28 chemical compo-nents and 65 targets of XJDHD were obtained for the treatment of psoriasis. The functional mechanism of XJDHD in the treatment ofpsoriasis may associated with a variety of pathways such as NO biosynthesis. After treatment, PASI score, DLQI score, TCM syndromescore, and serum NO content of the two groups significantly improved (P<0.01), and the treatment group was better than the control group (P<0.05), and no adverse events observed. Conclusions XJDHD has the characteristics of multi-component, multi-channel, multi-target coordinated intervention in the treatment of psoriasis, which can significantly improve the clinical symptoms and quality oflife of patients. This study also preliminary verified that the pathology of psoriasis vulgaris were related to "blood" in TCM theory, andthe mechanism of XJDHD in the treatment of psoriasis by affecting the synthesis of NO.