Abstract:

Objective　To explore the mechanism of action of Sophora flavescens lotion in the treatment of mixed hemorrhoids. Methods　The drugs' main active ingredients and disease targets were screened from online pharmacology databases; enrichment analysis and molecular docking were conducted; enzyme-linked immunosorbent assay (ELISA) was used to detect the serum levels of interleukin-6 (IL-6) and transforming growth factor-β (TGF-β) in 100 patients with mixed hemorrhoids before and after the treatment with Sophora flavescens lotion at Shanghang County Traditional Chinese Medicine Hospital from January 1 to December 31, 2023. t test was used. Results　The main active ingredients of Sophora flavescens lotion are quercetin, luteolin, β-sitosterol, stigmasterol, and kaempferol. Sophora flavescens lotion interacts with the core targets of mixed hemorrhoids, such as protein kinase B (AKT1), interleukin-1β (IL-1β), IL-6, tumor necrosis factor (TNF), matrix metalloproteinase-9(MMP9), and TGF-β. The main active ingredients can effectively bind to the core targets. The enrichment analysis showed that it is mainly related to signaling pathways such as advanced glycation end product-receptor of advanced glycation end product (AGE-RAGE), phosphatidylinositol 3 kinase-v-akt murine thymoma viral oncogene homolog (PI3K-Akt), etc. The results of ELISA showed that the serum IL-6 level was lower after than before the treatment [10.15 (3.80, 14.48) vs (19.30(8.68, 27.00) mg/L) mg/L], and the TGF-β level was higher after than before the treatment [0.8 (0.6, 1.0) mg/L vs. 0.4 (0.2, 0.6) mg/L ] (both P<0.05). Conclusions　The effective active ingredients of Sophora flavescens lotion bind to the core targets, and exert therapeutic effects regulating the expression of inflammatory factors through signaling pathways such as AGE-RAGE and PI3K-Akt. This may be the main mechanism of Sophora flavescens lotion in treating mixed hemorrhoids.

Key words:

Mixed hemorrhoids, Sophora flavescens lotion, Network pharmacology, Mechanism of action

摘要：

目的　探讨苦参洗剂治疗混合痔的作用机制。方法　在网络药理学数据库中筛选出药物主要活性成分和疾病靶点，并进行富集分析和分子对接；采用酶联免疫吸附试验（enzyme-linked immunosorbent assay，ELISA）检测上杭县中医院肛肠科2023年1月1日至12月31日收治的100例混合痔患者苦参洗剂治疗前后血清白细胞介素-6（interleukin-6，IL-6）、转化生长因子-β（transforming growth factor-β，TGF-β）水平。采用t检验。结果　苦参洗剂主要活性成分为槲皮素、木犀草素、β-谷甾醇、豆甾醇、山奈酚。苦参洗剂与混合痔相互作用核心靶点为蛋白激酶B（protein kinase B，AKT1）、白细胞介素-1β（interleukin-1β，IL-1β）、IL-6、肿瘤坏死因子（tumor necrosis factor，TNF）、基质金属蛋白酶-9（matrix metalloproteinase 9，MMP9）、TGF-β。主要有效成分能与核心靶点有效结合。富集分析显示，主要与晚期糖基化产物-晚期糖基化终末产物受体（advanced glycation end product-receptor of advanced glycation end product，AGE-RAGE）、磷脂酰肌醇三激酶-蛋白激酶B（phosphatidylinositol 3 kinase-v-akt murine thymoma viral oncogene homolog，PI3K-Akt）等信号通路有关。ELISA检测结果显示，治疗后，血清IL-6水平低于治疗前［10.15（3.80，14.48）mg/L比19.30（8.68，27.00）mg/L］，血清TGF-β水平高于治疗前［0.8（0.6，1.0）mg/L比0.4（0.2，0.6）mg/L］（均P<0.05）。结论　苦参洗剂有效活性成分与核心靶点结合，通过AGE-RAGE、PI3K-Akt等信号通路调节炎症因子的表达，进而发挥治疗作用。这可能是苦参洗剂治疗混合痔的主要作用机制。

关键词:

混合痔, 苦参洗剂, 网络药理学, 作用机制