基于網(wǎng)絡(luò)藥理學(xué)與分子對(duì)接的紫草治療銀屑病作用機(jī)制研究【摘要】目的：本文采用網(wǎng)絡(luò)藥理學(xué)和分子對(duì)接技術(shù)研究紫草治療銀屑病的作用機(jī)制。方法：首先通過(guò)TCMSP數(shù)據(jù)庫(kù)獲取紫草的活性成分；利用SwissTargetPrediction數(shù)據(jù)庫(kù)獲取紫草活性成分；GeneCards數(shù)據(jù)庫(kù)收集銀屑病來(lái)自人類的相關(guān)基因，然后篩選紫草與銀屑病的共有靶點(diǎn)；其次使用STRING構(gòu)建PPI網(wǎng)絡(luò)，在DAVID平臺(tái)上進(jìn)行富集分析，運(yùn)用Cytoscape軟件構(gòu)建可視化網(wǎng)絡(luò)圖，最后使用AutoDock軟件對(duì)藥物成分和靶點(diǎn)蛋白進(jìn)行分子對(duì)接驗(yàn)證。結(jié)果：經(jīng)篩選后得到紫草活性成分共10個(gè)和銀屑病疾病靶點(diǎn)共1209個(gè)，交集分析后得出紫草治療銀屑病的共有靶點(diǎn)共105個(gè)；GO分析得出細(xì)胞外基質(zhì)分解等生物過(guò)程405個(gè)；內(nèi)肽酶活性等功能分子101個(gè)；細(xì)胞組成包括細(xì)胞質(zhì)等74個(gè)；KEGG分析得到與紫草治療銀屑病作用機(jī)制密切相關(guān)的通路共137條。分子對(duì)接結(jié)果顯示lithospermidinA,lithospermidinB,acetylshikonin與關(guān)鍵靶點(diǎn)蛋白對(duì)接良好。結(jié)論：通過(guò)網(wǎng)絡(luò)藥理學(xué)方法探究紫草治療銀屑病的功效網(wǎng)絡(luò)，并用分子對(duì)接技術(shù)進(jìn)行驗(yàn)證，為紫草治療銀屑病的作用機(jī)制提供科學(xué)依據(jù)?！娟P(guān)鍵詞】網(wǎng)絡(luò)藥理學(xué)；分子對(duì)接；紫草；銀屑?。蛔饔脵C(jī)制

StudyonthemechanismofLithospermumintreatingpsoriasisbasedonNetworkPharmacologyandMolecularDocking[Abstrast]Objective:Inthispaper,NetworkPharmacologyandMolecularDockingtechnologywereusedtoexplorethemechanismofactionofLithospermuminthetreatmentofpsoriasis.Methods:Firstly,theactiveingredientsofLithospermumwereobtainedbyTCMSPdatabase,thecorrespondingtargetsoftheingredientswerepredictedusingSwissTargetPredictiondatabase,therelevantgenesofpsoriasisfromhumanwerecollectedbyGeneCards,thenthecommontargetsofLithospermumandpsoriasiswerescreened.Secondly,thePPInetworkwasconstructedusingtheSTRING,GOandKEGGpathwayanalysisontheDAVIDplatform.ThevisualnetworkdiagramwasconstructedbyCytoscapesoftware.Finally,MolecularDockingofdrugcomponentsandtargetproteinswasverifiedusingAutoDocksoftware.Results:Afterscreening,atotalof10activeingredientsofLithospermumand1209psoriasistargetswereobtained,and105commontargetsofLithospermumforpsoriasiswereobtainedafterintersectionanalysis.GOanalysisrevealed405BiologicalProcessessuchasextracellularmatrixdisassembly;includingendopeptidaseactivity101FunctionalMolecules;Cellularcompositionincludescytoplasm,andother74.KEGGpathwayanalysisshowedthatatotalof137pathwayswerecloselyrelatedtothemechanismofactionofLithospermuminthetreatmentofpsoriasis.MolecularDockingresultsshowedthatlithospermidinA,lithospermidinBandacetylshikoninweredockedwellwithkeytargetproteins.Conclusion:TheefficacynetworkofLithospermuminthetreatmentofpsoriasiswasexploredbyNetworkPharmacologyandvalidatedbyMolecularDockingtoprovidescientificevidenceforthemechanismofactionofLithospermuminthetreatmentofpsoriasis.[Keyword]NetworkPharmacologyMolecularDockingtechnologyLithospermumPsoriasisMechanismsofaction

目錄1前言 前言紫草，紫草科紫草屬植物，入藥部位為新疆紫草Arnebiaeuchroma（Royle）Johnst.或內(nèi)蒙紫草ArnebiaguttataBunge的干燥根。紫草性寒，味甘、咸，歸心、肝經(jīng)，具有清熱涼血，活血解毒，透疹消斑的功效，用于血熱毒盛，斑疹紫黑，麻疹不透，瘡瘍，濕疹，水火燙傷ADDINEN.CITE<EndNote><Cite><Author>國(guó)家藥典委員會(huì)</Author><Year>2020</Year><RecNum>366</RecNum><DisplayText><styleface="superscript">[1]</style></DisplayText><record><rec-number>366</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709084443">366</key></foreign-keys><ref-typename="Book">6</ref-type><contributors><authors><author><styleface="normal"font="default"charset="134"size="100%">國(guó)家藥典委員會(huì)</style></author></authors></contributors><titles><title><styleface="normal"font="default"charset="134"size="100%">中華人民共和國(guó)藥典（一部）</style></title></titles><pages>355-356</pages><section>355-356</section><dates><year>2020</year></dates><pub-location><styleface="normal"font="default"charset="134"size="100%">北京</style></pub-location><publisher><styleface="normal"font="default"charset="134"size="100%">中國(guó)醫(yī)藥科技出版社</style></publisher><urls></urls></record></Cite></EndNote>[1]。紫草在我國(guó)具有悠久的歷史，紫草的藥用功效最早記錄在《神農(nóng)本草經(jīng)》ADDINEN.CITE<EndNote><Cite><Author>尚志鈞</Author><Year>1995</Year><RecNum>367</RecNum><DisplayText><styleface="superscript">[2]</style></DisplayText><record><rec-number>367</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709086769">367</key></foreign-keys><ref-typename="Book">6</ref-type><contributors><authors><author><styleface="normal"font="default"charset="134"size="100%">尚志鈞</style></author></authors></contributors><titles><title><styleface="normal"font="default"charset="134"size="100%">神農(nóng)本草經(jīng)校注</style></title></titles><pages>144</pages><dates><year>1995</year></dates><pub-location><styleface="normal"font="default"charset="134"size="100%">北京</style></pub-location><publisher><styleface="normal"font="default"charset="134"size="100%">學(xué)苑出版社</style></publisher><urls></urls></record></Cite></EndNote>[2]中：“主心腹邪氣，五疸，補(bǔ)中益氣，利九竅，通水道?！标U述了其補(bǔ)中益氣，通調(diào)水道的藥用功效。而《本草圖經(jīng)》ADDINEN.CITE<EndNote><Cite><Author>蘇頌</Author><Year>1994</Year><RecNum>368</RecNum><DisplayText><styleface="superscript">[3]</style></DisplayText><record><rec-number>368</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709087052">368</key></foreign-keys><ref-typename="Book">6</ref-type><contributors><authors><author><styleface="normal"font="default"charset="134"size="100%">蘇頌</style></author></authors></contributors><titles><title><styleface="normal"font="default"charset="134"size="100%">本草圖經(jīng)</style></title></titles><dates><year>1994</year></dates><pub-location><styleface="normal"font="default"charset="134"size="100%">安徽</style></pub-location><publisher><styleface="normal"font="default"charset="134"size="100%">安徽科學(xué)技術(shù)出版社</style></publisher><urls></urls></record></Cite></EndNote>[3]進(jìn)一步記載了紫草透疹消斑的功效:“治傷寒時(shí)疾，發(fā)瘡疹不出者，以此作藥，使其發(fā)出。”現(xiàn)代研究表明，紫草具有抗炎、抗菌、抗腫瘤、免疫調(diào)節(jié)、抗氧化等藥理作用，其中紫草抗炎的藥理作用研究最為深入。賈穎等人通過(guò)二甲苯致小鼠耳腫脹和腹部皮膚毛細(xì)血管通透性增高模型實(shí)驗(yàn)，證明復(fù)方紫草凝膠制劑對(duì)治療急性炎癥具有良好的效果，能抑制毛細(xì)血管通透性增加ADDINEN.CITE<EndNote><Cite><Author>賈穎</Author><Year>2020</Year><RecNum>1</RecNum><DisplayText><styleface="superscript">[4]</style></DisplayText><record><rec-number>1</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1708999071">1</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>賈穎</author><author>王佳敏</author><author>王世暉</author><author>劉凱麗</author><author>楊大偉</author><author>王艷</author></authors></contributors><auth-address>山西中醫(yī)藥大學(xué);</auth-address><titles><title>復(fù)方紫草凝膠外用制劑的抗炎與抑菌作用研究%J日用化學(xué)工業(yè)</title></titles><pages>848-853</pages><volume>50</volume><number>12</number><keywords><keyword>復(fù)方紫草凝膠外用制劑</keyword><keyword>表面活性劑</keyword><keyword>炎癥</keyword><keyword>抑菌</keyword><keyword>二甲苯</keyword></keywords><dates><year>2020</year></dates><isbn>1001-1803</isbn><urls><related-urls><url>/kcms2/article/abstract?v=HboJJBuTKtRoqbSUF_gyIn3DMjm19mXYNgFjYpg9VcwJqWwPam3Dq7SRsyIpXotdYdfR6w_MibUZPxzXoBe6u86I6L4dSlJ-YmPFh6d8bqazl2ps0SrnFEH1_H4cMmRu0uRIFUS4CzF_bZDQFT190g==&uniplatform=NZKPT&language=CHS</url></related-urls></urls><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[4]。李陳采用外用復(fù)方紫草油能明顯抑制幼齡小鼠的急性耳廓腫脹、變應(yīng)性接觸性皮炎等炎癥，并觀察小鼠皮膚組織病理形態(tài)，證實(shí)外用復(fù)方紫草油能治療小兒尿布皮炎且治愈率高、不良反應(yīng)少ADDINEN.CITE<EndNote><Cite><Author>李陳</Author><Year>2018</Year><RecNum>3</RecNum><DisplayText><styleface="superscript">[5]</style></DisplayText><record><rec-number>3</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1708999239">3</key></foreign-keys><ref-typename="Thesis">32</ref-type><contributors><authors><author>李陳</author></authors><tertiary-authors><author>?？?J,成都中醫(yī)藥大學(xué)</author></tertiary-authors></contributors><titles><title>外用復(fù)方紫草油治療小兒尿布皮炎的抗炎機(jī)制研究</title></titles><keywords><keyword>復(fù)方紫草油</keyword><keyword>小兒尿布皮炎</keyword><keyword>外治</keyword><keyword>火郁發(fā)之</keyword><keyword>抗炎</keyword></keywords><dates><year>2018</year></dates><work-type>博士</work-type><urls><related-urls><url>/kcms2/article/abstract?v=HboJJBuTKtRNcOr_57IXYIyYa38q-R_B4X5bmuFHu1cOBLOsd5PYibYEPH5GMEhsngoUgUf0SygAOXhW7IG4ESaDcW53xjPhYlTR7sM5xwJH8yTn1I7ySpRlAO4KSnxRMy5D3tI9msRKhV3qKW8RTw==&uniplatform=NZKPT&language=CHS</url></related-urls></urls><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[5]。紫草含有多種化學(xué)成分，包括多糖類、生物堿類、萘醌類等，紫草抗炎作用中活性最強(qiáng)的成分之一是萘醌類成分紫草素。紫草素通過(guò)抑制蛋白酶體、活化細(xì)胞通路、降低巨噬細(xì)胞蛋白表達(dá)等發(fā)揮抗炎作用，因此紫草素對(duì)關(guān)節(jié)炎、哮喘、牛皮癬和乳腺炎等不同疾病的炎癥有較好的治療效果ADDINEN.CITE<EndNote><Cite><Author>錢(qián)雪</Author><Year>2021</Year><RecNum>4</RecNum><DisplayText><styleface="superscript">[6]</style></DisplayText><record><rec-number>4</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1708999454">4</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>錢(qián)雪</author><author>李海濤</author><author>曾萬(wàn)祥</author><author>史曉芬</author><author>張峰倫</author><author>陳斌</author><author>葛翎</author><author>黃曉德</author><author>周謙</author></authors></contributors><auth-address>南京中醫(yī)藥大學(xué);南京野生植物綜合利用研究院;博賢實(shí)業(yè)(廣東)有限公司;南京醫(yī)科大學(xué)附屬無(wú)錫人民醫(yī)院;南京中醫(yī)藥大學(xué)附屬中西醫(yī)結(jié)合醫(yī)院江蘇省中醫(yī)藥研究院;</auth-address><titles><title>紫草化學(xué)成分、藥理作用及產(chǎn)品應(yīng)用研究進(jìn)展%J中國(guó)野生植物資源</title></titles><pages>52-56+69</pages><volume>40</volume><number>03</number><keywords><keyword>紫草</keyword><keyword>化學(xué)成分</keyword><keyword>藥理作用</keyword></keywords><dates><year>2021</year></dates><isbn>1006-9690</isbn><urls><related-urls><url>/kcms2/article/abstract?v=HboJJBuTKtRRNjV-qn3Cdw4ydJTUxHCFWwx9vX2Q3GFWutvltCV_kjuSAjWf3Ry-QAEOELn8_oE7TAB1rPQ1MMkLNINA2Yb1I34uCoBZS0geTy4JJhhZaOZQgmIY2SPGXhRvG3CrWZIS9fkOmc0WBg==&uniplatform=NZKPT&language=CHS</url></related-urls></urls><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[6]。梁鞏等人將紫草素凝膠涂抹在有傷口的驢皮上，探究紫草素的抗炎作用，表明紫草素能降低炎癥因子表達(dá)，抑制炎癥反應(yīng)而促進(jìn)傷口愈合ADDINEN.CITE<EndNote><Cite><Author>梁鞏</Author><Year>2020</Year><RecNum>9</RecNum><DisplayText><styleface="superscript">[7]</style></DisplayText><record><rec-number>9</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1708999644">9</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>梁鞏</author><author>王艷萍</author><author>苗凱</author><author>王璐</author><author>王曉路</author><author>曾維斌</author></authors></contributors><auth-address>石河子大學(xué)動(dòng)物科技學(xué)院;深圳羅茲曼國(guó)際轉(zhuǎn)化醫(yī)學(xué)研究院;</auth-address><titles><title>紫草素抑制炎癥促進(jìn)驢皮傷口愈合的效果%J中國(guó)畜牧獸醫(yī)</title></titles><pages>2295-2303</pages><volume>47</volume><number>07</number><keywords><keyword>紫草素</keyword><keyword>傷口愈合</keyword><keyword>瘢痕</keyword><keyword>炎癥因子</keyword></keywords><dates><year>2020</year></dates><isbn>1671-7236</isbn><urls><related-urls><url>/doi/10.16431/ki.1671-7236.2020.07.036</url></related-urls></urls><electronic-resource-num>10.16431/ki.1671-7236.2020.07.036</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[7]。紫草藥用范圍廣泛，可內(nèi)服水煎劑治療蕁麻疹、過(guò)敏性紫癜、痤瘡等，或制成紫草油外用治療嬰兒濕疹、燒燙傷、激素依賴性皮炎等皮膚病ADDINEN.CITE<EndNote><Cite><Author>張凡</Author><Year>2020</Year><RecNum>14</RecNum><DisplayText><styleface="superscript">[8]</style></DisplayText><record><rec-number>14</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709000296">14</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>張凡</author><author>王綰江</author><author>景慧玲</author></authors></contributors><auth-address>陜西中醫(yī)藥大學(xué);西安市中醫(yī)醫(yī)院;</auth-address><titles><title>紫草的現(xiàn)代藥理研究及皮膚科中的應(yīng)用%J中醫(yī)藥導(dǎo)報(bào)</title></titles><pages>168-172</pages><volume>26</volume><number>09</number><keywords><keyword>紫草</keyword><keyword>化學(xué)成分</keyword><keyword>藥理作用</keyword><keyword>銀屑病</keyword><keyword>皮膚</keyword><keyword>臨床應(yīng)用</keyword></keywords><dates><year>2020</year></dates><isbn>1672-951X</isbn><urls><related-urls><url>/doi/10.13862/43-1446/r.2020.09.045</url></related-urls></urls><electronic-resource-num>10.13862/43-1446/r.2020.09.045</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[8]。紫草除了作為藥品使用外，還有其他多種用途。由于其富含色素，已被運(yùn)用到紡織品染色工業(yè)上；紫草提取物具有抑菌、抗氧化的功效，可制成化妝品，其安全性和有效性相比于工業(yè)化妝品更受到人們認(rèn)可ADDINEN.CITE<EndNote><Cite><Author>馬生軍</Author><Year>2021</Year><RecNum>18</RecNum><DisplayText><styleface="superscript">[9]</style></DisplayText><record><rec-number>18</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709000459">18</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>馬生軍</author><author>耿陽(yáng)</author><author>馬露</author><author>朱戀</author></authors></contributors><auth-address>新疆農(nóng)業(yè)大學(xué)食品科學(xué)與藥學(xué)學(xué)院;</auth-address><titles><title>藥用紫草研究進(jìn)展%J中國(guó)現(xiàn)代中藥</title></titles><pages>177-184</pages><volume>23</volume><number>01</number><keywords><keyword>紫草</keyword><keyword>新疆紫草</keyword><keyword>內(nèi)蒙紫草</keyword></keywords><dates><year>2021</year></dates><isbn>1673-4890</isbn><urls><related-urls><url>/doi/10.13313/j.issn.1673-4890.20190719004</url></related-urls></urls><electronic-resource-num>10.13313/j.issn.1673-4890.20190719004</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[9]。銀屑病又稱“牛皮癬”，是一種常見(jiàn)的慢性皮膚病，全球各地發(fā)病率不同，但都呈現(xiàn)上升趨勢(shì)，成人患病率達(dá)到11.43%ADDINEN.CITE<EndNote><Cite><Author>張紅霞</Author><Year>2023</Year><RecNum>22</RecNum><DisplayText><styleface="superscript">[10]</style></DisplayText><record><rec-number>22</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709000604">22</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>張紅霞</author><author>王麗新</author></authors></contributors><auth-address>寧夏醫(yī)科大學(xué)中醫(yī)學(xué)院;</auth-address><titles><title>銀屑病流行病學(xué)及危險(xiǎn)因素研究進(jìn)展%J寧夏醫(yī)學(xué)雜志</title></titles><pages>670-672</pages><volume>45</volume><number>07</number><keywords><keyword>銀屑病</keyword><keyword>流行病學(xué)</keyword><keyword>危險(xiǎn)因素</keyword></keywords><dates><year>2023</year></dates><isbn>1001-5949</isbn><urls><related-urls><url>/doi/10.13621/j.1001-5949.2023.07.0670</url></related-urls></urls><electronic-resource-num>10.13621/j.1001-5949.2023.07.0670</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[10]。銀屑病常見(jiàn)分類有尋常型、紅皮病型、關(guān)節(jié)病型和膿皰型4種類型，臨床癥狀上尋常型多為患者皮膚出現(xiàn)紅色薄膜和點(diǎn)狀出血并帶有容易脫落的銀白色鱗屑；紅皮病型患者絕大部分皮膚潮紅并出現(xiàn)大量皮屑；關(guān)節(jié)病型患者通常除了具有尋常型皮損以外，還伴有關(guān)節(jié)處的紅腫、疼痛；膿皰型銀屑病表現(xiàn)為紅斑上出現(xiàn)許多白色無(wú)菌性膿皰以及脫皮和結(jié)痂。由于銀屑病病程長(zhǎng)易復(fù)發(fā)，加上出現(xiàn)大面積的紅斑、脫屑、瘙癢等癥狀，因此對(duì)許多患者的日常生活及心理健康造成了嚴(yán)重的影響。在中醫(yī)范疇上，銀屑病被稱為“白疕”。中醫(yī)推測(cè)銀屑病的病因以血分為主，分為血熱、血燥、血瘀，目前臨床上銀屑病多見(jiàn)于血熱證。治療血熱型銀屑病主要的理論體系包括玄府理論、血分理論以及伏邪理論等ADDINEN.CITE<EndNote><Cite><Author>劉貴軍</Author><Year>2023</Year><RecNum>29</RecNum><DisplayText><styleface="superscript">[11]</style></DisplayText><record><rec-number>29</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709000753">29</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>劉貴軍</author><author>向曉晴</author><author>唐毅博</author><author>馬天明</author></authors></contributors><auth-address>黑龍江中醫(yī)藥大學(xué)附屬第四醫(yī)院;黑龍江中醫(yī)藥大學(xué);黑龍江中醫(yī)藥大學(xué)附屬第二醫(yī)院;</auth-address><titles><title>中醫(yī)藥治療銀屑病血熱證的研究進(jìn)展%J中醫(yī)藥學(xué)報(bào)</title></titles><pages>101-105</pages><volume>51</volume><number>12</number><keywords><keyword>銀屑病</keyword><keyword>血熱證</keyword><keyword>中醫(yī)藥</keyword><keyword>研究進(jìn)展</keyword></keywords><dates><year>2023</year></dates><isbn>1002-2392</isbn><urls><related-urls><url>/doi/10.19664/ki.1002-2392.230264</url></related-urls></urls><electronic-resource-num>10.19664/ki.1002-2392.230264</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[11]。有學(xué)者提出“新血證論”思想ADDINEN.CITE<EndNote><Cite><Author>蒯仂</Author><Year>2023</Year><RecNum>375</RecNum><DisplayText><styleface="superscript">[12]</style></DisplayText><record><rec-number>375</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709090739">375</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>蒯仂</author><author>王瑞平</author><author>李欣</author><author>秦萬(wàn)章</author><author>羅楹</author><author>楊涵</author><author>李斌</author></authors></contributors><auth-address>上海中醫(yī)藥大學(xué)附屬岳陽(yáng)中西醫(yī)結(jié)合醫(yī)院皮膚科;上海市中醫(yī)藥研究院皮膚病研究所;同濟(jì)大學(xué)附屬皮膚病醫(yī)院;復(fù)旦大學(xué)附屬中山醫(yī)院皮膚科;上海中醫(yī)藥大學(xué)岳陽(yáng)臨床醫(yī)學(xué)院;上海中醫(yī)藥大學(xué)附屬岳陽(yáng)中西醫(yī)結(jié)合醫(yī)院康復(fù)醫(yī)學(xué)科;</auth-address><titles><title>銀屑病“新血證論”辨治銀屑病理論溯源及實(shí)踐%J世界臨床藥物</title></titles><pages>293-297</pages><volume>44</volume><number>03</number><keywords><keyword>銀屑病</keyword><keyword>新血證論</keyword><keyword>血熱陽(yáng)浮</keyword><keyword>血瘀</keyword><keyword>病機(jī)</keyword></keywords><dates><year>2023</year></dates><isbn>1672-9188</isbn><urls><related-urls><url>/doi/10.13683/j.wph.2023.03.016</url></related-urls></urls><electronic-resource-num>10.13683/j.wph.2023.03.016</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[12]，闡述了銀屑病血熱是由于陰陽(yáng)失衡，陽(yáng)浮于表；血瘀是久病營(yíng)衛(wèi)失?；驓庋蛔悖蛔詈筇岢隼坠傩詻?，有祛風(fēng)解毒、清熱涼血的功效，是治療銀屑病的良好中藥。近年研究表明ADDINEN.CITE<EndNote><Cite><Author>儀凡</Author><Year>2023</Year><RecNum>47</RecNum><DisplayText><styleface="superscript">[13]</style></DisplayText><record><rec-number>47</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709001034">47</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>儀凡</author><author>趙子慧</author><author>劉博文</author><author>李林昌</author><author>劉玉冰</author><author>張廣中</author></authors></contributors><auth-address>首都醫(yī)科大學(xué)附屬北京中醫(yī)醫(yī)院皮膚科;北京中醫(yī)藥大學(xué)研究生院;</auth-address><titles><title>中醫(yī)溫陽(yáng)法論治銀屑病的用藥規(guī)律探究%J中國(guó)醫(yī)院用藥評(píng)價(jià)與分析</title></titles><pages>1170-1173+1178</pages><volume>23</volume><number>10</number><keywords><keyword>溫陽(yáng)法</keyword><keyword>銀屑病</keyword><keyword>數(shù)據(jù)挖掘</keyword><keyword>關(guān)聯(lián)分析</keyword><keyword>用藥規(guī)律</keyword><keyword>中醫(yī)藥</keyword></keywords><dates><year>2023</year></dates><isbn>1672-2124</isbn><urls><related-urls><url>/doi/10.14009/j.issn.1672-2124.2023.10.004</url></related-urls></urls><electronic-resource-num>10.14009/j.issn.1672-2124.2023.10.004</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[13]，銀屑病患者多為陽(yáng)虛癥，陽(yáng)氣不足則氣滯血瘀，故提出溫陽(yáng)法治療銀屑病。溫陽(yáng)法在兼顧清熱涼血等病機(jī)同時(shí)，增添溫里藥、解表藥、補(bǔ)氣藥、活血化瘀藥等溫陽(yáng)補(bǔ)氣，養(yǎng)陰益血；銀屑病病變臟腑主要為肝，肝氣郁結(jié)則生瘀，于是溫陽(yáng)法強(qiáng)調(diào)理肝氣?！靶卵C論”與“溫陽(yáng)法”均從不同角度提出中醫(yī)藥治療銀屑病的方向，為銀屑病臨床用藥治療提供一定的參考。目前銀屑病的病因認(rèn)為與遺傳、環(huán)境、感染等多因素相關(guān)，但確切病因和發(fā)病機(jī)制尚未明確，治療也尚無(wú)特效療法。有研究發(fā)現(xiàn)，銀屑病的發(fā)病機(jī)制與免疫炎癥有一定的關(guān)系，多種免疫細(xì)胞和細(xì)胞因子與銀屑病的發(fā)病機(jī)制密切相關(guān)。因此銀屑病在現(xiàn)代藥理學(xué)的發(fā)病機(jī)制研究上主要集中于免疫方向，其中包括IL-16(白介素-16)、IL-17(白介素-17)、IL-23(白介素-23)、TNF-α(腫瘤壞死因子-α）等多個(gè)細(xì)胞因子，表觀遺傳調(diào)控，JAK-STAT通路，代謝異常等發(fā)病機(jī)制ADDINEN.CITE<EndNote><Cite><Author>劉婧雯</Author><Year>2023</Year><RecNum>294</RecNum><DisplayText><styleface="superscript">[14]</style></DisplayText><record><rec-number>294</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709014717">294</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>劉婧雯</author><author>朱蕾</author></authors></contributors><auth-address>中國(guó)醫(yī)學(xué)科學(xué)院基礎(chǔ)醫(yī)學(xué)研究所,北京協(xié)和醫(yī)學(xué)院基礎(chǔ)學(xué)院;</auth-address><titles><title>銀屑病發(fā)病機(jī)制及藥物研究新進(jìn)展%J藥學(xué)學(xué)報(bào)</title></titles><pages>2942-2951</pages><volume>58</volume><number>10</number><keywords><keyword>銀屑病</keyword><keyword>發(fā)病機(jī)制</keyword><keyword>化學(xué)藥物</keyword><keyword>生物制劑</keyword></keywords><dates><year>2023</year></dates><isbn>0513-4870</isbn><urls><related-urls><url>/doi/10.16438/j.0513-4870.2023-0468</url></related-urls></urls><electronic-resource-num>10.16438/j.0513-4870.2023-0468</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[14]。趙亞等人建立不同免疫狀態(tài)的小鼠模型，采用咪喹莫特誘導(dǎo)小鼠銀屑病，探究T細(xì)胞在銀屑病發(fā)病機(jī)制中的作用。結(jié)果顯示含有T細(xì)胞的小鼠銀屑病癥狀比T細(xì)胞確實(shí)的小鼠癥狀更為嚴(yán)重，淋巴細(xì)胞含量增高，則表明T細(xì)胞與銀屑病的發(fā)病機(jī)制密不可分ADDINEN.CITE<EndNote><Cite><Author>趙亞</Author><Year>2022</Year><RecNum>85</RecNum><DisplayText><styleface="superscript">[15]</style></DisplayText><record><rec-number>85</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709003064">85</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>趙亞</author><author>吳亞運(yùn)</author><author>劉麗娟</author><author>趙瑞芝</author></authors></contributors><auth-address>廣州中醫(yī)藥大學(xué)第二附屬醫(yī)院;廣東省中醫(yī)癥候研究重點(diǎn)實(shí)驗(yàn)室;省部共建中醫(yī)濕證重點(diǎn)實(shí)驗(yàn)室;</auth-address><titles><title>咪喹莫特致不同免疫狀態(tài)小鼠銀屑病模型比較研究%J中國(guó)比較醫(yī)學(xué)雜志</title></titles><pages>41-47</pages><volume>32</volume><number>06</number><keywords><keyword>銀屑病</keyword><keyword>動(dòng)物模型</keyword><keyword>免疫細(xì)胞</keyword><keyword>ATP酶</keyword></keywords><dates><year>2022</year></dates><isbn>1671-7856</isbn><urls><related-urls><url>/urlid/11.4822.R.20220609.0951.012</url></related-urls></urls><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[15]。楊旭燕等人提出MAPK信號(hào)通路中的主要負(fù)調(diào)控因子Spred1參與銀屑病的發(fā)病機(jī)制，推測(cè)Spred1的異常調(diào)節(jié)和突變可能在銀屑病的發(fā)病中起到重要作用ADDINEN.CITE<EndNote><Cite><Author>楊旭燕</Author><RecNum>94</RecNum><DisplayText><styleface="superscript">[16]</style></DisplayText><record><rec-number>94</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709003149">94</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>楊旭燕</author><author>李俊琴</author><author>牛旭平</author><author>成彥蓉</author><author>李新華</author></authors></contributors><auth-address>山西醫(yī)科大學(xué)第九臨床醫(yī)學(xué)院;山西醫(yī)科大學(xué)附屬太原中心醫(yī)院皮膚科免疫性皮膚病干細(xì)胞山西省重點(diǎn)實(shí)驗(yàn)室;</auth-address><titles><title>SPRED1，參與銀屑病發(fā)病的重要環(huán)節(jié)？%J中國(guó)免疫學(xué)雜志</title></titles><pages>1-8</pages><keywords><keyword>銀屑病</keyword><keyword>細(xì)胞增殖</keyword><keyword>血管增生</keyword><keyword>Spred1</keyword><keyword>MAPK信號(hào)通路</keyword></keywords><dates></dates><isbn>1000-484X</isbn><urls><related-urls><url>/urlid/22.1126.R.20231102.1650.002</url></related-urls></urls><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[16]。有研究發(fā)現(xiàn)ADDINEN.CITEADDINEN.CITE.DATA[17]，銀屑病患者的PANoptosis信號(hào)高表達(dá)且有兩種模式，高相關(guān)性的PANoptosis模式發(fā)現(xiàn)了顯著失調(diào)的免疫反應(yīng)。在治療銀屑病的中藥中，紫草具有臨床效果好、作用緩和持久、毒副作用少的優(yōu)勢(shì)。目前臨床上使用紫草治療銀屑病多采用以紫草為君藥的復(fù)方進(jìn)行治療。早期在2003年，王雅娟等人便通過(guò)使用紫草活血湯治療尋常型銀屑病，評(píng)價(jià)患者PASI得分和血流流變學(xué)，結(jié)果表明紫草活血湯可以明顯縮小皮損面積及有效改善紅斑、丘疹、鱗屑等癥狀，對(duì)治療尋常型銀屑病有較好的臨床療效ADDINEN.CITE<EndNote><Cite><Author>王雅娟</Author><Year>2003</Year><RecNum>120</RecNum><DisplayText><styleface="superscript">[18]</style></DisplayText><record><rec-number>120</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709003232">120</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>王雅娟,石景偉,董西林,陳琪,揚(yáng)杰</author></authors></contributors><auth-address>西安交通大學(xué)第二醫(yī)院中醫(yī)科,西安交通大學(xué)第二醫(yī)院中醫(yī)科,西安交通大學(xué)第二醫(yī)院中醫(yī)科,西安交通大學(xué)第二醫(yī)院中醫(yī)科,西安交通大學(xué)第二醫(yī)院中醫(yī)科陜西西安710004,陜西西安710004,陜西西安710004,陜西西安710004,陜西西安710004</auth-address><titles><title>紫草活血湯治療銀屑病的療效及對(duì)血液流變學(xué)的影響%J西安交通大學(xué)學(xué)報(bào)(醫(yī)學(xué)版)</title></titles><pages>275-276+296</pages><number>03</number><keywords><keyword>銀屑病</keyword><keyword>血液流變學(xué)</keyword><keyword>中藥</keyword><keyword>治療</keyword></keywords><dates><year>2003</year></dates><isbn>1671-8259</isbn><urls><related-urls><url>/kcms2/article/abstract?v=F5NaIWgMQ1DIUJDIXkMgcC-HZ7-DP7O9A89aSY9O42_4E9IwN1yeV8A-GK_GmyIGK2i4gMxEE0J-DOyBDOzI4FKv0oUnm7Oy6WDnSk-UkOK1b_EYSNQ0_jD4BrLvOxEkb3hB4xQxEKA=&uniplatform=NZKPT&language=CHS</url></related-urls></urls><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[18]；在2021年，徐志立等人使用復(fù)方紫草湯灌胃給藥小鼠，結(jié)果顯示復(fù)方紫草湯可明顯緩解咪喹莫特誘導(dǎo)的小鼠表皮角質(zhì)形成增殖減少，皮損程度降低并且能顯著地抑制小鼠體內(nèi)血漿的TNF-α表達(dá)，含量降低ADDINEN.CITE<EndNote><Cite><Author>徐志立</Author><Year>2021</Year><RecNum>130</RecNum><DisplayText><styleface="superscript">[19]</style></DisplayText><record><rec-number>130</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709003339">130</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>徐志立</author><author>梁晗業(yè)</author><author>邊澈</author><author>于彩娜</author></authors></contributors><auth-address>遼寧中醫(yī)藥大學(xué);</auth-address><titles><title>復(fù)方紫草湯對(duì)咪喹莫特所致銀屑病小鼠的治療作用%J兒科藥學(xué)雜志</title></titles><pages>6-10</pages><volume>27</volume><number>03</number><keywords><keyword>銀屑病</keyword><keyword>咪喹莫特</keyword><keyword>復(fù)方紫草湯</keyword></keywords><dates><year>2021</year></dates><isbn>1672-108X</isbn><urls><related-urls><url>/doi/10.13407/ki.jpp.1672-108X.2021.03.002</url></related-urls></urls><electronic-resource-num>10.13407/ki.jpp.1672-108X.2021.03.002</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[19]。除了以紫草為君藥的復(fù)方，紫草的單一活性成分紫草素同樣能緩解銀屑病癥狀。紫草素具有良好的免疫抗炎活性，在血管平滑肌細(xì)胞的細(xì)胞周期中具有抗增殖、促凋亡、減緩細(xì)胞周期進(jìn)程的重要作用ADDINEN.CITE<EndNote><Cite><Author>馬生軍</Author><Year>2021</Year><RecNum>132</RecNum><DisplayText><styleface="superscript">[9]</style></DisplayText><record><rec-number>132</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709003339">132</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>馬生軍</author><author>耿陽(yáng)</author><author>馬露</author><author>朱戀</author></authors></contributors><auth-address>新疆農(nóng)業(yè)大學(xué)食品科學(xué)與藥學(xué)學(xué)院;</auth-address><titles><title>藥用紫草研究進(jìn)展%J中國(guó)現(xiàn)代中藥</title></titles><pages>177-184</pages><volume>23</volume><number>01</number><keywords><keyword>紫草</keyword><keyword>新疆紫草</keyword><keyword>內(nèi)蒙紫草</keyword></keywords><dates><year>2021</year></dates><isbn>1673-4890</isbn><urls><related-urls><url>/doi/10.13313/j.issn.1673-4890.20190719004</url></related-urls></urls><electronic-resource-num>10.13313/j.issn.1673-4890.20190719004</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[9]。李小瓊經(jīng)實(shí)驗(yàn)驗(yàn)證紫草素能明顯緩解酒精加重的咪喹莫特誘導(dǎo)小鼠銀屑病的皮損現(xiàn)象，并發(fā)現(xiàn)紫草素能抑制PKM2的表達(dá)，緩解銀屑病小鼠的皮炎ADDINEN.CITE<EndNote><Cite><Author>李小瓊</Author><Year>2022</Year><RecNum>145</RecNum><DisplayText><styleface="superscript">[20]</style></DisplayText><record><rec-number>145</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709003548">145</key></foreign-keys><ref-typename="Thesis">32</ref-type><contributors><authors><author>李小瓊</author></authors><tertiary-authors><author>高興華%J,中國(guó)醫(yī)科大學(xué)</author></tertiary-authors></contributors><titles><title>紫草素通過(guò)PKM2-TH17途徑緩解酒精加重的咪喹莫特誘導(dǎo)的小鼠銀屑病樣皮炎</title></titles><keywords><keyword>酒精</keyword><keyword>紫草素</keyword><keyword>IL-17</keyword><keyword>銀屑病</keyword><keyword>丙酮酸激酶2</keyword></keywords><dates><year>2022</year></dates><work-type>博士</work-type><urls><related-urls><url>/doi/10.27652/ki.gzyku.2022.000020</url></related-urls></urls><electronic-resource-num>10.27652/ki.gzyku.2022.000020</electronic-resource-num><remote-database-provider>Cnki</remote-database-provider></record></Cite></EndNote>[20]。王潔等人使用紫草素對(duì)銀屑病患者的皮膚組織標(biāo)本進(jìn)行治療，驗(yàn)證了紫草素可調(diào)控TGF-β1/Survivin通路有效緩解銀屑病皮膚炎癥ADDINEN.CITE<EndNote><Cite><Author>王潔</Author><Year>2021</Year><RecNum>163</RecNum><DisplayText><styleface="superscript">[21]</style></DisplayText><record><rec-number>163</rec-number><foreign-keys><keyapp="EN"db-id="tzdszpe5gf99x3e99stpwzagzxvdptzex9xe"timestamp="1709003611">163</key></foreign-keys><ref-typename="JournalArticle">17</ref-type><contributors><authors><author>王潔</author><author>趙菊花</author><author>李達(dá)</author><author>何啟敏</author><author>何振興</author></authors></contributors><auth-address>南充市中心醫(yī)院皮膚科;南充市中心醫(yī)院肝膽外科;</auth-address><titles><title>紫草素調(diào)控TGF-β1/Survivin通路對(duì)銀屑病皮膚炎癥反應(yīng)的影響%J四川中醫(yī)</title></titles><pages>49-53</pages><volume>