基于Meta分析桥接网络药理学的鼻渊通窍颗粒治疗慢性鼻窦炎的疗效评价及潜在机制研究

doi:10.6040/j.issn.1673-3770.0.2021.505

Abstract

Abstract: Objective The efficacy of biyuan tongqiao granules and clarithromycin in the treatment of chronic rhinosinusitis was evaluated in this study. Based on Meta-analysis and network pharmacology, the potential mechanism of biyuan tongqiao granules and clarithromycin in chronic rhinosinusitis treatment was investigated. Methods Web of Science, PubMed, EMBASE, China journal full text database(CNKI), Vipers full text database(VIP), and Wanfang database literature(established since November 2021)were used to retrieve and screen the literature on chronic rhinosinusitis treatment using biyuan tongqiao granules. Randomized controlled trials(RCTs)were selected, and the quality of the literature that met the inclusion criteria was evaluated. Meta-analysis was performed for studies that met the quality criteria using RevMan 5.3 software. Target nasal abnormalities were screened using the TCMSP and BATMAN-TCM databases. Chronic sinusitis targets were screened using the GeneCards database, OMIM database, drug bank database, and PharmGKB database. Both targets, nasal abnormalities and chronic sinusitis, were screened using the FunRich software. The DAVID platform was used to conduct gene ontology biological processes, Kyoto gene, and genome encyclopedia pathway analysis on the shared targets of chronic rhinosinusitis. Key target screening was performed using the Cytoscape software. Results Eight original studies with a total of 1018 patients were included, among these 530 patients were in the treatment group and 488 patients in the control group. The clinical efficiency of biyuan tongqiao granules alone in the treatment group ［RR=1.15, 95%CI(1.05, 1.27］, Z=2.91, P=0.004)and the clinical efficiency of biyuan tongqiao granules combined with clindamycin in the treatment group ［RR=1.31. 95%CI(1.18, 1.45), Z=5.14, P<0.000 01］ were significantly different. The VAS scores(MD=-7.15, 95%CI(-8.22, -6.08), Z=13, P<0.000 01)in the treatment group for biyuan tongqiao granules combined with clindamycin and in the control group for clindamycin were also significantly different. The Lund-Kennedy score ［MD=-2.68, 95%CI(-4.64, -0.72), Z=2.68, P=0.007］ was significantly different. Network pharmacology identified a total of 48 targets and the KEGG-enriched pathways included the HIF-1 signaling pathway, Toll-like receptor signaling pathway, NOD-like receptor signaling pathway, and NF-kappa B signaling pathway. The key targets in the treatment of chronic sinusitis were TNF, IL6, AKT1, VEGFA, and PTGS2. Conclusion The combination of biyuan tongqiao granules with clarithromycin or biyuan tongqiao granules alone indicated that their therapeutic effects were better than those of clarithromycin alone. Due to the limitation of the quality of included studies, more high-quality studies are required to validate the above findings. Key targets for the effects of biyuan tongqiao granules in the treatment of chronic rhinosinusitis are TNF, IL6, AKT1, VEGFA, and PTGS2.

Key words: Biyuan tongqiao granules, Chronic rhinosinusitis, Meta-analysis, Network pharmacology, Evaluation of the efficacy

CLC Number:

R765.4+1

JIANG Xuelian, ZHANG Jingyue, WEI Xudong. Evaluation of the efficacy and potential mechanism of biyuan tongqiao granules in chronic sinusitis treatment based on Meta-analysis bridging network pharmacology[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 226-236.

References

[1] 中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组.慢性鼻-鼻窦炎诊断和治疗指南(2012年,昆明)[J]. 中华耳鼻咽喉头颈外科杂志, 2013(2): 92-94. doi: 10.3760/cma.j.issn.1673-0860.2013.02.002.
[2] Biswas K, Chang A, Hoggard M, et al. Toll-like receptor activation by sino-nasal mucus in chronic rhinosinusitis[J]. Rhinology, 2017, 55(1): 59-69. doi: 10.4193/Rhin16.201.
[3] Demirdag YY, Ramadan HH. Direct measurement of upper airway inflammation in children with chronic rhinosinusitis: implications for asthma[J]. Curr Opin Allergy Clin Immunol, 2016, 16(1): 18-23. doi: 10.1097/ACI.0000000000000237.
[4] 王悦, 慢性鼻窦炎应用鼻渊通窍颗粒的治疗效果及对鼻纤毛传输功能的影响[J]. 养生保健指南, 2018(48): 247. doi: 10.3969/j.issn.1006-6845.2018.48.239.
[5] 陈宇, 丁科全, 何雯等. 克拉霉素强化治疗慢性鼻窦炎的临床观察[J]. 中国卫生标准管理, 2020, 11(3): 89-91. CHEN Yu, DING Kequan, HE Wen, et al. Clinical observation of intensive treatment of chronic sinusitis with clarithromycin[J]. China Health Standard Management, 2020, 11(3): 89-91.
[6] 王士贞. 中医耳鼻咽喉科学[M]. 2版. 北京:中国中医药出版社, 2007.
[7] 中华医学会耳鼻咽喉科学分会. 慢性鼻窦炎鼻息肉临床分型分期及内窥镜鼻窦手术疗效评定标准(1997年, 海口)[J]. 中华耳鼻咽喉科杂志, 1998(3): 6.
[8] 陈旎珺, 吴继昌, 胡原, 等. 鼻渊通窍颗粒联合克拉霉素治疗小儿慢性鼻窦炎的临床疗效及对炎性反应因子的影响[J]. 世界中医药, 2019, 14(7): 1780-1783, 1788. doi:10.3969/j.issn.1673-7202.2019.07.033. CHEN Nijun, WU Jichang, HU Yuan, et al. Clinical effects of biyuan Tongqiao Granule combined with clarithromycin in children with chronic sinusitis and its influence on inflammatory factors[J]. World Chinese Medicine, 2019, 14(7): 1780-1783, 1788. doi:10.3969/j.issn.1673-7202.2019.07.033.
[9] 洪海裕, 陈奕伸, 洪仲思, 等. 鼻渊通窍颗粒联合克拉霉素治疗不伴息肉的慢性鼻-鼻窦炎疗效观察[J]. 中药材, 2015, 38(6): 1334-1336. doi:10.13863/j.issn1001-4454.2015.06.057.
[10] 林君. 鼻渊通窍颗粒联合克拉霉素颗粒治疗小儿慢性鼻窦炎的疗效观察[J]. 中国现代医生, 2014, 52(32): 34-36. LIN Jun. The effect of Biyuan Tongqiao Granule combined clarithromycin granules on children with chronic sinusitis[J]. China Modern Doctor, 2014, 52(32): 34-36.
[11] 林响, 曹时珍. 鼻渊通窍颗粒辅助治疗小儿慢性鼻窦炎的可行性及安全性[J]. 慢性病学杂志, 2017, 18(11): 1294-1295, 1298. doi:10.16440/j.cnki.1674-8166.2017.11.036.
[12] 向华, 杨飞, 周意, 等. 鼻渊通窍颗粒联合克拉霉素治疗小儿慢性鼻窦炎的临床疗效[J]. 医学综述, 2017, 23(5): 1038-1040. doi:10.3969/j.issn.1006-2084.2017.05.045. XIANG Hua, YANG Fei, ZHOU Yi, et al. Effect of biyuan Tongqiao Granule combined with clarithromycin in treatment of pediatric chronic sinusitis[J]. Medical Recapitulate, 2017, 23(5): 1038-1040, 3. doi:10.3969/j.issn.1006-2084.2017.05.045.
[13] 郑顺昌, 杨娟娟. 鼻渊通窍颗粒治疗儿童慢性鼻窦炎85例疗效观察[J]. 山东医药, 2010, 50(37): 93. doi: 10.3969/j.issn.1002-266X.2010.37.066.
[14] 楚选云, 高建步. 鼻渊通窍颗粒治疗慢性鼻-鼻窦炎的效果及对鼻纤毛传输功能的影响[J]. 世界中医药, 2018, 13(5):1191-1194. 10.3969/j.issn.1673-7202.2018.05.035. CHU Xuanyun, GAO Jianbu. Efficacy of biyuan tongqiao granules in treating chronic sinusitis and effects on nasal ciliary transmission[J]. World Chinese Medicine, 2018, 13(5):1191-1194. 10.3969/j.issn.1673-7202.2018.05.035.
[15] 李华斌, 赖玉婷, 姜文秀. 慢性鼻窦炎的内表型研究进展及精准治疗[J]. 山东大学耳鼻喉眼学报, 2019, 33(3): 9-13. doi: 10.6040/j.issn.1673-3770.1.2018.043. LI Huabin, LAI Yuting, JIANG Wenxiu. Endotypes and precision medicine in chronic sinusitis treatment[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(3): 9-13. doi: 10.6040/j.issn.1673-3770.1.2018.043.
[16] 娄鸿飞, 王成硕. 慢性鼻窦炎分型研究进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(3): 10-13. doi: 10.6040/j.issn.1673-3770.1.2018.008. LOU Hongfei, WANG Chengshuo. Progress in classification of chronic sinusitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2018, 32(3): 10-13. doi: 10.6040/j.issn.1673-3770.1.2018.008.
[17] 黄颖睿, 林亚明. 中医治疗慢性鼻窦炎的临床进展[J]. 云南中医中药杂志, 2021, 42(10): 86-88. doi:10.16254/j.cnki.53-1120/r.2021.10.023.
[18] 许政敏, 李博, 张建基, 等. 鼻渊通窍颗粒治疗儿童鼻部炎症专家共识[J]. 中国实用儿科杂志, 2021, 36(8): 561-564. doi:10.19538/j.ek2021080601. XU Zhengmin, LI Bo, ZHANG Jianji, et al. Expert consensus on the treatment of childhood rhinitis with Biyuan Tongqiao Granules[J]. Chinese Journal of Practical Pediatrics, 2021, 36(8): 561-564. doi:10.19538/j.ek2021080601.
[19] Cho HJ, Kim CH. Oxygen matters: hypoxia as a pathogenic mechanism in rhinosinusitis[J]. BMB Rep, 2018, 51(2): 59-64. doi:10.5483/bmbrep.2018.51.2.014.
[20] Do NY, Shin HJ, Lee JE. Wheatgrass extract inhibits hypoxia-inducible factor-1-mediated epithelial-mesenchymal transition in A549 cells[J]. Nutr Res Pract, 2017, 11(2): 83-89. doi:10.4162/nrp.2017.11.2.83.
[21] 尹文华, 刘素琴, 陈志凌, 等. 缺氧诱导因子1α与黏蛋白5在慢性鼻-鼻窦炎组织中的表达与意义[J]. 中国耳鼻咽喉头颈外科, 2016, 23(11): 632-636. doi:10.16066/j.1672-7002.2016.11.004. YIN Wenhua, LIU Suqin, CHEN Zhiling, et al. Expression of hypoxia-inducible factor-1α mRNA and MUC5 in chronic rhinosinusitis and their correlation[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2016, 23(11): 632-636. doi:10.16066/j.1672-7002.2016.11.004.
[22] 王银鑫, TLR2、TLR4在真菌球型鼻窦炎的表达及意义[D]. 新乡,新乡医学院, 2020.
[23] Rai G, Das S, Ansari MA, et al. TLR-2 expression and dysregulated human Treg/Th17 phenotype in Aspergillus flavus infected patients of chronic rhinosinusitis with nasal polyposis[J]. Microb Cell Fact, 2020, 19: 215. doi:10.1186/s12934-020-01481-3.
[24] 张岳, 唐年亚. 补肺益脾通窍汤对慢性鼻窦炎家兔模型NF-κB p65的影响[J]. 中医研究, 2016, 29(1): 65-67. doi:10.3969/j.issn.1001-6910.2016.01.28.
[25] Yang HW, Kim HJ, Park JH, et al. Apigenin alleviates TGF-β1-induced nasal mucosa remodeling by inhibiting MAPK/NF-kB signaling pathways in chronic rhinosinusitis[J]. PLoS One, 2018, 13(8): e0201595. doi:10.1371/journal.pone.0201595.
[26] Jung HJ, Zhang YL, Kim DK, et al. The role of NF-κB in chronic rhinosinusitis with nasal polyps[J]. Allergy Asthma Immunol Res, 2019, 11(6): 806. doi:10.4168/aair.2019.11.6.806.
[27] 陈雨, 徐志猛, 李萍. 钙离子信号介导Nod样受体蛋白炎性小体激活的研究进展[J]. 中国药科大学学报, 2021, 52(5): 513-521. doi:10.11665/j.issn.1000-5048.20210501. CHEN Yu, XU Zhimeng, LI Ping. Calcium signal-mediated activation of NLRP3 inflammasome[J]. Journal of China Pharmaceutical University, 2021, 52(5): 513-521. doi:10.11665/j.issn.1000-5048.20210501.
[28] Qing X, Zhang YQ, Peng Y, et al. miR-142-3p regulates inflammatory response by contributing to increased TNF-α in chronic rhinosinusitis with nasal polyposis[J]. Ear Nose Throat J, 2021, 100(1): NP50-NP56. doi:10.1177/0145561319847972.
[29] 陈薇, 刘仲娟, 叶菁. 慢性鼻-鼻窦炎鼻黏膜中糖原合成酶激酶3β与PI3K/Akt及白细胞介素6间的相关性[J]. 中华耳鼻咽喉头颈外科杂志, 2013, 48(2): 128-134. doi:10.3760/cma.j.issn.1673-0860.2013.02.017. CHEN Wei, LIU Zhongjuan, YE Jing. Relationship among the expression of GSK3β, PI3DK/Akt, and IL-6 in chronic rhinosinusitis[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2013, 48(2): 128-134. doi:10.3760/cma.j.issn.1673-0860.2013.02.017.
[30] Pietruszewska W, Fendler W, Podwysocka M, et al. Expression of transcript variants of PTGS1 and PTGS2 genes among patients with chronic rhinosinusitis with nasal polyps[J]. Diagnostics(Basel), 2021, 11(1): 135. doi:10.3390/diagnostics11010135.
[31] Shi LL, Ma J, Deng YK, et al. Cold-inducible RNA-binding protein contributes to tissue remodeling in chronic rhinosinusitis with nasal polyps[J]. Allergy, 2021, 76(2): 497-509. doi:10.1111/all.14287.
[32] Tian TF, Q Yuan, J Ye, et al. Relationship and significance among IL-6,PI3K/Akt and GSK 3β in chronic rhinosinusitis[J]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi, 2016, 30(23): 1859-1864. doi: 10.13201/j.issn.1001-1781.2016.23.006.

Metrics

Viewed

Full text

Abstract

Cited

Shared

Discussed

Comments

Recommended 10

[1]	HE Shou-huan,CHEN Bin,YIN Shan-kai,SU Kai-ming,JIANG Xiao . Morphological changes of the upper airway in OSAHS patients with UPPP [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(5): 385 -388 .
[2]	SONG Xi-cheng,ZHANG Qing-quan,XIA Yong-hong,LIU Lu-yi, YU Lu-xin,WANG Gao,JIANG Xiu-liang . Post-operative ICU monitoring and nursing for patients with OSAHS[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(5): 389 -392 .
[3]	XUE Wei-guo,SUN Jie,JIN Zheng,SHI Wen-bin,XIN Lu,LIN Guo-Jing,LI Jia-yun . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(4): 300 -303 .
[4]	ZHANG Qing-quan,LI Xin-min,WANG Qiang,WANG Yong-fu . Some experience of the endoscopy treatment of maxillary sinus lesion with the canine tooth fossa approach[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(1): 38 -39 .
[5]	DONG Pin,LI Xiao-yan,TU Li-qiang,MENG Qing-hong,WANG Sang,XIE Jin,JIANG Yan . Reconstruction for advanced hypopharyngeal carcinoma and laryngeal recurrent carcinoma[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(5): 385 -387 .
[6]	JIANG Shao-hong,ZHU Yu-hong,WANG Qiang,SONG Xi-cheng . Intractable primary epistaxis: a report of 101 cases[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(6): 542 -544 .
[7]	. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(1): 74 -77 .
[8]	LEIXun, LIU Qianghe, KONG Zhongyu, XIANG Qiu, GENG WANping, HUANG Hui, DONG Yiyuan, LIU Fangxian. ARelationship between expression of Survivin and radiosensitization effect of EGCG in xenotransplanted nasopharyngeal carcinoma[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2009, 23(1): 6 -9 .
[9]	. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2009, 23(2): 73 -74 .
[10]	. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2010, 24(01): 29 -33 .

Evaluation of the efficacy and potential mechanism of biyuan tongqiao granules in chronic sinusitis treatment based on Meta-analysis bridging network pharmacology

PDF (PC)

Abstract

Cite this article

share this article

References

Related Articles 15

Metrics

Comments

Recommended 10

[1]	AO Tian,CHENG Lei. An endotype study of chronic rhinosinusitis with nasal polyps and precise control and treatment under the guidance [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 7-14.
[2]	YAO Shuang,LOU Hongfei. Advances in endotypes and precision medicine in chronic rhinosinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 20-29.
[3]	SHI Shuai, ZHENG Quan,CHENG Lei. Research advances of dupilumab in the treatment of chronic rhinosinusitis with nasal polyps [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 36-42.
[4]	WANG Huan, HU Li,YU Hongmeng. Research progress of olfactory dysfunction in chronic rhinosinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 43-49.
[5]	YI Ruonan,CHEN Fuquan. Eosinophils and Olfactory Dysfunction [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 50-55.
[6]	GU Yu, WAN Xin,XIAO Zi'an. The interaction between neutrophils and eosinophils in chronic rhinosinusitis and the implications on treatment options [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 56-63.
[7]	LIN Hai, ZHU Ying,ZHANG Weitian. The roles of ion channels in the pathogenesis of chronic rhinosinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 64-70.
[8]	QIAO Xinjie,. Research progress on the signal transduction pathway and other factors related to epithelial-mesenchymal transformation in chronic rhinosinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 71-77.
[9]	HUANG Danyi, ZHANG Ting,CHEN Jing, ZHANG Wei. Progress of research regarding the role of the epithelial barrier in chronic rhinosinusitis with nasal polyps [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 78-83.
[10]	LI Jiani, ZHU Dongdong,MENG Cuida. The role of epigenetics in the pathogenesis of chronic rhinosinusitis with nasal polyps [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 84-91.
[11]	CAO Xuan,XIAO Xuping, LI Yunqiu. Advances in the application of hyaluronic acid in chronic sinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 104-109.
[12]	WANG Na,CHAI Xiangbin. Research progress on prostate-derived ETS factor in asthma and inflammatory diseases of the nasal mucosa [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 136-141.
[13]	LIU Yitong, ZHOU Suizi,QIU Qianhui. Research progress on NLRP3 inflammasome in chronic rhinosinusitis and allergic rhinitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 142-146.
[14]	WANG Lu, XIE Hui, LU Meidi, DENG Xinxing, LI Qingyun. Based on network pharmacology and molecular docking to explore the mechanism of “Chuanxiong-Baizhi” medicine in the treatment of sinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 154-164.
[15]	LI Lin, GAO Zhengwen, CUI Nan, SUN Jianping, HUANG Xianming, CUI Jing. Bioinformatics analysis of gene expression profile in pediatric patients with chronic rhinosinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2022, 36(3): 171-180.