基于Meta分析和网络药理学探讨大柴胡汤治疗梗阻性黄疸术后的临床疗效及作用机制*

作者：白丽露1，邵玉雪1，肖文冲1，周素芳2

单位：1.贵州中医药大学，贵州 贵阳 550025； 2.贵州中医药大学第一附属医院，贵州 贵阳 550001

引用：引用：白丽露，邵玉雪，肖文冲，周素芳.基于Meta分析和网络药理学探讨大柴胡汤治疗梗阻性黄疸术后的临床疗效及作用机制[J].中医药导报,2026,32(5):227-235.

DOI：10.13862/j.cn43-1446/r.2026.05.035

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摘要：

目的：通过Meta分析评估大柴胡汤对梗阻性黄疸术后的治疗作用，再结合网络药理学及分子对接进行分析验证。方法：系统检索中国知网、维普中文期刊服务平台、万方数据知识服务平台等8个数据库，检索时间为建库至2025年3月22日，使用RevMan 5.4软件进行Meta分析。结合网络药理学、分子对接探索机制并评估大柴胡汤的活性成分及梗阻性黄疸术后的靶点。结果：共纳入1 461例患者，治疗组748例，对照组713例，与梗阻性黄疸术后+常规治疗相比，梗阻性黄疸术后+大柴胡汤治疗在临床有效率、黄疸指数、肝功能、凝血功能、血流动力学指标方面改善显著。网络药理学筛选了大柴胡汤的151种有效成分，329个共有靶点，190条相关通路，关键活性成分如5,7,4'-三甲基芹菜素、黄芩黄酮Ⅱ、5，7，4′-三羟基-8-甲氧基黄酮、异橙黄酮、新黄芩素等可能通过作用于AKT1、TNF、IL-6、GAPDH、TNF等核心靶点，调控肿瘤信号通路、PI3K-Akt、AGE-RAGE等多条信号通路，通过抗炎、抗凋亡、抗氧化和免疫调节来发挥治疗梗阻性黄疸术后的作用。结论：大柴胡汤可调控多个关键信号通路，从而增强术后恢复效果，改善患者肝功能，且安全性好，具有较好的抗炎和免疫调节作用。

关键词：梗阻性黄疸术后；大柴胡汤；Meta分析；网络药理学；分子对接

Abstract：Objective: To evaluate the therapeutic effect of Dachaihu Decoction (DCH) on postoperative obstructive jaundice (OJ) through Meta-analysis, and to verify its mechanism combined with network pharmacology and molecular docking. Methods: 8 databases including China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (CSTJ), and Wanfang Data Knowledge Service Platform (Wanfang Data) were systematically searched from the establishment of the databases to March 22, 2025. Meta-analysis was performed using RevMan 5.4 software. Network pharmacology and molecular docking were applied to explore the mechanism, active ingredients of DCH, and potential targets for postoperative OJ. Results: A total of 1,461 patients were included, with 748 in the treatment group and 713 in the control group. Compared with postoperative OJ + conventional treatment, postoperative OJ + DCH showed significant improvements in clinical effective rate, jaundice index, liver function, coagulation function and hemodynamic parameters. Network pharmacology screened 151 active components, 329 common targets, and 190 related pathways of DCH. Key active components such as 5,7,4'-trimethylapigenin, skullcapflavone Ⅱ, 5,7,4'-trihydroxy-8-methoxyflavone, isosinensetin, and neobaicalein may exert therapeutic effects on postoperative OJ by acting on core targets including AKT1, TNF, and IL-6, regulating multiple signaling pathways such as cancer signaling pathway, PI3K-Akt signaling pathway, and AGE-RAGE signaling pathway, and exerting anti-inflammatory, anti-apoptotic, antioxidant, and immunomodulatory effects. Conclusion: DCH can regulate multiple key signaling pathways to enhance postoperative recovery, improve liver function with favorable safety, and exhibit significant anti-inflammatory and immunomodulatory effects.

Key words：postoperative obstructive jaundice; Dachaihu Decoction; Meta-analysis; network pharmacology; molecular docking

发布时间：2026-05-24

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