中药抗深静脉血栓的网络药理学与多靶点机制研究进展

Research Progress on Network Pharmacology and Multi-Target Mechanisms of Traditional Chinese Medicine in Treating Deep Venous Thrombosis

摘要: 深静脉血栓(Deep Venous Thrombosis, DVT)病理机制错综复杂，西医单一靶向药物在临床使用时存在明显短板。而中医药依靠多组分共同起效、多点位调控、多条通路协同干预的特点，在血栓预防与治疗领域拥有不可替代的研究价值。本文梳理近年来国内外相关文献报道，系统归纳网络药理学在中药干预DVT方向的各类应用成果，整理单味药材与经典活血复方抗血栓的分子调控规律，为后续开展中药抗DVT靶点深度研究、创新中药研发以及临床成果落地转化提供理论参考。本文选取活血通络类代表方剂补阳还五汤、桃红四物汤，搭配丹参、水蛭、三七等常用活血单味药作为分析载体，借助网络药理学搭建“活性成分–疾病靶点–信号通路”互作网络，再利用分子对接模拟验证核心靶点与中药小分子的结合能力。分析结果表明，中药改善DVT病变主要依靠四条作用路径：维持体内凝血、抗凝动态平衡、阻断血小板过度活化聚集、修复受损血管内皮、抑制血栓相关炎症连锁反应；该调控过程核心靶点为F2、AKT1、NF-κB，信号通路集中于凝血–纤溶通路、PI3K-AKT通路与NF-κB炎症通路。目前将网络药理学与分子对接相结合，能够清晰地阐释中药、复方多成分协同抗DVT的作用规律，但该领域仍存在不少待解决问题，适配中医辨证体系的病证结合动物模型较为稀缺、公共数据库靶点预测存在一定假阳性、静态网络模型无法还原血栓全程动态病理改变。后续研究可融合多组学检测、人工智能预测模型等新技术，弥补现有研究体系的不足，助力中药抗DVT机制研究朝着精准化、标准化方向推进。

Abstract: Deep venous thrombosis (DVT) features complicated pathological mechanisms, and single-target drugs cannot fully meet clinical treatment demands. Benefiting from multi-component, multi-target and multi-pathway regulatory features, traditional Chinese medicine (TCM) shows distinctive advantages in preventing and curing thrombotic disorders. This paper sorts out domestic and foreign research documents published in recent years, summarizes the application of network pharmacology in exploring TCM intervention against DVT, and sorts out the molecular regulatory mechanisms of single herbs and classic formulas for anti-thrombosis, so as to lay theoretical foundations for follow-up targeted mechanism research, new drug development and clinical transformation of anti-DVT TCM preparations. Representative meridian-unblocking formulas Buyang Huanwu Decoction and Taohong Siwu Decoction, as well as common blood-activating herbs Salvia miltiorrhiza, leech and Panax notoginseng are selected as research objects. The interaction network of active ingredients, disease targets and signaling pathways is constructed via network pharmacology, and molecular docking simulation is performed to test the binding activity between core protein targets and herbal small molecules. The analytical results reveal that TCM relieves DVT lesions through four major regulatory modes: stabilizing the dynamic balance of coagulation and anticoagulation, restraining excessive platelet aggregation and activation, repairing damaged vascular endothelium, and suppressing inflammatory cascade reactions induced by thrombosis. F2, AKT1 and NF-κB are the core regulatory targets, and the dominant signaling pathways include coagulation-fibrinolysis pathway, PI3K-AKT pathway and NF-κB inflammatory pathway. Joint application of network pharmacology and molecular docking has become an effective method to interpret the synergistic anti-DVT mechanism of single herbs and compound prescriptions. Even so, the existing research system still has obvious limitations, including insufficient syndrome-disease combined animal models matching TCM differentiation theory, inevitable false positive data in database target prediction, and the inherent defect that static network models fail to reflect dynamic pathological changes during DVT progression. In further research, integrated multi-omics detection and artificial intelligence prediction models can be adopted to make up for current research deficiencies, and drive the research on TCM against DVT to develop in a precise and standardized direction.