中国中药杂志

2020, v.45(06) 1213-1218

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基于临床经验和分子对接技术的抗新型冠状病毒中医组方快速筛选模式及应用
Rapid establishment of traditional Chinese medicine prevention and treatment of 2019-nCoV based on clinical experience and molecular docking

牛明;王睿林;王仲霞;张萍;柏兆方;景婧;郭玉明;赵旭;湛小燕;张子腾;宋雪艾;秦恩强;王伽伯;肖小河;
NIU Ming;WANG Rui-lin;WANG Zhong-xia;ZHANG Ping;BAI Zhao-fang;JING Jing;GUO Yu-ming;ZHAO Xu;ZHAN Xiao-yan;ZHANG Zi-teng;SONG Xue-ai;QIN En-qiang;WANG Jia-bo;XIAO Xiao-he;China Military Institute of Chinese Medicine,Fifth Medical Center of Chinese PLA General Hospital;Integrative Medical Center,Fifth Medical Center of Chinese PLA General Hospital;Infectious Disease Treatment and Investigation Center,Fifth Medical Center of Chinese PLA General Hospital;

摘要(Abstract):

2019年12月中上旬以来,新型冠状病毒肺炎疫情肆虐全国并波及海外20余个国家和地区,目前主要是对症支持治疗,还没有针对性的有效药物和疫苗。充分借鉴中医药防治SARS等重大疫病的理论和经验,利用现代生物医学知识和研究手段,快速形成有效的中医药防治方案,是中医药应对新突发传染病的重要使命和有力抓手。鉴于新型冠状病毒与SARS病毒的基因序列具有较高的同源性,且二者在致病机制和临床表现等方面也有较大的相似性,该团队探索建立了基于临床经验和分子对接技术的抗新型冠状病毒中医组方快速筛选模式(简称分子对接辅助中医组方),即组织临床小组和研究小组,分别采用不同策略和方法"背靠背式"筛选中医方药,然后对2组筛选结果进行比对和整合分析,优化形成中医药防治方案。结果表明,研究小组从国家及各省市公布的中医药抗SARS和新型冠状病毒方案中,筛选发现46个能作用于新型冠状病毒S-蛋白与人体ACE2结合区域且具有较高结合能的中药活性成分,主要归属于金银花、桑叶等7味中药,与临床小组根据中医理论和临床经验所拟中医组方的主要药味具有较好的吻合度,这从治疗靶标分析角度为中医组方的科学性和潜在疗效提供了佐证。同时提示,中医组方除可能改善临床症状或证候外,还具有潜在的直接抑制病毒感染作用。在此基础上,该团队优化形成了抗新型冠状病毒中医组方"克冠1号",在第一时间为该院防治新突发传染病提供了有一定临床经验和客观证据支持的中医方剂。该中医方剂与西医对症支持治疗联合用于临床救治,初步显示中西医结合治疗优于单纯的西医对症支持治疗。该研究创新了中医药科学防治新突发传染病的临床科研一体化攻关模式和方法,对进一步完善中医药应对重大疫情的快速响应机制、进一步提高中医药防治新突发传染病的能力和水平等具有重要意义。
The coronavirus disease 2019(COVID-19) is raging in China and more than 20 other countries and regions since the middle of December 2019. Currently, there is no specific drug or vaccine besides symptomatic supportive therapy. Taking full advantage of the clinical experience of traditional Chinese medicine(TCM) in preventing and controlling major epidemics such as SARS, it is an important mission for TCM to propose effective formula with immediate response and solid evidence by using modern biomedical knowledge and techniques(molecular docking assisted TCM formulation for short). In view of the high homology between the gene sequences of the novel coronavirus and SARS virus, and the similarities between the two in terms of pathogenic mechanism and clinical manifestations, our team established a rapid screening and optimization model for the prevention and treatment of the novel coronavirus based on clinical experience and molecular docking technology. Firstly, the clinical team and the research team pre-developed and screened TCM formula by using "back-to-back" manner. Then, the formula was optimized and determined by comparing and analyzing the results of the two groups. The results showed that the research team screened out 46 active ingredients from candidate TCMs that could act on the novel coronavirus S-protein-binding site of human ACE2 protein, which were mainly attributed to 7 herbs such as Lonicerae Japonicae Flos and Mori Folium. The result was largely consistent with the formula raised by the clinical group, verifying and supporting its rationality. This provides evidence for the scientific and potential efficacy of the TCM prescription from the perspective of treatment target analysis, and also suggests that the TCM prescription has the potential to directly inhibit viral infection in addition to improving clinical symptoms or syndromes. Based on this, our team optimized and formed a new anti-coronavirus TCM prescription "Keguan Yihao", immediately providing the TCM prescription with certain clinical experience and objective evidence support for the prevention and treatment of new emergent infectious diseases in our hospital. The TCM prescription was combined with modern medicine symptomatic supportive treatment for clinical treatment, preliminary results showed better effect than symptomatic supportive therapy alone. This research has innovated the method mode in clinical practice and basic research integration of traditional Chinese medicine for the prevention and control of new emerging infectious diseases. It is of great significance to further improve the rapid response mechanism of TCM in face of major epidemics, and further improve the capability level of TCM to prevent and treat new emerging infectious diseases.

关键词(KeyWords): 新型冠状病毒肺炎;新型冠状病毒;中医药;组方筛选;分子对接;临床科研一体化
COVID-19;2019-nCoV;traditional Chinese medicine;formula screening;molecular docking;clinical practice and basic research integration

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 牛明;王睿林;王仲霞;张萍;柏兆方;景婧;郭玉明;赵旭;湛小燕;张子腾;宋雪艾;秦恩强;王伽伯;肖小河;
NIU Ming;WANG Rui-lin;WANG Zhong-xia;ZHANG Ping;BAI Zhao-fang;JING Jing;GUO Yu-ming;ZHAO Xu;ZHAN Xiao-yan;ZHANG Zi-teng;SONG Xue-ai;QIN En-qiang;WANG Jia-bo;XIAO Xiao-he;China Military Institute of Chinese Medicine,Fifth Medical Center of Chinese PLA General Hospital;Integrative Medical Center,Fifth Medical Center of Chinese PLA General Hospital;Infectious Disease Treatment and Investigation Center,Fifth Medical Center of Chinese PLA General Hospital;

Email:

DOI: 10.19540/j.cnki.cjcmm.20200206.501

参考文献(References):

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