Journal of ethnopharmacology · 2026
Exploring the dosage-effect relationship and mechanism of Huangqi in Huangqi Guizhi Wuwu decoction for treating rheumatoid arthritis based on the compatibility of the formula.
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Gong Xiaohong, Li Huan, Guo Hongtao, Wang Zihua, Wang Bingsen, Xing Qinghua, Lu Chaoqun, Zhao Zhina, Wu Shangwen, Zhu Keying, Qi Shangwen, Li Songwei
Аннотация
ETHNOPHARMACOLOGICAL RELEVANCE: Rheumatoid arthritis (RA) is an autoimmune disease characterized by synovitis and joint destruction, and qi-blood deficiency is an important factor in the pathogenesis of the disease. Huangqi Guizhi Wuwu Decoction (HGWD) can exert the effects of replenishing qi and nourishing blood, warming the meridians and unblocking collaterals, and harmonizing blood to relieve arthralgia in the treatment of RA. However, there is great controversy regarding the dosage of Astragalus membranaceus (Fisch.) Bge. (Astragali Radix, HQ), the sovereign drug in this prescription, in clinical practice.
AIM OF THE STUDY: To explore the influence of the dosage of HQ in HGWD on the therapeutic effect of RA.
MATERIALS AND METHODS: Bioinformatics methods were used to construct a components-targets (CT) network, analyze the compatibility relationship of the five drugs in HGWD according to the principle of emperor, minister, assistant and courier, and dissect the potential network relationship through which HQ exerts its sovereign drug effect in the prescription. The collagen-induced arthritis (CIA) animal model was used to explore the molecular mechanisms through which HGWD with different dosages of HQ regulates the JAK/STAT signaling pathway in the treatment of RA. A multi-center, randomized, double-blind, placebo-parallel controlled study was conducted to investigate the efficacy and safety of HGWD with different dosages of HQ in the treatment of RA patients with qi-blood deficiency syndrome.
RESULTS: In this study, by constructing a CT network, it was found that the emperor herb had the highest average target degree, but its average number of targets was lower than that of the minister herb. This suggests that increasing the dosage of the emperor herb may enhance the therapeutic effect of the compound formula in the treatment of RA. Animal studies found that when the dosage of HGWD was within 30g, there was a positive correlation between the dosage of HQ and the therapeutic effect. The underlying mechanism may be related to reducing the levels of pro-inflammatory cytokines, increasing the levels of anti-inflammatory factors, and regulating synovial cell apoptosis through the JAK/STAT signaling pathway. RCT study found that HGWD with high-dosage HQ combined with tofacitinib could significantly improve the total effective rate of TCM syndromes and ACR20/70 response rate, reduce disease activity, alleviate clinical symptoms of patients, decrease inflammatory indicators, and improve the overall status of patients. It has high safety, and the combination with tofacitinib has synergistic and toxicity-reducing effects.
CONCLUSIONS: Increasing the dosage of HQ to 30g in HGWD can significantly improve RA symptoms. This decoction may exert anti-RA effects by inhibiting the JAK/STAT signaling pathway and promoting synovial cell apoptosis, and the combination with tofacitinib can achieve synergistic and toxicity-reducing effects.
AIM OF THE STUDY: To explore the influence of the dosage of HQ in HGWD on the therapeutic effect of RA.
MATERIALS AND METHODS: Bioinformatics methods were used to construct a components-targets (CT) network, analyze the compatibility relationship of the five drugs in HGWD according to the principle of emperor, minister, assistant and courier, and dissect the potential network relationship through which HQ exerts its sovereign drug effect in the prescription. The collagen-induced arthritis (CIA) animal model was used to explore the molecular mechanisms through which HGWD with different dosages of HQ regulates the JAK/STAT signaling pathway in the treatment of RA. A multi-center, randomized, double-blind, placebo-parallel controlled study was conducted to investigate the efficacy and safety of HGWD with different dosages of HQ in the treatment of RA patients with qi-blood deficiency syndrome.
RESULTS: In this study, by constructing a CT network, it was found that the emperor herb had the highest average target degree, but its average number of targets was lower than that of the minister herb. This suggests that increasing the dosage of the emperor herb may enhance the therapeutic effect of the compound formula in the treatment of RA. Animal studies found that when the dosage of HGWD was within 30g, there was a positive correlation between the dosage of HQ and the therapeutic effect. The underlying mechanism may be related to reducing the levels of pro-inflammatory cytokines, increasing the levels of anti-inflammatory factors, and regulating synovial cell apoptosis through the JAK/STAT signaling pathway. RCT study found that HGWD with high-dosage HQ combined with tofacitinib could significantly improve the total effective rate of TCM syndromes and ACR20/70 response rate, reduce disease activity, alleviate clinical symptoms of patients, decrease inflammatory indicators, and improve the overall status of patients. It has high safety, and the combination with tofacitinib has synergistic and toxicity-reducing effects.
CONCLUSIONS: Increasing the dosage of HQ to 30g in HGWD can significantly improve RA symptoms. This decoction may exert anti-RA effects by inhibiting the JAK/STAT signaling pathway and promoting synovial cell apoptosis, and the combination with tofacitinib can achieve synergistic and toxicity-reducing effects.