Intervention of traditional Chinese medicine San-Feng-Tong-Qiao-Di-Wan on allergic rhinitis: a network pharmacology and metabolomics study.

Background: San-Feng-Tong-Qiao-Di-Wan (SFTQDW) is a patented compound Chinese medicine used for acute and chronic rhinitis with few side effects. Its key components have antiallergic activity, making it potentially suitable for allergic rhinitis (AR). However, there is a lack of systematic research on its efficacy and mechanism of action for AR. This study aims to evaluate the potential and mechanism of SFTQDW in treating AR using network pharmacology, AR animal models, clinical observation, and serum metabolomics. Methods: Network pharmacology was used to screen active ingredients and targets, followed by an AR mouse model study comparing SFTQDW 3.00 vs. 1.45 mg/g body weight vs. control. In a clinical substudy nested within an active-controlled trial, 35 AR patients received a 7-day SFTQDW treatment. Patient efficacy was assessed using Visual Analog Scale (VAS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), and Epworth Sleepiness Scale (ESS) before and after treatment. Metabolic pathways and inflammatory responses were analyzed through serum metabolomics pre- and post-treatment. Results: SFTQDW was found to target 16 allergy-related proteins in network pharmacology analysis. In an OVA-mouse model, the 3.00 mg/g dose of SFTQDW reduced sneezing frequency, nasal-rubbing bouts, serum immunoglobulin E (IgE) levels, nasal-tissue eosinophil counts, and goblet-cell hyperplasia more effectively than the 1.45 mg/g dose. In a clinical study with 32 adults, oral SFTQDW for 7 days improved VAS, RQLQ, and ESS scores. Serum metabolomics revealed 27 differentiated metabolites, with effects on linoleic acid metabolism and aminoacyl-tRNA biosynthesis. Conclusions: By possibly modulating the PTGS2/5(S)-HETE axis and its associated lipid inflammatory metabolites, SFTQDW helped alleviate nasal inflammation and acute symptoms in mice and patients.