基于TCMIP V2.0探析新型冠状病毒肺炎全病程中医证候和推荐方剂的科学内涵  

Exploration on scientific connotation of TCM syndromes and recommended prescriptions against COVID-19 based on TCMTP V2.0

作　　者：许海玉[1,2] 张彦琼 秦月雯 赵海誉 王萍[1] 刘峰 XU Hai-yu;ZHANG Yan-qiong;QING Yue-wen;ZHAO Hai-yu;WANG Ping;LIU Feng(Institute of Chinese Materia Medica,China Academy of Chinese Medical Sciences,Beijing 100700,China;Shaanxi Institute of International Trade&Commerce,Xi'an 712046,China;Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]中国中医科学院中药研究所,北京100700 [2]陕西国际商贸学院,陕西西安712046 [3]天津中医药大学,天津301617

出　　处：《中国中药杂志》2020年第7期1488-1498,共11页China Journal of Chinese Materia Medica

基　　金：国家重点研发计划项目(2017YFC1702303,2017YFC1702104);中国中医科学院中药研究所应急专项课题(ZXKT2020-003);陕西省高校青年创新团队和陕西省科技厅项目(2016SF-378)。

摘　　要：新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)自首次确诊以来,引起了全社会的高度关注,中医药针对COVID-19肺炎发病全过程治疗的参与度高,临床疗效确切。中医药以整体观念和辨证论治为理论和思维特色,证候是中医药理论的核心,该研究以"症状"为切入点,运用中药整合药理学网络计算平台2.0(TCMIP V2.0,http://www.tcmip.cn/),构建COVID-19肺炎初期(寒湿郁肺证)、重症期(疫毒闭肺证)、危重期(内闭外脱证)、恢复期(肺脾气虚证)4个时期代表证候和代表方剂的分子网络,探析COVID-19肺炎各阶段证候的生物学基础及推荐方剂对证治疗的分子机制。结果显示,"免疫-炎症"相关分子可能贯穿COVID-19肺炎发病和进展全过程,在重症期和危重期患者炎症分子网络占比明显加大,该时期可能存在细胞因子风暴,同时出现呼吸障碍、心肺功能失调、神经系统紊乱等多脏器分子网络失衡。推荐方剂具有潜在的增强机体免疫功能、减轻炎症反应、加强营养物质吸收代谢、调节能量代谢、缓解心肺功能异常、调节神经系统功能等多方面作用,推测对呼吸困难、胸闷气促、腹胀便秘、汗出肢冷、神昏、烦躁等症状具有较好的改善作用,体现了"多成分、多靶标、多通路、多效应"的整合干预特点。该研究系统构建COVID-19发病4个阶段证候的分子网络,体现"对证"和"对症"治疗的中医优势和特色,对于揭示推荐方剂作用原理和科学内涵有所帮助,以期对中医药防治COVID-19提供参考。Coronavirus disease 2019(COVID-19) has attracted great attentions from the whole world. Traditional Chinese medicine(TCM) has been widely used and shown satisfying efficacies in treating all stages of COVID-19. In this study, the molecular interaction networks of different stages of COVID-19(the early, severe, critical and recovery stage) were constructed using the links among symptoms-related genes collected from TCMIP V2.0(http://www.tcmip.cn/), an integrated pharmacology network-computing platform for TCM. Following the network topological feature calculation and functional enrichment analysis, we found that the molecular targets and pathways related with the "immune-inflammation system" were involved throughout all the stages of COVID-19. The severe stage and the critical period of COVID-19 were occupied by a large proportion of inflammatory factors and pathways, suggesting that there might be a cytokine storm in these periods, along with respiratory disorders, cardiopulmonary dysfunction, nervous system disorders, etc. Accordingly, the therapeutic targets and pathways hit by the recommended prescriptions against COVID-19 were also aimed to regulate the balance of immune-inflammation system, nutrient absorption and metabolism, abnormal energy metabolism, the cardio-pulmonary function, nerve system function, etc., which may be related to the therapeutic effects of these prescriptions in terms of several clinical symptoms, such as expiratory dyspnea, chest tightness and shortness of breath, abdominal distension and constipation, sweating and limb cold, dizziness, and irritability, etc. The above findings reflect the integrative actions of TCM characterizing by multiple-components, multiple-targets, multiple-pathways, and multiple-effects. This study systematically constructed the molecular networks of different TCM syndromes during the development and progression of COVID-19 and uncovered the biological basis for symptomatic treatment of TCM. Furthermore, our data revealed the pharmacological mechanisms and the

关 键 词：中药整合药理学网络计算平台 网络药理学 新型冠状病毒肺炎 中医证候 推荐方剂 

分 类 号：TP391.3[自动化与计算机技术—计算机应用技术] R259[自动化与计算机技术—计算机科学与技术]