《伤寒论》太阳病篇药症规律挖掘  

Exploring the rules of medication and symptom treatment in Taiyang disease chapter of treatise on Cold Damage Diseases

作　　者：丁琳译 赵屹 卜德超[2] 董雷 高凯 曹婉琛 韩丽娜 DING Linyi;ZHAO Yi;BU Dechao;DONG Lei;GAO Kai;CAO Wanchen;HAN Li’na(Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学,北京100029 [2]中国科学院计算技术研究所,北京100190

出　　处：《陕西中医》2022年第1期83-89,共7页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划项目(2018YFC1704106)。

摘　　要：目的:分析《伤寒论》太阳病篇的条文,归纳其用药特点,挖掘其用药规律和药症规律。探究药症评分较高的桂枝汤和以“发热,头痛,汗出,恶风,浮脉”为主症的桂枝汤证的相关治疗机制,为现代化和科学化解释经方的治疗机制研究提供参考。方法:本研究使用FangNet(http://fangnet.org)平台对太阳病篇有方症的条文以医案的形式进行录入,使用数据挖掘分析其用药的性味归经特点,药对和药症组合规律,并运用网络药理学相关方法揭示桂枝汤和桂枝汤证共有靶基因和相关的生物学过程与通路。结果:太阳病篇符合研究条件的条文共121个病例,58味中药,症状210余种。经平台分析桂枝汤证的主要症状发热,浮脉,恶寒,出汗,恶风为太阳病篇的高频症状,与组成桂枝汤的甘草、大枣、桂枝、生姜、芍药这五味中药关系密切,且这五味中药属太阳病篇的核心及高频用药。经网络药理学分析,发现桂枝汤在治疗桂枝汤证时主要与细胞磷酸化从而促进程神经元的死亡,激活DNA转录因子的活性和RNA聚合酶Ⅱ正向调控pri-miRNA转录的生物过程相关;并与免疫系统和心血管通路相关。结论:58味中药可以治疗210余种症状,足以体现仲景用药精妙,组方严谨。组成桂枝汤的中药位居前列,印证了桂枝汤为“群方之首”。不论是平台分析的药症关系还是从分子生物学机制,均能证明桂枝汤与桂枝汤的证关系密切。Objective:The article of treatise on Taiyang disease chapter of Treatise on Cold Damage Diseases was analyzed,the characteristics of medication were summarized,the rules of medication and symptoms were explored,and the relevant therapeutic mechanisms of Guizhi decoction with high symptom score and Guizhi decoction syndrome with fever,headache,sweating,bad wind and floating pulse as the main symptoms were explored.Methods:In this study,FangNet(http://fangnet.org)platform was used to input prescriptions of Taiyang Disease Chapter in the form of medical records,and data mining was used to analyze the characteristics of herb use,herb pairs and syndrome combination,then the network pharmacology related methods were used to reveal the common target genes and related biological processes of Guizhi decoction and Guizhi decoction syndrome and pathways.Results:A total of 121 cases,58 Chinese herbs and more than 210 kinds of symptoms met the study conditions of Taiyang Disease Chapter.Through platform analysis,the main symptoms of Guizi decoction syndrome,fever,floating vein,aversion to cold,sweating and aversion to wind,are the high-frequency symptoms of Taiyang Disease Chapter,which are closely related to the five traditional Chinese medicines composed of Guizi decoction,such as GanCao,Daozi,Guizhi,Shaoyao and Shengjiang,and these five traditional Chinese medicines belong to the core and high-frequency medication of Taiyang Disease Chapter.Through network pharmacological analysis,it was found that Guizhi decoction in the treatment of Guizhi Decoction syndrome mainly promotes the death of progressive neurons through cell phosphorylation,activates the activity of DNA transcription factors and positively regulates the biological process of PRI-mirNA transcription by RNA polymeraseⅡ.It is associated with the immune system and cardiovascular pathways.Conclusion:58 herbs can treat more than 210 symptoms,enough to reflect ZhongJing medicine exquisite,rigorous prescription.Both the relationship between drugs and symptoms analyz

关 键 词：《伤寒论》 太阳病篇 数据挖掘 网络药理学 用药规律 桂枝汤 桂枝汤证 

分 类 号：R222[医药卫生—中医基础理论]