基于中医寒疫理论的中药防治疫病用药规律与作用机制分析  

Medication law and mechanism of traditional Chinese medicine in prevention and treatment of epidemic diseases: based on traditional Chinese medicine theory of cold pestilence

作　　者：李泽宇 郝二伟[1,2,3] 曹瑞 林思 陈淑莹 黄显婷 徐婉茹 侯小涛 邓家刚[1,2,3] LI Ze-yu;HAO Er-wei;CAO-Rui;LIN-Si;CHEN Shu-ying;HUANG Xian-ting;XU Wan-ru;HOU Xiao-tao;DENG Jia-gang(China-ASEAN Joint Laboratory for International Cooperation in Traditional Medicine Research,Guangxi University of Chinese Medicine,Nanning 530200,China;Guangxi Key Laboratory of Theory and Transformation of Traditional Chinese Medicine Prescriptions for Damp Diseases,Nanning 530200,China;Guangxi Key Laboratory of Eficacy Study on Chinese Materia Medica,Nanning 530200,China)

机构地区：[1]广西中医药大学中国-东盟传统药物研究国际合作联合实验室,广西南宁530200 [2]广西中医湿病方药理论与转化重点实验室,广西南宁530200 [3]广西中药药效研究重点实验室,广西南宁530200

出　　处：《中国中药杂志》2022年第17期4765-4777,共13页China Journal of Chinese Materia Medica

基　　金：中国-东盟传统药物研究国际合作联合实验室中心建设项目(AD19110165);国家自然科学基金项目(82060762);广西科技重大专项(桂科AA18118049)。

摘　　要：疫病的流行对人类社会造成了严重危害,中医药在防治疫病方面做出了重大贡献,进一步探究考查传统中医药理论下的用药规律及作用机制,对于攻克疾病、新药开发等借鉴意义重大。该文首先对中医寒疫理论在现代疫病中的相关性进行了考证,确定并分析了新型冠状病毒肺炎(COVID-19)、传染性非典型肺炎(SARS)、甲型H1N1流感这三大流行性疫病与寒疫之间的关系,并深层次讨论了在中医寒疫理论指导下防治现代疫病的疗效及相关差异性;应用数据挖掘和本草考证的方法,从各数据库及相关古籍中收集治疗寒疫的相关处方,并通过高频次中药及药对分析、关联规则分析、聚类分析考查了用药规律,如确定了高置信度处方“甘草-柴胡-芍药”“甘草-半夏-柴胡”等,并结合聚类处方分析其中医辨证治法,得到了新药物组合为“干姜-附子-人参”“茯苓-白术”“桂枝-细辛”“陈皮-紫苏”“半夏-厚朴-苍术”“芍药-当归-甘草-柴胡-黄芩-生姜”“麻黄-杏仁-石膏”“川芎-羌活-白芷-桔梗-防风”;将寒疫用药规律分析中高频药物的抗病毒活性成分进行了文本挖掘,发现这些化学成分可通过抑制病毒复制、调控病毒蛋白及抗病毒信号、抑制蛋白酶活性等方式发挥抗病毒作用。然后应用网络药理学,在药理作用研究进展的基础上,考证了其抗SARS冠状病毒(SARS-CoV)、新型冠状病毒(2019-nCoV)、甲型H1N1流感病毒的作用机制,确定了作用靶点为肿瘤坏死因子(TNF)、血管内皮生长因子A(VEGFA)、S-位点半胱氨酸富集蛋白(SRC)、表皮生长因子受体(EGFR)、基质金属蛋白酶9(MMP9)、丝裂原活化蛋白激酶14(MAPK14)、环氧合酶2(PTGS2)等,作用通路涉及MAPK通路、晚期糖基化终产物及其受体(AGE-RAGE)通路、COVID-19通路、雷帕霉素(mTOR)通路等。该文通过分析中医寒疫理论指导下的中药防治疫病用药规律及作用Epidemic diseases have caused huge harm to the society. Traditional Chinese medicine(TCM) has made great contributions to the prevention and treatment of them. It is of great reference value for fighting diseases and developing drugs to explore the medication law and mechanism of TCM under TCM theory. In this study, the relationship between the TCM theory of cold pestilence and modern epidemic diseases was investigated. Particularly, the the relationship of coronavirus disease 2019(COVID-19), severe acute respiratory syndrome(SARS), and influenza A(H1 N1) with the cold pestilence was identified and analyzed. The roles of TCM theory of cold pestilence in preventing and treating modern epidemic diseases were discussed. Then, through data mining and textual research, prescriptions for the treatment of cold pestilence were collected from major databases and relevant ancient books, and their medication laws were examined through analysis of high-frequency medicinals and medicinal pairs, association rules analysis, and cluster analysis. For example, the prescriptions with high confidence levels were identified: "Glycyrrhizae Radix et Rhizoma-Bupleuri Radix-Paeoniae Radix Alba" "Glycyrrhizae Radix et Rhizoma-Pinelliae Rhizoma-Bupleuri Radix", and TCM treatment methods with them were analyzed by clustering analysis to yield the medicinal combinations: "Zingiberis Rhizoma-Aconiti Lateralis Radix Praeparata-Ginseng Radix et Rhizoma" "Poria-Atractylodis Macrocephalae Rhizoma" "Cinnamomi Ramulus-Asari Radix et Rhizoma" "Citri Reticulatae Pericarpium-Perillae Folium" "Pinelliae Rhizoma-Magnoliae Officinalis Cortex-Atractylodis Rhizoma" "Paeoniae Radix Alba-Angelicae Sinensis Radix-Glycyrrhizae Radix et Rhizoma-Bupleuri Radix-Scutellariae Radix-Rhizoma Zingiberis Recens" "Ephedrae Herba-Armeniacae Semen Amarum-Gypsum Fibrosum" "Chuanxiong Rhizoma-Notopterygii Rhizoma et Radix-Angelicae Dahuricae Radix-Platycodonis Radix-Saposhnikoviae Radix". Then, according to the medication law for cold pestilence, the antiviral active compo

关 键 词：寒疫 中医药 用药规律 作用机制 新型冠状病毒肺炎 传染性非典型肺炎 甲型H1N1流感 

分 类 号：R254[医药卫生—中医内科学]