仲景方辨治惊悸病的特点及高频药对桂枝-茯苓核心通路靶点的筛选  

The Characteristics of Zhongjing Prescription in Distinguishing and Treating Palpitations and the Screening of the Core Pathways and Targets of High-frequency Herbs Guizhi-Fuling

作　　者：王明珠 姚磊[1] 李建华[1] 桂明泰[1] 芦波[1] 周训杰[1] 符德玉[1] WANG Mingzhu;YAO Lei;LI Jianhua;GUI Mingtai;LU Bo;ZHOU Xunjie;FU Deyu(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《中西医结合心脑血管病杂志》2022年第18期3274-3279,共6页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家自然科学基金项目(No.82174130);上海市进一步加快中医药事业三年行动计划项目(No.2018-2020);中医心病专科;上海市卫生健康委员会中医药科研项目(No.2022QN031);上海中医药大学预算内科研项目(No.2021LK097)。

摘　　要：目的 以仲景方为基础,梳理张仲景治疗惊悸病的常用方药,寻找高频药对,并探讨其可能的作用靶点。方法 通过对《伤寒杂病论》原文梳理,寻找仲景方治疗惊悸病的高频药对,并基于网络药理学进一步挖掘桂枝-茯苓治疗惊悸病的核心靶点基因和关键信号通路。结果 条文汇总发现药对桂枝-茯苓在惊悸病治疗中的关键作用。桂枝-茯苓治疗心律失常的主要作用成分包括烯酸、氢化松苓酸、麦角甾等。主要信号通路为钙离子信号通路、神经活性配体受体通路、细胞凋亡等信号通路等。进一步对排名第一的钙离子信号通路的核心靶点筛选发现CHRM/ADRA/ADRB/PRKCA可能为桂枝-茯苓调控钙离子信号通路干预心律失常的核心靶点。结论 通过梳理文献,总结归纳仲景方对惊悸病的辨证论治规律,有助于找到惊悸病治疗的关键切入点,理清辨证施治思路,为后期深入开展相关机制研究和指导临床实践奠定基础。Objective Based on Zhongjing Prescription, we sort out Zhang Zhongjing′s commonly used prescriptions for palpitations treatment to find high-frequency drug pairs and explore their possible targets.Methods High-frequency drug pair of Zhongjing Prescription were searched to explored the core target genes and key signal pathways of Guizhi-Fuling via network pharmacology.Results Guizhi-Fuling played a key role in the treatment of palpitations.The active ingredients of Guizhi-Fuling for arrhythmia mainly included enoic acid, trametenolic acid, ergosterol, etc.The main signal pathways included calcium ion signal pathway, neural active ligand receptor pathway, apoptosis signal pathways.CHRM/ADRA/ADRB/PRKCA might be the core target of Guizhi-Fuling by regulating calcium signaling pathway to interfere with arrhythmia.Conclusion The study results summarized the syndrome differentiation and treatment rule of Zhongjing Prescription in the treatment of palpitations, which is helpful to find the highlight of palpitations and clarify the thinking of syndrome differentiation and treatment.

关 键 词：惊悸病 仲景方 药对 通路 靶点 

分 类 号：R289.5[医药卫生—方剂学]