基于病证结合的中药复方治疗糖尿病机制  

Therapeutic Mechanism of TCM Compound Prescriptions Against Different Syndromes of Diabetes Mellitus Based on Combination of Disease and Syndrome

作　　者：尚津锋 李倩楠 刘欣[1] 崔一然 SHANG Jin-Feng;LI Qian-Nan;LIU Xin;CUI Yi-Ran(School of Chinese Materia Medica,Bejing University of Chinese Medicine,Bejing 100029,China;Department of Pharmacy,Beijing Hospital of Traditional Chinese Medicine,Capital Medical University,Beijing 10o010,China)

机构地区：[1]北京中医药大学中药学院,北京100029 [2]首都医科大学附属北京中医医院药学部,北京100010

出　　处：《中国药物经济学》2022年第9期67-74,共8页China Journal of Pharmaceutical Economics

基　　金：北京市优秀人才培养资助项目(2018000021469G256)。

摘　　要：目的 基于病证结合思想探讨小陷胸汤、消渴丸、玉泉丸、杞菊地黄丸4个中药复方治疗糖尿病不同证候的分子学机制。方法 通过中医药整合药理学研究平台V2.0(TCMIP V2.0)获取方剂、疾病、证候的靶标,筛选核心靶点。利用DAVID平台进行基因本体(GO)富集分析和京都基因和基因组百科全书(KEGG)富集分析。采用Cytoscape3.8.0软件构建疾病与证候靶点相结合的“中药-靶标-通路-证候-疾病”网络。结果 4个复方治疗糖尿病均涉及FoxO信号通路和c AMP信号通路,与细胞基本生理功能和能量转化相关。治疗痰热互结证涉及胰岛素抵抗等通路,与调节胰岛素和胰高血糖素分泌有关。肺热津伤证的治疗与抑制Measles等免疫炎症通路相关。玉泉丸通过PI3K-Akt信号通路等治疗气阴两虚型糖尿病。肝肾阴虚证的治疗通路主要为急性髓系白血病、子宫内膜癌、黑色素瘤等。结论 本研究以“态靶结合”和“病证结合”为主导思想,揭示了4个复方治疗糖尿病不同证候的多成分、多靶点、多通路的作用机制,诠释了方剂治疗糖尿病证候的科学内涵,为今后中药治疗糖尿病提供依据和参考。Objective To explore the mechanism of Xiaoxianxiong decoction, Xiaoke pill, Yuquan pill and Qiju Dihuang pill in the treatment of different syndromes of diabetes based on the thought of combination of disease and syndrome. Methods The study obtained the targets of prescriptions, disease and syndromes, and screened the core targets through Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine(TCMIP) V2.0. DAVID platform was used to conduct Gene Ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG) analysis. Cytoscape 3.8.0 software was used to construct "herb-target-pathway-syndrome-disease" network. Results Pathways involved in the treatment of diabetes mellitus with four compound prescriptions included FoxO signaling pathway and cAMP signaling pathway,which were related to cell basic physiological function and energy transformation. The treatment of phlegm heat syndrome involved insulin resistance and other pathways, which were related to the regulation of insulin and glucagon secretion. The treatment of lung heat and fluid injury syndrome was related to the inhibition of immune inflammatory pathways such as Meales. Yuquan pill was used to treat qi and yin deficiency of diabetes through PI3K-Akt signaling pathway and other pathways. The treatment of yin deficiency of liver and kidney syndrome involved acute myeloid leukemia, endometrial cancer,melanoma and so on. Conclusion This study took "combination of state and target" and "combination of disease and syndrome" as the leading thought, reveals the mechanism of four compound prescriptions in treating different syndromes of diabetes with multiple-components, multiple-targets and multiple-pathways,explains the scientific connotation of prescription treatment of diabetes syndrome and provides basis and reference for the treatment of diabetes of using TCM in the future.

关 键 词：病证结合 小陷胸汤 消渴丸 玉泉丸 杞菊地黄丸 糖尿病 中医药整合药理学研究平台V2.0 

分 类 号：R587.1[医药卫生—内分泌] R285.5[医药卫生—内科学]