基于数据挖掘的冠心病合并抑郁的中医药诊疗规律及机制分析  

The Rules of Chinese Medicine in Diagnosis and Treatment of Coronary Heart Disease Complicated with Depression Based on Data Mining

作　　者：徐嘉唯 蒋跃绒[2] 张京春[2] XU Jiawei;JIANG Yuerong;ZHANG Jingchun(Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]国家中医心血管病临床医学研究中心/中国中医科学院西苑医院心血管中心,北京100091

出　　处：《中西医结合心脑血管病杂志》2022年第22期4065-4074,共10页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家自然科学基金项目(No.81373822);中国中医科学院科技创新工程项目(No.CI2021A00908);全国中医特色技术传承骨干人才项目,编号:国中医药人教函〔2019〕36号。

摘　　要：目的基于数据挖掘和网络药理学方法探讨中医药治疗冠心病合并抑郁的组方用药规律及核心药物作用机制。方法以“冠心病”“冠状动脉粥样硬化性心脏病”“急性冠脉综合征”“抑郁”“胸痹”“郁证”等为检索词,在中文数据库中进行检索,采用古今医案云平台V2.3.9分析其症状频次、用药频次及药物聚类分析,对高频症状进行证素提取及积分统计并得出核心方,随后对核心方进行网络药理学分析。结果冠心病合并抑郁的病位证素分别为肝、心、心神,病性证素分别为气滞、血瘀、气虚、血虚、阳亢、阴虚、阳虚。冠心病合并抑郁状态的聚类方中,类方1:茯苓、柴胡、甘草、白芍、当归;类方2:丹参、赤芍、郁金、川芎、香附。复杂网络分析得出核心方由柴胡、白芍、川芎、当归、丹参、茯苓、郁金、香附8味药组成,核心处方的主要活性成分为芍药甙酮、槲皮素、毛地黄黄酮、丹参酮ⅡA等,主要靶点有STAT3、HSP90AA1、PIK3R1、MAPK3、PIK3CA、MAPK1、EP300、CTNNB1、HRAS等。结论中医药治疗冠心病合并抑郁多以心肝同治,用药以理气活血与益气养血并重。通过复杂网络分析得出核心方,并对其作用靶点及机制进行网络药理学分析,为进一步探索冠心病合并抑郁的组方用药规律提供了借鉴。Objective Based on data mining and network pharmacology methods,to explore the traditional Chinese medicine prescription rules of core drugs in the treatment of coronary heart disease complicated with depression.Methods"Coronary heart disease""coronary atherosclerotic heart disease""acute coronary syndrome""depression""chest obstruction""depression"were searched in Chinese database,and their symptom frequency,medication frequency,and drug cluster analysis were analyzed using the Ancient and Modern Medical Record Cloud Platform V2.3.9.Syndrome element extraction and integral statistics were carried out for high-frequency symptoms,and the core prescriptions were obtained for network pharmacology analysis of the core prescriptions.Results The syndrome elements of disease location of coronary heart disease with depression were liver,heart,and mind,and the symptom factor of disease nature were Qi stagnation,blood stasis,Qi deficiency,blood deficiency,Yang hyperactivity,Yin deficiency,and Yang deficiency.Group 1:Poria cocos,Bupleurum,liquorice,Radix Paeoniae Alba,Angelica;Group 2:Salvia miltiorrhiza,Radix Paeoniae root,Rhadix Curcumae,Rhizoma Chuanxiong,Cyperus Rotundus.The complex network analysis showed that the core formula was composed of 8 herbs,including Bupleurum,Radix Paeoniae Alba,Rhizoma Chuanxiong,Angelica,salvia miltiorrhiza,Poria cocos,Radix Curcumae,and Cyperus Rotundus.It was found that the main active ingredients of the core prescription were paeoniflorin,quercetin,luteolina,and tanshinoneⅡA,and the main targets were STAT3,HSP90AA1,PIK3R1,MAPK3,PIK3CA,MAPK1,EP300,CTNNB1,and HRAS,etc.Conclusion In the treatment of coronary heart disease complicated with depression,the heart and liver are mostly treated together,with equal emphasis on regulating Qi and promoting blood circulation,and nourishing Qi and blood.At the same time,the core formula is obtained through complex network analysis,and network pharmacology analysis has been conducted to try to explore its action target and mechanism.

关 键 词：冠心病 抑郁 胸痹 郁证 数据挖掘 网络药理学 

分 类 号：R259[医药卫生—中西医结合] R277.7[医药卫生—中医内科学]