基于数据挖掘和网络药理学探讨叶天士治疗胸痹心痛病的用药规律  

Analysis of the Medication Law of Ye Tianshi in Treatment of Chest Bi and Heart Pain Based on Data Mining and Network Pharmacology

作　　者：颜梦凡 李鑫辉 刘泳钊 李彩云 蒋啸 YAN Mengfan;LI Xinhui;LIU Yongzhao;LI Caiyun;JIANG Xiao(Hunan University of Traditional Chinese Medicine,Changsha 410208,China)

机构地区：[1]湖南中医药大学中医学院,长沙410208

出　　处：《中国中医基础医学杂志》2024年第4期667-673,共7页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：国家自然科学基金面上项目(82074392);湖南省自然科学基金区域联合基金项目(2023JJ50036);湖南省中医药管理局重点课题(A2023013)。

摘　　要：目的分析叶天士治疗胸痹心痛病的用药规律以及核心药物组合的潜在作用机制,为临床治疗提供依据。方法遴选《叶天士医学全书》中治疗胸痹心痛病的方剂,建立数据库,借助Microsoft Excel 2021、SPSS Modeler 18.0、SPSS 25.0进行中药频次统计分析、关联规则分析、聚类分析、因子分析。运用BATMAN-TCM网站、GeneCards、DrugBank、OMIM、TTD数据库获取核心药物组合与疾病的靶点,使用STRING网站和Cytoscape3.9.1软件分析靶蛋白相互作用关系,并筛选出核心靶点,采用Metascape网站和微生信网站对核心药物组合与疾病的相关靶点做基因本体(gene ontology,GO)和京都基因与基因组百科全书(kyoto encyclopedia of genes and genomes,KEGG)富集分析。结果收集方剂100首,涉及中药169味,单味中药使用频次≥8次的高频中药有茯苓(45次)、半夏(23次)、桂枝(23次)、生姜(21次)等,其中药性以温、平为主,药味以甘、苦、辛为主,药物多归心、肺、脾经,功效排名前3位的是补虚药、化痰止咳平喘药、利水渗湿药。关联规则分析得到11组强关联药物组合,置信度最高的是半夏-生姜-茯苓。聚类分析得出5类药物组合,新处方3首,因子分析得出8个公因子,新处方3首,多有温阳、祛痰、活血、补血、益气养阴之效。网络药理学研究得出核心药物组合半夏-生姜-茯苓治疗胸痹心痛病有205个相关靶点,将肿瘤坏死因子(tumor necrosis factor,TNF)、FOS原癌基因(fos proto-oncogene,FOS)、一氧化氮合成酶(nitric oxide synthase,NOS)3作为关键靶点,钙离子(calcium,Ca^(2+))信号通路和环状鸟苷单磷酸酯-蛋白激酶G(cyclic guanosine monophosphate-protein kinase,cGMP-PKG)信号通路是核心药物组合治疗胸痹心痛病的潜在信号通路。结论叶天士治疗胸痹心痛病多从温阳化痰、活血化瘀、益气养阴3个方面选方用药,核心药物组合半夏-生姜-茯苓可能通过TNF、FOS、NOS3等靶点对钙离�Objective Analysis of the medication law of Ye Tianshi in the treatment of chest Bi and heart pain and potential mechanisms of action of core drug combinations to provide a basis for clinical treatment.Methods The prescriptions for the treatment of chest Bi and heart pain disease from the Complete Book of Medicine of Ye Tianshi were selected,and a database was established to conduct statistical analysis of the frequency of Chinese medicine,association rule analysis,cluster analysis,and factor analysis with the help of Microsoft Excel 2021,SPSS Modeler 18.0 and SPSS 25.0.The BATMAN-TCM website,GeneCards,DrugBank,OMIM,and TTD databases were used to obtain the targets of the core drug combinations and diseases,and the STRING website and Cytoscape 3.9.1 software were used to analyze the target protein interactions and screen the core targets.Gene ontology(GO)and kyoto encyclopedia of genes and genomes(KEGG)enrichment analyses were performed on the Metascape website and the Bioinformatics website for core drug combinations with disease-related targets.Results The 100 recipes included in the list of criteria involved 169 Chinese herbal medicines,with the frequency of use of a single herbal medicine≥8 times as a high-frequency herbal medicine,including Fuling(45 times),Banxia(23 times),Guizhi(23 times),and Shengjiang(21 times),etc.The medicinal properties were mostly warm and moderate,and the taste of the medicines was mostly sweet,bitter,and pungent,and they mostly belonged to the heart,lung and spleen meridians.The top three effects are to tonify deficiency,to resolve phlegm and cough,and to induce dampness.The association rule analysis yielded 11 groups of strongly associated drug combinations,with the highest confidence level being Banxia-Shengjiang-Fuling.Cluster analysis yielded five drug combinations and three new prescriptions,and factor analysis yielded eight male factors and three new prescriptions,most of which were effective in warming Yang,dispelling phlegm,invigorating Blood,tonifying Blood,benefiting Qi

关 键 词：胸痹 心痛 冠心病 数据挖掘 网络药理学 用药规律 

分 类 号：R285.5[医药卫生—中药学]