姚娓治疗不寐的经验总结及潜在新方作用机制研究  

Yao Wei's Experience in the Treatment of Insomnia and the Potential Mechanism of the New Prescription

作　　者：鞠文雪 姚娓[1,3] JU Wenxue;YAO Wei(The Second Hospital of Dalian Medical University,Dalian 116023,China;The 967th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China,Dalian 116021,China;Institute(College)of Integrative Medicine,Dalian Medical University,Dalian 116044,China)

机构地区：[1]大连医科大学附属第二医院,辽宁大连116023 [2]中国人民解放军联勤保障部队第967医院,辽宁大连116021 [3]大连医科大学中西医结合研究院(学院),辽宁大连116044

出　　处：《中国中医基础医学杂志》2024年第5期857-864,共8页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：第五批全国中医临床优秀人才研修项目(国中医药人教函〔2022〕1号);辽宁省优秀中医临床人才培养项目(辽卫办发〔2021〕29号);大连医科大学附属第二医院院内培育项目(dy2yynpy202218)。

摘　　要：目的基于中医传承辅助平台挖掘姚娓教授治疗不寐的用药规律,探究潜在新方治疗不寐的作用机制。方法收集门诊不寐病例200例,运用中医传承辅助平台建立数据库并对处方药物进行四气五味、归经、频次统计、组方规律、潜在新方等分析,挖掘姚娓教授的用药规律及组方思想,利用网络药理学方法探究潜在新方的有效成分、靶点及信号通路。结果200个处方共涉及59个方剂和168味药物,分析得到核心药组为“炙甘草-半夏-茯苓-枳实-党参-陈皮-柴胡-黄芩”,选取潜在新方“木香-佛手-白术-藿香-青皮-诃子-五味子-厚朴”进行网络药理学研究,筛选后得到44个有效活性成分,得到104个“异病同治”的作用靶点,关键活性成分包括槲皮素、柚皮素、豆甾醇、川陈皮素、鸢尾素等,在蛋白互作网络中可筛选出包括白介素(interleukin,IL)-6、丝氨酸/苏氨酸蛋白激酶(protein kinasesB,PKB,又称AKT1)、肿瘤坏死因子(tumor necrosis factor,TNF)、白介素(interleukin,IL)-1β、血管内皮生长因子(vascular endothelial growth factor,VEGFA)、胱天蛋白酶(recombinant caspase,CASP)3、过氧化物酶体增生激活受体γ(peroxisome proliferative activated receptor gamma,PPARG)、IL-8(又称趋化因子CXCL8)等频次较高(均高于50)的靶蛋白,并对以上关键靶点进行基因本体(geneontology,GO)功能富集分析和京都基因组百科全书(kyoto encyclopedia of genesand genome,KEGG)通路富集分析,发现潜在新方治疗不寐与糖尿病并发症中的晚期糖基化终产物及其受体(advanced glycation end products-receptor for advanced glycation end products,AGE-RAGE)信号通路、IL-17信号通路、肿瘤坏死因子信号通路等有关。结论姚娓教授认为不寐的核心病机为“脾虚肝郁,气血不和,神魂不安”,治疗注重调畅气机、调脾之本、心肝同治等,潜在新方可能通过AGE-RAGE信号通路、IL-17信号通路、TNF信号通路等发挥�Objective Based on the traditional Chinese medicine inheritance assistance platform,to explore the medication patterns of Professor Yao Wei in treating insomnia and explore the mechanism of potential new prescriptions in treating insomnia.Methods 200 cases of insomnia in outpatient clinics were collected,and a database was established using traditional Chinese medicine inheritance assistance platform software.Prescription drugs were analyzed for four Qi and five flavors,meridian tropism,frequency statistics,formula formation rules,and potential new formulas.Professor Yao Wei's medication patterns and formula formation ideas were explored.The network pharmacology method was used to explore the Active ingredient,targets,and signal pathways of potential new prescriptions.Results A total of 59 prescriptions and 168 medicines were involved in the 200 prescriptions.The core prescription"Licorice-Pinellia ternata-Poria cocos-Fructus Aurantii-Codonopsis pilosula-Tangerine peel-Bupleurum chinense-Scutellaria baicalensis"was analyzed,and the potential new prescription"Muxiang-Bergamot-Atractylodes macrocephala-Patchouli-Qingpi-Myrobalan-Schisandra chinensis-magnolia officinalis"was selected for network pharmacology research.After screening,44 effective active ingredients were obtained,and 104 relevant action targets of"treating different diseases simultaneously"were obtained.The key active ingredients including Quercetin Naringenin,stigmasterol,Nobiletin,and iris can be screened from the protein interaction network,including IL-6,AKT1,TNF,and IL-1β,VEGFA,CASP3,PPARG,CXCL8 and other target proteins with high frequency(all higher than 50),and GO function enrichment analysis and KEGG pathway enrichment analysis were carried out on the above key targets,it was found that the potential new treatment for insomnia was related to AGE-RAGE signal pathway,IL-17 signal pathway,tumor necrosis factor signal pathway,etc.Conclusion Professor Yao Wei believes that the core pathogenesis of insomnia is"spleen deficiency and liver stagnatio

关 键 词：姚娓 不寐 异病同治 AGE-RAGE信号通路 

分 类 号：R223.1[医药卫生—中医基础理论]