基于医院数据和网络药理学的中药治疗子宫腺肌病用药规律分析  

Analysis of Medication Patterns for Traditional Chinese Medicine Treatment of Adenomyosis Based on Hospital Data and Network Pharmacology

作　　者：向利珠 罗述善 李云波 黄海涛[3] 黄文玲[3] 卜晓玲[3] 耿韦华 XIANG Lizhu;LUO Shushan;LI Yunbo;HUANG Haitao;HUANG Wenling;BU Xiaoling;GENG Weihua(Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine,Beijing 100029,China;Hebei University,Hebei Baoding 071002,China;Dongfang Hospital of Beijing University of Traditional Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学第三附属医院,北京100029 [2]河北大学,保定071002 [3]北京中医药大学东方医院,北京100078

出　　处：《现代中医药》2024年第5期104-115,共12页Modern Chinese Medicine

基　　金：国家青年自然科学基金项目(81704112)。

摘　　要：目的通过数据挖掘和网络药理学分析子宫腺肌病(adenomyosis,AM)的用药规律及作用机制。方法收集2017年1月-2020年12月在北京中医药大学附属东方医院诊断为AM患者的中药信息,构建中医药治疗AM的数据库,运用中医传承辅助平台软件(V2.5)进行用药规律分析,运用TCMSP检索高频药对化合物及治疗靶点,与Genecards、DisGeNET、DrugBank和OMIM数据库筛选出AM的靶点相映射并取交集,STRING数据平台构建可视化蛋白-蛋白相互作用(Protein-protein interactions,PPI)网络模型,利用Metascape对关键靶点进行GO和KEGG富集分析。结果共收集处方1293条,其中涉及使用的中药293味,总频数21136次。性味归经中以寒、温,苦、甘、辛,“肝”、“脾”为主。关联规则54条,新方分析7个。高频药对延胡索-赤芍缓解AM痛经情况的关键靶点59个,KEGG通路157条。关键靶点为TNF、AKT1、TP53、VEGFA、IL-6、HIF-1A、MMP9、MMP2、IL-1β等,主要通路为癌症信号通路、PI3K-Akt、HIF-1、IL-17信号通路。结论活血化瘀止痛,软坚散结消癥的药物为治疗AM的主要药物,且核心药物延胡索-赤芍治疗AM痛经症状的潜在信号通路可为中药的疗效机制研究提供思路。Objective To analyze the medication pattern and mechanism of action of adenomyosis(AM)through data mining and network pharmacology.Methods Collect traditional Chinese medicine information of patients diagnosed with AM at Dongfang Hospital Affiliated to Beijing University of Traditional Chinese Medicine from January 2017 to December 2020,construct a database for the treatment of AM with traditional Chinese medicine,use the Traditional Chinese Medicine Inheritance Assistance Platform software(V2.5)to analyze medication patterns,use TCMSP to search for high-frequency drug pairs and treatment targets,and map them to Genecards,DisGeNET,DrugBank,and OMIM databases to screen AM targets and take intersections.The STRING data platform constructs a visual protein-protein interactions(PPI)network model,and uses Metascape to perform GO and KEGG enrichment analysis on key targets.Results A total of 1293 prescriptions were collected,including 293 traditional Chinese medicines used,with a total frequency of 21136 times.The nature and taste is mainly characterized by coldness,warmth,bitterness,sweetness,and spiciness in the meridians,with“liver”and“spleen”as the main components.There are 54 association rules and 7 new analysis rules.There are 59 key targets and 157 KEGG pathways for high-frequency drugs to alleviate AM dysmenorrhea with Corydalis yanhusuo and Paeonia lactiflora.The key targets are TNF,AKT1,TP53,VEGFA,IL-6,HIF-1A,MMP9,MMP2,IL-1β,etc.The main pathways are the cancer signaling pathway,PI3K Akt,HIF-1,IL-17 signaling pathway.Conclusion The main drugs for treating AM are those that promote blood circulation,remove blood stasis,relieve pain,and soften hardness,disperse nodules,and eliminate symptoms.The potential signaling pathway of the core drug Yanhusuo Chishao in treating AM dysmenorrhea symptoms can provide ideas for the study of the therapeutic mechanism of traditional Chinese medicine.

关 键 词：子宫腺肌病 痛经 数据挖掘 辨治规律 网络药理学 作用机制 延胡索 赤芍 

分 类 号：R271.9[医药卫生—中西医结合]