基于数据挖掘和网络药理学分析中医药防治糖尿病肾病脾肾气虚证的用药规律及作用机制  

Medication Rules and Mechanism of TCM in TCM Prevention and Treatment of Diabetic Kidney Disease with Spleen and Kidney Qi Deficiency Syndrome Based on Data Mining and Network Pharmacology

作　　者：陈占科 陈凯丽[2] 刘昊霖 冯素香 崔伟峰[3] 徐江雁 CHEN Zhanke;CHEN Kaili;LIU Haolin;FENG Suxiang;CUI Weifeng;XU Jiangyan(The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450000;Henan University of Chinese Medicine,Zhengzhou Henan China 450046;Henan Provincial Hospital of Integrative Medicine,Zhengzhou Henan China 450000)

机构地区：[1]河南中医院大学第一附属医院,河南郑州450000 [2]河南中医药大学,河南郑州450046 [3]河南省中西医结合医院,河南郑州450000

出　　处：《中医学报》2024年第10期2217-2226,共10页Acta Chinese Medicine

基　　金：国家重点研究开发计划基金项目(2020YFE0201800);河南中医药大学第一附属医院博士基金项目(2022BSJJ2007);河南省中医药科学研究专项课题项目(2022ZY1007);河南省大学生创新创业训练计划项目(202310471046);河南中医药大学苗圃项目(MP2023-47)。

摘　　要：目的:分析中医药防治糖尿病肾病(diabetic kidney disease,DKD)脾肾气虚证的用药规律及核心药物作用机制。方法:回顾性分析河南中医药大学第一附属医院、河南省中医院、河南中医药大学第三附属医院确诊的DKD脾肾气虚证患者的病案资料,对其临床数据进行频次分析、聚类分析、因子分析和复杂网络社团结构分析,总结用药规律;并通过网络药理学及分子对接技术预测核心药物潜在作用机制。结果:共纳入587例患者病案资料,涉及中药348味,用药以黄芪、茯苓、白术、川芎、当归居多,性味以甘苦、温为主,主归肝脾经,高频中药聚类分析可聚为5类,因子分析提取到11个公因子,复杂网络社团结构分析显示“黄芪、茯苓、白术、当归、川芎、牛膝”为临床治疗DKD脾肾气虚证的核心药物。通过网络药理学预测到核心药物有效活性成分45个,槲皮素、汉黄芩素、山柰酚、黄芩素、异鼠李素等为主要成分,潜在作用靶点228个,疾病靶点1147个,药物与疾病交集靶点113个,丝裂原活化蛋白激酶14(mitogen-activated protein kinase 14,MAPK14)、沉默信息调节因子1(silent information regulator type 1,SIRT1)、白细胞介素-2(interleukin-2,IL-2)、肿瘤坏死因子(tumor necrosis factor,TNF)、糖原合成酶激酶3B(glycogen synthase kinase 3B,GSK3B)等为核心靶点,主要参与高级糖基化终末产物-受体(advanced glycosylation end product-receptor of AGE,AGE-RAGE)、MAPK、IL-17、磷脂酰肌醇-3-激酶/丝苏氨酸蛋白激酶(phosphatidyl-inositol 3-kinase/serine-threonine kinase,PI3K/Akt)等信号通路。分子对接反向验证主要成分槲皮素、汉黄芩素、山柰酚、黄芩素和异鼠李素和核心靶点MAPK14、SIRT1、IL-2、TNF、GSK3B结合活性较好。结论:中医药治疗DKD脾肾气虚证以益气扶正为主,辅用理气解郁、化痰祛湿、通经活络等祛其邪,黄芪、茯苓、白术、当归、川芎、牛膝为核心药物,其�Objective:To analyze the medication rules and mechanism of core drugs in the prevention and treatment of diabetic kidney disease(DKD)of Spleen and Kidney Qi deficiency syndrome with traditional Chinese medicine.Methods:The first affiliated hospital to Henan University of Chinese Medicine,Henan Provincial Hospital of Traditional Chinese Medicine,and the Third Affiliated Hospital to Henan University of Traditional Chinese Medicine were retrospectively analyzed the medical records of patients with Spleen and Kidney Qi deficiency diagnosed with DKD,and the clinical data were analyzed by frequency analysis,cluster analysis,factor analysis and complex network community structure analysis,and the medication rules were summarized.With network pharmacology and molecular docking technology,the potential mechanism of action of core drugs is predicted.Results:A total of 587 cases were included,involving 348 flavors of traditional Chinese medicine,and the drugs were mostly Huangqi(Astragalus),Fuling(Poria cocos),Baizhu(Atractylodes macrocephala),Chuanxiong(Ligusticum chuanxiong Hort),Danggui(Angelica sinensis),which are mainly sweet and/or bitter and warm in property,with the channel tropism are mainly Liver and Spleen meridians.The high-frequency cluster analysis of Chinese medicine could be clustered into 5 categories,and 11 common factors were extracted by factor analysis,and the complex network community structure analysis showed that"Huangqi(Astragalus),Fuling(Poria cocos),Baizhu(Atractylodes macrocephala),Danggui(Angelica sinensis),Chuanxiong(Ligusticum chuanxiong Hort)and Niuxi(Radix achyranthis bidentatae)"were the core drugs for the clinical treatment of spleen and kidney qi deficiency syndrome in DKD.Through network pharmacology,45 active ingredients of core drugs were predicted,including quercetin,baicalein,kaempferol,baicalein,and isorhamnetin as the main components,with 228 potential targets,1147 disease targets,113 drug-disease intersection targets,mitogen-activated protein kinase 14(MAPK14),and silent informati

关 键 词：糖尿病肾病 脾肾气虚证 数据挖掘 网络药理学 分子对接 

分 类 号：R259.872[医药卫生—中西医结合]