中药治疗不孕症的用药规律及作用机制研究  

Study on the medication rules and mechanism of traditional Chinese medicine in the treatment of infertility

作　　者：曾位位 甘大莉 林晓莹 何婉平 廖雅山 徐继辉 ZENG Weiwei;GAN Dali;LIN Xiaoying(The department of Pharmay,Shenzhen Longgang Second People's Hospital,Shenzhen 518112,China;不详)

机构地区：[1]深圳市龙岗区第二人民医院药学部,广东深圳518112 [2]深圳市龙岗区第三人民医院社管中心,广东深圳518115 [3]深圳市龙岗区第二人民医院中医科,广东深圳518112

出　　处：《中国处方药》2025年第6期12-20,共9页Journal of China Prescription Drug

摘　　要：目的基于数据挖掘探讨中药治疗不孕症的用药规律及核心药材,基于网络药理学探索核心药材的作用机制。方法将经治疗后受孕的不孕症患者的中药处方录入数据库,借助SPSS 25.0、SPSS Modeler18.0统计软件进行频数分析、聚类分析和关联规则分析。利用网络药理学分析方法寻找不孕症与核心药材活性成分交集靶点并进行基因本体论(GO)功能富集和京都基因与基因组百科全书(KEGG)通路富集分析及分子对接。结果共录入某院中药处方688首,涉及中药190味。单味药物中,使用频次最高的为熟地黄;使用频次排名前50的中药多归肝、脾、肺、肾经,四气五味以平、甘、苦、辛为主,主要功效为补血、补气、补阴。聚类分析提取核心药物组合8组,熟地黄、山药、茯苓、菟丝子、女贞子和当归是该院治疗不孕症的核心药材。网络药理学分析结果显示,6种核心药材的活性成分中,有29个成分与不孕症的治疗有关。核心药材治疗不孕症的潜在靶点有148个,其中核心靶点为肿瘤蛋白53(TP53)、肿瘤坏死因子(TNF)、蛋白激酶B1(AKT1)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、雌激素受体α(ESR1)、半胱氨酸天冬氨酸蛋白酶3(CASP3)、JUN;关键活性成分为槲皮素、山奈酚、异鼠李素、β-甾固醇和木犀草素。GO功能与KEGG通路富集分析表明,核心药材可能通过调控生物过程(如氧化应激反应)、分子功能(如DNA结合转录因子及RNA聚合酶Ⅱ-特异性DNA-结合转录因子结合)及细胞组分(如膜筏与膜微结构域),协同改善不孕症病理状态;同时,其作用机制涉及内分泌代谢相关通路,包括脂质代谢与动脉粥样硬化、化学致癌物受体激活及内分泌抵抗等,为多靶点干预不孕症提供理论依据。结论某院治疗不孕症的用药特点是以平性为主,注重肝肾同调、益气补血,治疗不孕症的关键是通过药材中的活性成分调控多条�Objective To explore the medication rules and core herbs used in the treatment of infertility using traditional Chinese medicine(TCM)based on data mining,and to explore the mechanism of action of these core herbs using network pharmacology.Methods The TCM prescriptions of infertility patients who conceived after treatment were entered into the database.SPSS 25.0 and SPSS Modeler 18.0 statistical software were manipulated for analysis of frequency,cluster and association rule.Besides,network pharmacology analysis was used to identify the intersection target between infertility and core herbs active components,followed by Gene Ontology(GO)functional enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis and molecular docking.Results A total of 688 TCM prescriptions from a hospital were recorded,involving 190 different herbal medicines.Among them,the most frequently used single herb was Rehmannia glutinosa.The top 50 herbs used by frequency were associated with the liver,spleen,lung,and kidney meridians,with properties of being neutral,sweet,bitter,or pungent,and primary functions of nourishing blood,replenishing qi,and supplementing yin.Cluster analysis identified eight core herbal combinations,with Rehmannia glutinosa,Dioscorea opposita,Poria cocos,Cuscuta chinensis,Ligustrum lucidum,and Angelica sinensis forming the core herbs for treating infertility at this hospital.Network pharmacology analysis revealed that 29 active components from these 6 core herbs were related to infertility treatment,targeting 148 potential therapeutic nodes.Core targets included tumor protein 53(TP53),tumor necrosis factor(TNF),protein kinase B1(AKT1),interleukin-1β(IL1B),interleukin-6(IL6),estrogen receptor alpha(ESR1),caspase-3(CASP3),and JUN.The core active components were quercetin,kaempferol,isorhamnetin,β-sitosterol,and luteolin.GO functional and KEGG pathway enrichment analysis suggested that the core herbs may synergistically improve infertility pathology by regulating biological processes(such

关 键 词：女性不孕症 用药规律 作用机制 

分 类 号：R28[医药卫生—中药学]