决明子在藏药经方中的配伍规律及常见药组“三黄水”治疗瘙痒症作用机制研究

Study on the Combination Rule of Cassia Seed in Tibetan Medicine and the Mechanism of the Common Drug Group “Chu Ser Man Gsum” in Treating Pruritus

目的 探讨决明子在藏族医学中的配伍规律及常见药物组治疗“黄水”性皮肤病“瘙痒症”的作用机制。方法 收集《藏药方剂宝库》中含决明子的藏药方剂信息。在R语言中应用频数统计、关联规则、层次聚类等方法分析主治疾病、用药频次、常见药物组合;通过网络药理学分析常见药组有效成分、作用靶点和通路。结果 共收集201首含决明子藏药方剂,涉及主治疾病128种,频次最高的依次为皮肤病(66种)、风湿(47种)、痛风(44种)等。涉及药材647味,使用频率≥40%的有10味,依次为决明子、黄葵、琥珀、诃子等,其中决明子主要与黄葵、琥珀配伍。对决明子主治皮肤病的方剂进行关联规则和层次聚类分析,发现“决明子-琥珀-黄葵”组合为常见药组,藏医学称之为“三黄水药”,并与“六良药”“三果”等高度关联。进而对常见药组“决明子-琥珀-黄葵”进行网络药理学分析,发现“三黄水”中槲皮素、β-谷甾醇和芦荟素等主要成分可能通过EGFR、STAT3和TP53等靶点作用于PI3K-Akt信号通路、钙信号通路和MAPK信号通路,对黄水性皮肤瘙痒症起到治疗作用。结论 初步探析了决明子在藏药经典方剂中的配伍规律,发现决明子常与琥珀、黄葵等具有干涸黄水、消炎止痒功效的药物联用,形成了“决明子-琥珀-黄葵”为主的固定搭配药物组,体现了同效药物联用的增效减毒配伍理念。这种常用药组兼具模块化的规范性和个性化的辨证灵活性组方特点。同时,藏医对决明子的独特用法,有助于人们更加全面、立体地认识此药。通过进一步药理学研究,有望拓展其临床应用。

Objective To investigate the combination rules of the traditional Cassia seed in Tibetan medicine and its mechanism in treating“Chu Ser.”related diseases such as“Pruritus”.Methods Data was gathered from the“Tibetan Medicine Formula Repository”concerning formulations that included Cassia seed.Using R language,frequency statistics,association rules,and hierarchical clustering were employed to analyze principal diseases treated,medication frequency,and common drug combinations.Network pharmacology was utilized to assess effective components,action targets,and pathways of common drug groups.Results A total of 201 Tibetan medicine formulations containing Cassia seed were collected,addressing 128 main diseases,with the highest frequency being skin diseases(66)and rheumatism(47),gout(44)among others.There were 647 types of medicinal materials involved,with 10 used at a frequency of≥40%,successively including Cassia seed,Hollyhock,Amber,Terminalia chebula,etc.Cassia seed is primarily paired with Hollyhock and Amber.Analysis of association rules and hierarchical clustering of Cassia seed formulations for skin diseases revealed that the combination of Cassia seed,Amber,and Hollyhock,termed the“Chu Ser Sman Gsum.”in Tibetan medicine,has a high association with other groups like“Bzang Bo Drug”and“Vbras Bu Gsum.”.Network pharmacology analysis on the common drug group“Cassia seed-Amber-Hollyhock”found that primary ingredients such as quercetin,β-sitosterol,and aloin might act on targets like EGFR,STAT3,and TP53,influencing pathways like the PI3K-Akt signaling pathway,calcium signaling pathway,and MAPK signaling pathway,thereby playing a role in the treatment of“Chu Ser.”skin pruritus.Conclusion Preliminary analysis of the combination of Cassia seed in classical Tibetan medicine formulations revealed that it is often used with Amber and Hollyhock,which are known to dry Yellow Water and have anti-inflammatory and anti-itch properties,forming the common drug group“Cassia seed-Amber-Hollyhock”.This combination reflects the Tibetan medical principle of using synergistic drugs to concentrate therapeutic effects while reducing adverse side effects.It also embodies the characteristics of Tibetan medicine,which focuses on multiple components,multiple targets,and multiple pathways.Such a widely used combination in Tibetan formulations,which balances standardized modularity with individualized diagnostic flexibility,holds significant developmental value.