基于数据挖掘和网络药理学的《临证指南医案·癥瘕》用药研究

Study on Medication in Abdominal Mass, Guide to Clinical Practice with Medical Records Based on Data Mining and Network Pharmacology

目的挖掘《临证指南医案·癥瘕》的组方用药规律,探索治疗癥瘕基本组方的主要活性成分,初步研究治疗癥瘕基本组方的治疗机制。方法收集《临证指南医案·癥瘕》的病案,采用TCMISS软件进行组方数据分析,探讨用药规律,挖掘核心药物及新处方,运用TCMSP、TCM-Mesh、HIT、TCM-ID、HPO、Drug Bank、CTDg及KEGG数据库分析治疗癥瘕基本组方各药物靶标间相互作用关系及相关通路。运用STRING探讨其相关性。结果得到组方32则,药物75种,挖掘出2个核心药物组合和治疗癥瘕基本组方,得到治疗癥瘕基本组方的靶标基因1 397个,癥瘕的靶标基因46个,药物-疾病交集靶标基因15个,相关通路75条,其中女性腹部赘生物相关通路8条。结论叶天士治疗癥瘕以痰瘀同治、理气化痰、活血化瘀为主,其机制可能为机体激素应答和免疫应答等,同时受"下丘脑-垂体-卵巢生殖轴"相关通路和女性腹部赘生物相关通路等多靶标复杂通路的共同影响。

Objective To excavate medication rules of prescriptions in Abdominal Mass, Guide to Clinical Practice with Medical Records, to explore active ingredients of the basic prescription in the treatment of abdominal mass, and to initially analyze the treatment mechanism of the basic prescription for abdominal mass.Methods Medica cases in Abdominal Mass, Guide to Clinical Practice with Medical Records were collecteds.TCMISS was used to analyze data of prescriptions, to explore the medication rules, core drugs and new prescriptions.TCMSP, TCM-Mesh, HIT, TCM-ID, HPO, Drug Bank,CTDg and KEGG were used to analyze interaction between herb-disease targets and the related pathways in the treatment of abdominal mass.The correlation was analyzed by STRING.Results Totally 32 prescriptions were included, containing 75 herbs.2 core drug-pairs and basic prescriptions for abdominal mass treatment were evacuated.1397 targets genes of basic prescriptions for abdominal mass treatment and 46 targets genes for abdominal mass, 15 drug-disease intersection targets genes, 75 related pathways were obtained.Among them, 8 pathways were mainly related to female abdominal neoplasm.Conclusion The general rules of YE Tianshi in treating abdominal mass are treating both phlegm and stasis, regulating Qi and resolving phlegm, promoting blood circulation and removing blood stasis.Its mechanism might be the hormone response and immune response.It was affected by complex multi-targets and multi-pathways related with "hypothalamus-pituitary-ovary reproductive axis" and female abdominal neoplasm’s pathways.