国医大师吕仁和教授治疗糖尿病肾病核心药物组合及作用机制研究

Study on the core drug combinations and mechanism of National Physician Master and Professor LüRenhe in the treatment of diabetic nephropathy

目的挖掘吕仁和教授治疗糖尿病肾病的核心药物组合,探讨其多成分-多靶点-多通路的协同作用机制。方法收集2018年1月—2019年4月于北京中医药大学东直门医院吕仁和教授门诊就诊的糖尿病肾病患者病案,建立医案数据库。应用频数统计及关联规则算法挖掘吕仁和教授治疗糖尿病肾病的核心药物组合,并利用网络药理学方法对核心药物组合的作用机制进行分析。结果吕仁和教授治疗糖尿病肾病的核心药物组合为丹参、赤芍、牡丹皮。通过检索共得到105种化合物、47个化合物与疾病共同作用的关键靶点。对47个关键靶点进行富集分析后提示,丹参、赤芍、牡丹皮治疗糖尿病肾病可能与癌症中的蛋白多糖、糖尿病并发症中的AGE-RAGE信号通路、癌症通路、内分泌抵抗、EGFR酪氨酸激酶抑制剂耐药性、前列腺癌等信号通路有关。结论吕仁和教授治疗糖尿病肾病注重丹参、赤芍、牡丹皮药物组合的运用,本研究初步揭示了丹参、赤芍、牡丹皮多成分、多靶点、多通路的作用机制,为丹参、赤芍、牡丹皮的分子机制研究提供了一定的基础。

Objective To mine the core drug combinations of Professor LüRenhe in the treatment of diabetic nephropathy and explore its synergistic mechanism of multi-component,multi-target and multi-pathway.Methods The medical records of patients with diabetic nephropathy treated in the Outpatient Clinic of Professor LüRenhe of Dongzhimen Hospital of Beijing University of Chinese Medicine from January 2018 to April 2019 were collected and the medical record database was established.The frequency statistics and association rules algorithm were used to mine the core drug combinations of Professor LüRenhe in the treatment of diabetic nephropathy,and the network pharmacology method was used to analyze the mechanism of the core drug combinations.Results The core drug combinations of Professor LüRenhe in the treatment of diabetic nephropathy were Radix Salviae Miltiorrhizae,Radix Paeoniae Rubra and Cortex Moutan Radicis.A total of 105 compounds were obtained,and 47 of them were the key targets of interaction with diseases.The 47 key targets were enriched and analyzed,which showed that the treatment of diabetic nephropathy with Radix Salviae Miltiorrhizae,Radix Paeoniae Rubra and Cortex Moutan Radicis may be related to proteoglycan in cancer,AGE-RAGE signal pathway in diabetic complications,cancer pathway,endocrine resistance,drug resistance of EGFR tyrosine kinase inhibitor,prostate cancer,and so on.Conclusion Professor LüRenhe pays attention to the combination of Radix Salviae Miltiorrhizae,Radix Paeoniae Rubra and Cortex Moutan Radicis in the treatment of diabetic nephropathy.This study preliminarily reveals the multi-component,multi-target and multi-pathway mechanism of Radix Salviae Miltiorrhizae,Radix Paeoniae Rubra and Cortex Moutan Radicis,which provides a basis for the study of the molecular mechanism of Radix Salviae Miltiorrhizae,Radix Paeoniae Rubra and Cortex Moutan Radicis.