针灸治疗糖尿病胃轻瘫作用机制探析

Analysis of Mechanism of Acupuncture and Moxibustion in Treating Diabetic Gastroparesis

目的:借鉴网络药理学思路挖掘针灸治疗糖尿病胃轻瘫(DGP)的核心用穴,预测核心用穴治疗DGP的作用机制。方法:检索2020年1月前国内外公开发表的有关针灸治疗DGP的所有文献,运用Excel软件建立针灸治疗DGP的腧穴处方及影响因子指标数据库,采用IBM SPSS Modeler 18.0软件对腧穴相关数据进行关联分析;采用DAVID 6.8在线分析工具对关键靶点进行功能及通路富集分析,并运用Omicshare对富集结果进行可视化。结果:本研究纳入文献31篇,涉及17个腧穴,通过关联规则分析得出,足三里、三阴交、梁门、中脘是针灸治疗DGP的核心用穴;借鉴网络药理学分析方法发现,核心用穴治疗DGP时可使内皮素-1(ET-1)、胰岛素样生长因子-1(IGF-1)等20个因子表达下调,超氧化物歧化酶(SOD)、Rho相关蛋白激酶(ROCK)等19个因子表达上调,对该39个差异表达的因子进行富集分析得出,核心用穴治疗DGP的作用涉及生物过程、细胞组成、分子功能等多个方面,并可能主要通过调控丝裂原活化蛋白激酶(MAPK)信号通路而实现。结论:足三里、三阴交、梁门、中脘是针灸治疗DGP的核心用穴,MAPK信号通路是核心用穴治疗DGP的主要靶点。

Objective:To excavate the core acupoints of acupuncture and moxibustion to treat diabetic gastroparesis(DGP),and predict the core acupoints mechanism in the treatment of DGP based on network pharmacology.Methods:All literatures on acupuncture and moxibustion treatment of DGP published at home and abroad before January 2020 were searched.Excel software was used to establish the acupoint prescription and influence factor index database of acupuncture and moxibustion treatment of DGP,and IBM SPSS Modeler 18.0 software was used for correlation analysis of acupoint related data.DAVID 6.8 online analysis tool was used for functional and pathway enrichment analysis of key targets,and Omicshare was used to visualize the enrichment results.Results:Total 31 literatures were included in this study,involving 17 acupoints.Through association rule analysis,it was concluded that Zusanli(ST36),Sanyinjiao(SP6),Liangmen(ST21)and Zhongwan(RN12)were the core acupoints for acupuncture treatment of DGP.Referring to the network pharmacology analysis method,it was found that the core acupoint treatment of DGP could down-regulate the expression of 20 factors,such as endothelin-1(ET-1)and insulin-like growth factor-1(IGF-1),and up-regulate the expression of 19 factors,such as superoxide dismutase(SOD)and Rho associated coiledcoil forming protein kinase(ROCK).The enrichment analysis of the 39 differentially expressed factors showed that,the effect of core acupoint therapy on DGP involves biological process,cell composition,molecular function and other aspects,and may be mainly achieved through the regulation of mitogen-activated protein kinase(MAPK)signaling pathway.Conclusions:Zusanli,Sanyinjiao,Liangmen and Zhongwan are the core acupuncture acupoints for the treatment of DGP,and MAPK signaling pathway is the main target for the treatment of DGP.