国医大师林天东治疗反流性食管炎的用药规律与核心药对的潜在机制研究

Medication rule and potential mechanism of the core drug pairs in treating reflux esophagitis by LIN Tiandong,the national master of TCM

目的探讨国医大师林天东治疗反流性食管炎(reflux esophagitis,RE)的用药规律与核心药对的潜在作用机制。方法采集2020年1月至2022年1月于海南省中医院国医大师林天东门诊就诊的RE处方,建立处方数据库。采用用药频数统计及关联规则算法挖掘林天东教授治疗RE的核心药对,并利用网络药理学方法对核心药对的作用机制进行分析。结果共有249张处方纳入研究,半夏-沉香为核心药对;半夏-沉香药对中口服生物利用度≥40%的主要活性成分为钓樟烷、环(酪氨酸-苯丙氨酸)二肽、槲皮素、次黄嘌呤核苷、豆甾醇、儿茶素、12,13-环氧-9-羟基十九碳-7,10-二烯酸、新木姜子碱、黄芩苷;半夏-沉香药对治疗RE核心靶点8个,重要通路10条。结论国医大师林天东临床治疗RE的核心药对半夏-沉香可能通过调节机体免疫、抗炎、抗氧化、保护胃黏膜、抗肿瘤等反应发挥治疗作用。

Objective To explore the medication rule and the potential mechanism of core drug pair of LIN Tiandong,the national master of TCM in the treatment of reflux esophagitis(RE).Methods Prescriptions of RE treated in professor LIN Tiandong's clinic of Hainan Provincial Hospital of Traditional Chinese Medicine from January 2020 to January 2022 were collected to establish a prescription database.The drug frequency statistics and association rule algorithm were used to explore the core drug pairs of professor LIN Tiandong in the treatment of RE,and the mechanism of action of the core drug pairs was analyzed by network pharmacology.Results A total of 249 prescriptions were included in the study.Banxia(Pinelliae Rhizoma)-Chenxiang(Aquilariae Lignum Resinatum)was identified as the core drug pair.The main active components of OB≥40%in Banxia(Pinelliae Rhizoma)-Chenxiang(Aquilariae Lignum Resinatum)were linderane,(3S,6S)-3-(benzyl)-6-(4-hydroxybenzyl)piperazine-2,5-quinone,quercetin,hypoxanthine-9-beta-D-ribofuranoside,stigmasterol,nubigenol,12,13-epoxy-9-hydroxynonadeca-7,10-dienoic acid,norboldine,and baicalin.There were 8 core targets and 10 important pathways for the treatment of RE by Banxia(Pinelliae Rhizoma)-Chenxiang(Aquilariae Lignum Resinatum).Conclusion The core drug of Banxia(Pinelliae Rhizoma)-Chenxiang(Aquilariae Lignum Resinatum)of LIN Tiandong(the national master of TCM)'s clinical treatment of RE may play a therapeutic role through regulating immune,anti-inflammatory,antioxidant,gastric mucosa protection,anti-tumor and other reactions.