中医药治疗肿瘤相关性抑郁用药规律的挖掘及核心药物作用机制的网络药理学分析

Exploration of Medication Rules for the Treatment of Tumor-associated Depression with Chinese Medicine and Network Pharmacological Analysis of Therapeutic Mechanism of the Core Drugs

【目的】挖掘中医药治疗肿瘤相关性抑郁用药规律及其核心药物的作用机制。【方法】检索中国知网、万方、维普数据库中有关中医药治疗肿瘤相关性抑郁的文献,基于中医传承计算平台挖掘其用药规律,并采用网络药理学方法探讨核心药物的作用机制。【结果】共检索得到中医药治疗肿瘤相关性抑郁的文献70篇,处方69首,中药155味;药物主要归肝、心、脾经,药性以寒、温、平为主,药味多苦、甘、辛。用药频次居前5位的中药分别为柴胡、甘草、白芍、茯苓、郁金,药物关联频次最高的药对是柴胡-白芍。对用药频次居前5位的核心药物柴胡、甘草、白芍、茯苓、郁金进行网络药理学研究,结果显示核心药物的主要活性成分为槲皮素、山柰酚、柚皮素等,主要作用于丝氨酸/苏氨酸蛋白激酶(AKT1)、白细胞介素6(IL-6)、胱天蛋白酶3(CASP3)等靶点,通过5-羟色胺能突触、血脂与动脉粥样硬化、c GMP-PKG等通路发挥抗抑郁作用,主要活性成分可分别与核心靶点结合,且具有较好的亲和力。【结论】肿瘤相关性抑郁的中药治疗以疏肝理气、健脾养心为法,中医药通过多成分、多靶点、多通路发挥抗抑郁作用。

Objective To mine out the medication rules for the treatment of tumor-associated depression with Chinese medicine and to explore the therapeutic mechanisms of the core drugs. Methods Literature on the treatment of tumor-associated depression with Chinese medicine was retrieved from CNKI,Wanfang Data and VIP databases,the medication rules of Chinese medicine were mined based on the TCMICS platform,and network pharmacology approach was used to explore the therapeutic mechanisms of the core drugs. Results A total of70 articles of Chinese medicine therapy for tumor-related depression were obtained,involving 69 prescriptions and 155 herbal medicines. The medicines mainly had the meridian tropism of the liver, heart and spleen meridians,and their properties were characterized by being cold,warm and mild in nature,and by being bitter,sweet and pungent in taste. The top 5 frequently-used herbs were Bupleuri Radix, Glycyrrhizae Radix et Rhizoma,Paeoniae Radix Alba,Poria,and Curcumae Radix,and the herbal pair of Bupleuri Radix-Paeoniae Radix Alba had the highest association frequency. The network pharmacology analysis for the core herbs of Bupleuri Radix,Glycyrrhizae Radix et Rhizoma,Paeoniae Radix Alba,Poria,and Curcumae Radix was performed,and the results showed that the main active compounds of the core drugs were quercetin,kaempferol and naringenin,which mainly acted on the targets of AKT1,interleukin 6(IL-6)and caspase 3(CASP3)through the pathways of serotonergic synapse,lipid and atherosclerosis,and cGMP-PKG. The main active compounds can bind to the core targets separately with good affinity. Conclusion Chinese medicine for treatment of tumor-associated depression is through the methods of soothing liver and regulating qi,invigorating spleen and nourishing heart,and the antidepressant effects of Chinese medicine have the features of multi-components, multi-targets and multi-pathways.