基于数据挖掘和网络药理学探讨王孟庸治疗慢性肾小球肾炎用药规律及机制

Study on the Medication Rules and Mechanisms of WANG Mengyong in the Treatment of Chronic Glomerulonephritis Based on Data Mining and Network Pharmacology

目的:基于中医传承辅助平台及网络药理学方法探讨国家级名老中医王孟庸教授治疗慢性肾小球肾炎的用药规律和作用机制,为慢性肾小球肾炎的防治提供中医方案。方法:收集2013年1月1日至2021年8月30日王孟庸治疗慢性肾小球肾炎的门诊病历,运用关联规则、复杂系统熵聚类等方法对其用药规律进行分析,运用网络药理学及分子对接方法阐述核心用药的作用机制。结果:筛选出治疗慢性肾小球肾炎处方369份,分析得出王孟庸教授治疗慢性肾小球肾炎常用药物有黄芪、女贞子、当归、茯苓等61种,黄芪、女贞子、墨旱莲、熟地黄、当归、黄精、白芍、白术、茯苓、陈皮、牡丹皮11味中药为王孟庸教授核心处方用药。槲皮素、木犀草素、山奈酚、谷甾醇等成分是核心处方药物治疗慢性肾小球肾炎的主要成分,涉及苏丝氨酸特异性蛋白激酶1(AKT1)、血管内皮生长因子A(VEGFA)、肿瘤坏死因子(TNF)、白细胞介素6(IL6)等核心靶点。结论:王孟庸教授治疗慢性肾小球肾炎寒温并用,善用墨旱莲、女贞子组合护肾阴,以及五皮饮利水渗湿。核心药物治疗慢性肾小球肾炎机制可能与其抗氧化、抗炎、减少肾缺血再灌注期间的肾小管凋亡和炎症反应有关。

Objective:To explore the medication rules and action mechanism of Professor WANG Mengyong,a nationally renowned traditional Chinese medicine practitioner,in the treatment of chronic glomerulonephritis based on the auxiliary platform of traditional Chinese medicine(TCM)inheritance and network pharmacology,so as to provide a TCM scheme for the prevention and treatment of chronic glomerulonephritis.Methods:The outpatient medical records of WANG Mengyong in the treatment of chronic glomerulonephritis from January 1,2013 to August 30,2021 were collected,the medication rules was analyzed by association rules,complex system entropy clustering and other methods,and the action mechanism of core drugs was expounded by network pharmacology and molecular docking methods.Results:361 prescriptions for the treatment of chronic glomerulonephritis were selected.The analysis showed that 61 kinds of drugs commonly used by Professor WANG Mengyong in the treatment of chronic glomerulonephritis,including Huangqi(Astragali Radix),Nuzhenzi(Ligustri Lucidi Fructus),Danggui(Angelicae Sinensis Radix),Fuling(Poria),and etc,.It was considered that 11 traditional Chinese medicines such as Huangqi(Astragali Radix),Nuzhenzi(Ligustri Lucidi Fructus),Mohanlian(Ecliptae Herba),Shoudihuang(Rehmanniae Radix Praeparata),Danggui(Angelicae Sinensis Radix),Huangjing(Polygonati Rhizoma),Baishao(Paeoniae Radix Alba),Baizhu(Atractylodis Macrocephalae Rhizoma),Fuling(Poria),Chenpi(Citri Reticulatae Pericarpium),and Mudanpi(Moutan Cortex)were the core prescription drugs of Professor WANG Mengyong.It was found that quercetin,luteolin,kaempferol and sitosterol were the main components of core prescription drugs in the treatment of chronic glomerulonephritis,involving core targets such as threonine specific protein kinase 1(AKT1),vascular endothelial growth factor A(VEGFA),tumor necrosis factor(TNF)and interleukin-6(IL-6).Conclusion:WANG Mengyong treated chronic glomerulonephritis with the combination of cold and warm,and made good use of the combination of Mohanlian(Ecliptae Herba)and Nuzhenzi(Ligustri Lucidi Fructus)to protect kidney Yin,and Wupi Yin(五皮饮)to promote water and dampness.The mechanism of core drug treatment for chronic glomerulonephritis may be related to its antioxidant,anti-inflammatory,and reduction of renal tubular apoptosis and inflammatory response during renal ischemia-reperfusion.