基于数据挖掘及网络药理学探讨射血分数保留性心力衰竭的用药规律及作用机制

Medication rule and mechanism of action for heart failure with preserved ejection fraction:A study based on data mining and network pharmacology

目的:探讨中医药治疗射血分数保留性心力衰竭(HFPEF)的用药规律及作用机制。方法:收集中国知网2003年1月31日至2022年12月31日期间收录的中医药治疗HFPEF的相关文献,使用中医传承辅助平台V2.50进行用药规律分析,将核心药物进行网络药理学分析。结果:数据挖掘共纳入112个有效方剂,涉及127味中药,使用频次由高到低依次为黄芪、丹参、人参等,药性以温、寒、平为主,药味多甘、苦、辛,多归心、脾、肺经,共得到17个频次≥23次的药物组合,包括9味中药,7个新方组合;核心药物包括丹参、黄芪、葶苈子、人参、桂枝等。网络药理学分析得出核心药物共108个活性成分,可能作用靶点91个,与HFPEF共有52个交集靶点,主要包括肿瘤坏死因子(TNF)、白细胞介素-6(IL-6)、细胞肿瘤抗原p53(TP53)、白细胞介素-1β(IL-1β)、表皮生长因子受体(EGFR)等。核心药物主要作用于胞外、调控细胞增殖及凋亡、通过炎症反应及抗动脉粥样硬化以延缓HFPEF进程。结论:中医药治疗HFPEF的总治则为益气养阴、化瘀行水;网络药理学分析表明核心药物通过多成分、多靶点、多通路共同治疗HFPEF。

Objective:To investigate the medication rule and mechanism of action for heart failure with preserved ejection fraction(HFPEF) based on data mining and network pharmacology.Methods:CNKI was searched for articles on traditional Chinese medicine(TCM) treatment of HFPEF published from January 31,2003 to December 31,2022.Traditional Chinese Medicine Inheritance Support System V2.50 was used for medication rule analysis,and network pharmacology was performed for core drugs.Results:A total of 112 valid prescriptions were obtained by data mining,involving 127 TCM drugs,such as Astragalus membranaceus,Salvia miltiorrhiza,and Panax ginseng in the order of frequency of use.Most drugs were warm,cold or neutral in nature and had a sweet,bitter or pungent taste,and they mainly entered the heart,spleen,and lung meridians.A total of 17 drug combinations with a frequency of ≥23 times were obtained,involving 9 TCM drugs and 7 combinations of new prescriptions.Core drugs included Salvia miltiorrhiza,Astragalus membranaceus,Semen Lepidii,Panax ginseng,and Ramulus Cinnamomi.Network pharmacology obtained 108 active components of core drugs,91 possible action targets,and 52 intersecting targets with HFPEF,such as tumor necrosis factor,interleukin-6,TP53,interleukin-1β,and epidermal growth factor receptor.The core drugs mainly acted on extracellular structures,regulated cell proliferation and apoptosis,and delayed the progression of HFPEF by inhibiting inflammatory response and atherosclerosis.Conclusion:The principle of TCM treatment of HFPEF is benefiting Qi and nourishing Yin and resolving stasis and promoting the flow of water,and network pharmacology shows that the core drugs exert a therapeutic effect on HFPEF through multiple components,targets,and pathways.