基于数据挖掘的刘启泉教授治疗慢性萎缩性胃炎用药规律及机制研究

Medication Rules and Mechanism of Professor Liu Qiquan in Treatment of Chronic Atrophic Gastritis Based on Data Mining

目的 基于古今医案云平台及网络药理学方法,探讨刘启泉教授治疗慢性萎缩性胃炎(Chronic atrophic gastritis,CAG)的组方规律及核心药物作用机制,为CAG的治疗提供客观依据。方法 收集刘启泉教授治疗CAG门诊处方,通过古今医案云平台挖掘相关用药规律,对核心药物组合活性成分及CAG潜在靶点进行网络药理学机制分析。结果 共纳入635份医案,涉及176味中药,有42味中药使用频次超过110次,主要为清热药、理气药、补虚药及活血化瘀药;结合高频药物、关联规则及聚类分析得到治疗CAG的核心药物组合为:蒲公英、延胡索、当归、茯苓、郁金、石菖蒲、白芍、莪术、香附。网络药理学分析表明核心药物组合中8-异戊烯基山奈酚、山柰酚、β-谷甾醇等活性成分作用于蛋白激酶B1(Proteinkinase B1,AKT1)、肿瘤抑制因子p53(Tumorsuppressorp53,Tp53)、白介素-6(Interleukin-6,IL-6)、肿瘤坏死因子(Tumor necrosis factor,TNF)等核心靶点;核心药物组合治疗CAG的潜在靶点主要富集在66个细胞组成、99种分子功能和683个生物过程中;生物学通路主要为癌症通路、白介素-17(Interleukin-17,IL-17)信号通路、TNF信号通路、磷脂酰肌醇3-激酶/蛋白激酶B(Phosphoinosi-tide 3-kinase/proteinkinase B,PI3K/Akt)信号通路、p53信号通路等。结论 通过数据挖掘方法较好体现了刘启泉教授治疗CAG的用药规律,即以“肝郁热毒血瘀”为核心病机,以调肝为先,解毒、活血、补虚并用;并初步揭示了刘启泉教授治疗CAG用药的多靶点作用机制,为临床应用提供参考。

Objective To explore the medication rules and core drug mechanisms of Professor Liu Qiquan in the treatment of chronic atrophic gastritis(CAG)based on the ancient and modern medical case cloud platform and network pharmacology methods and provide objective evidence for the treatment of CAG.Methods The outpatient prescriptions of Professor Liu Qiquan for treating CAG were collected.The relevant medication rules were excavated through the ancient and modern medical case cloud platform.The active ingredients of core drug combinations and potential targets of CAG were analyzed via network pharmacology methods.Results A total of 635 medical cases were included,involving 176 drugs,with 42 used more than 110 times,mainly for clearing heat,regulating qi,tonifying deficiency,activating blood,and resolving stasis.In combination of high-frequency drugs,association rules,and cluster analysis,the core drug combination for treating CAG was determined to be Taraxaci Herba,Corydalis Rhizoma,Angelicae Sinensis Radix,Poria,Curcumae Radix,Acori Tatarinowii Rhizoma,Paeoniae Radix Alba,Curcumae Rhizoma,and Cyperi Rhizoma.Network pharmacology analysis showed that active ingredients such as 8-isopentenyl kaempferol,kaempferol,and β-sitosterol in the core drug combination acted on core targets such as protein kinase B1(AKT 1),tumor suppressor p53(TP 53),interalleukin(IL)-6,and tumor necrosis factor(TNF).The potential targets of the core drug combination for treating CAG were mainly enriched in 66 cellular components,99 molecular functions,and 683 biological processes.The main biological pathways included cancer pathway,IL-17 signaling pathway,TNF signaling pathway,phosphoinositide 3-kinase/protein kinase B(PI3K/Akt)signaling pathway,and p53 signaling pathway.Conclusion The data mining method effectively reflects the medication rules of Professor Liu Qiquan in the treatment of CAG,focusing on the core pathogenesis of “liver depression,heat-toxin,and blood stasis”,prioritizing liver regulation,detoxification,promoting blood circulation,and tonifying deficiency simultaneously.It also preliminarily revealed the multi-target mechanism of Professor Liu Qiquan in the treatment of CAG,providing references for clinical application.