刘敏如教授治疗多囊卵巢综合征胞中脂膜壅塞诸证的用药规律

Professor LIU Minru's Medication Rule in Treatment of Polycystic Ovary Syndrome(Intracellular Lipid Membrane Congestion Syndrome)

目的:分析总结刘敏如教授治疗多囊卵巢综合征胞中脂膜壅塞诸证的用药规律及核心处方,探索其潜在作用机制。方法:运用双平台开展数据挖掘,分析刘教授治疗本病的处方用药规律,提取核心处方;以网络药理学方法获取核心处方有效成分,构建中药-有效成分-靶点网络,分析其潜在作用机制。结果:纳入医案处方321张,涉及178味中药,成方颗粒28种。药物主归肝、肾经,味以甘、辛、苦为主,性多温、平、微寒;常用药对包括山药-熟地黄、川芎-当归、柴胡-枳壳、皂角刺-莪术等,常用血府逐瘀汤、四物汤、养精种玉汤、左归丸、四逆散组方。核心处方由当归、白芍、皂角刺、淫羊藿等12味药物组成,含74个有效成分,核心成分有槲皮素、木犀草素、山柰酚、非瑟酮、β-谷甾醇等;发现关键靶点37个,涉及磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(Akt)、丝裂原活化蛋白激酶(MAPK)、Janus酪氨酸蛋白激酶(JAK)/信号转导与转录激活因子(STAT)等信号通路。结论:该病虚实错杂,刘教授围绕“肾虚为本,痰瘀为标”的核心病机,在“肾气为根,保阴为本”“育阴涵阳”的学术思想指导下,平补肾中阴阳,养精血顾其本,散结、活血理气治其标;遣药组方思路严谨,核心处方具有多成分、多靶点、多通路综合调控的特点。

Objective:To analyze and sum up the medication rule and the core prescription of Professor LIU Minru in the treatment of polycystic ovary syndrome(intracellular lipid membrane congestion syndrome)and explore the effect mechanism underlying the medication.Method:Two platforms were used to carry out data mining to analyze the characteristics and rules of Professor LIU's prescriptions for the treatment of this disease.Network pharmacology was used to further clarify active ingredients in the core prescription,and a traditional Chinese medicine-active ingredient-target network was constructed,with the potential mechanism of action analyzed.Result:A total of 321 prescriptions were included in the medical records,involving 178 Chinese medicinals and 28 kinds of formula granules.The Chinese medicinals mainly act on the liver and kidney meridians,whose main tastes were sweetness,pungency,and bitterness and properties were mainly warm,mild,and slightly cold.Commonly used medicine pairs include Dioscoreae Rhizoma-Rehmanniae Radix Praeparata,Chuanxiong Rhizoma-Angelicae Sinensis Radix,Bupleuri Radix-Aurantii Fructus,and Gleditsiae Spina-Curcumae Rhizoma.The commonly used formulas are Xuefu Zhuyutang,Siwugang,Yangjing Zhongyutang,etc.The core prescription is composed of 12 Chinese medicinals such as angelica,white peony,saponaria thorn,and epimedium,containing 74 active ingredients,including quercetin,luteolin,kaempferol,fisetin,andβ-sitosterol.A total of 37 key targets were found,involving phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt),mitogen-activated protein kinase(MAPK),Janus protein tyrosine kinase(JAK)/signal transduction and activator of transcription(STAT),and other signaling pathways.Conclusion:The pathogenesis of this disease is complex.Professor LIU adheres to the pathogenesis of"kidney deficiency as the root cause,and phlegm retention as the symptom".Under the guidance of the academic ideology of"kidney Qi as the root,and protecting Yin as the foundation"and"nurturing Yin to support Yang",she takes into account Yin and Yang in kidney tonic,replenishes and consolidates the essence and blood,and relieves manifestations by dissipating mass,activating blood,and regulating Qi.She has a rigorous thinking in formulating prescriptions.The core prescription has the characteristics of comprehensive regulation by multiple components at multiple targets in multiple pathways.