基于数据挖掘清代江浙名医与川派名医治疗血证用药对比研究

目的:基于数据挖掘探讨清代江浙名医治疗血证的用药规律,并与同时期川派治疗血证的代表医家唐容川用药特点进行对比研究。方法:对《清代名医医案精华》所载医案进行收集、整理,采用Microsoft Office Excel 2019建立方药数据库,统计用药频数、药物分类,运用IBM SPSS Statistics 22.0软件对高频药物进行聚类分析,运用IBM SPSS Modeler 18.0 Apriori算法对高频药物进行关联规则分析。结果:共纳入《孟河四家医集》中费伯雄医案、马培之医案、丁甘仁医案、巢崇山医案,《临证指南医案》《湿热病篇》的血证医案,《新安医学名医医案精华》《新安医学内科精华》《新安医集丛刊》血证医案,《钱塘医派》的血证医案中所记载的医案378则,涉及方剂共378首,总用药物频数,其中高频药物(出现频数 ≥ 40) 16种,使用频数最多的是茯苓(207),聚类分析得到有意义的药物聚类4组;关联规则分析得到6组强关联药对。结论:两地医家对血证的病因病机及用药特点上具有共性,也有差异,清代江浙名医治疗血证注重“血病治气”、“见血不止血”,治法以健脾除湿、益气养血、温中止血为主,用药上极具江浙特色,药食同源;后者则以补益气血、疏肝和解为主。两者在血证中对于补益药与止血药的运用是同样看重的。Objective: Based on data mining to explore the medication rules of famous doctors in Jiangsu and Zhejiang in the Qing Dynasty for treating blood evidence, and to conduct a comparative study with the characteristics of medication used by Tang Rongchuan, a representative doctor of the Chuan school for treating blood evidence in the same period. METHODS: The medical cases contained in the Essence of Medical Cases of Famous Doctors of the Qing Dynasty were collected and organized, and Microsoft Office Excel 2019 was used to establish a database of prescription medicines, statistically count the frequency of medication use, drug classification, cluster analysis of high-frequency medicines by using IBM SPSS statistics 22.0 software, and cluster analysis of high-frequency medicines by using IBM SPSS Modeler 18.0. Apriori algorithm was used to analyze the association rules of high-frequency drugs. Results: A total of 378 medical cases recorded in Fei Boxiong’s medical cases, Ma Peizhi’s medical cases, Ding Ganren’s medical cases, and Chao Chongshan’s medical cases in Menghe Four Medical Collections, the blood evidence medical cases in Clinical Guidelines for Medical Cases, and Damp-Heat Diseases, the blood evidence medical cases in Essentials of Famous Physicians of Hsin-An Medicine, Essentials of Internal Medicine in Hsin-An Medicine, and Hsin-An Medical Collections, the blood evidence medical cases in the Qiantang School of Medical Sciences were incorporated, and the total number of formulas involved was 378. The total frequency of drugs used, of which 16 high-frequency drugs (frequency of occurrence ≥ 40), the most frequently used is Poria (207), cluster analysis obtained 4 groups of meaningful drug clusters;association rule analysis obtained 6 groups of strongly associated drug pairs. Conclusion: The etiology and pathogenesis of the blood syndrome and the characteristics of the medicines used by the medical practitioners of the two places have commonalities and differences. The famous doctors of Jiangsu and Zhejiang in the Qing Dynasty treated the blood syndrome by focusing on “treating qi for the blood disease” and “not stopping the bleeding at the sight of the blood”, and the treatments of strengthening the spleen and removing the dampness, benefiting qi to nourish the blood and warming up the middle to stop the bleeding were the major ones, and the medicines used were very characteristic of Jiangsu and Zhejiang. The treatment is based on strengthening the spleen and removing dampness, benefiting qi and nourishing blood, warming the middle and stopping bleeding, and using medicines with the same source of medicine and food. In the latter, tonifying qi and blood, dredging the liver and conciliation were the mainstays. The use of tonic and hemostatic drugs was equally valued in both cases.

基于网络药理学和分子对接探讨紫苏子治疗糖尿病心肌损伤的机制

目的基于网络药理学和分子对接探讨紫苏子治疗糖尿病心肌损伤(DMI)的机制。方法检索TCMSP数据库,筛选出紫苏子的主要活性成分和相关靶点,从Gene Cards和OMIM数据库中筛选获得DMI的相关靶点。将紫苏子的作用靶点与疾病靶点取交集得到紫苏子治疗DMI的潜在靶点,使用STRING 11.0构建PPI网络,并通过网络拓扑分析筛选9个核心靶点。采用Metascape平台分析对交集靶点进行GO和KEGG富集分析。最后运用Auto Dock Vina 1.1.2进行分子对接验证。结果共筛选出105个紫苏子活性成分调控DMI的潜在靶点,通过网络拓扑分析中的degree值筛选出ALB、AKT1、IL6、VEGFA、TNF、TP53、CASP3、MAPK1、EGFR等9个核心靶点;GO富集分析筛选出细胞氮化合物反应、有毒物质反应、无机物反应、细胞成分运动的正调控、炎症反应等15个生物学过程;KEGG富集筛选出癌症通路、PI3K-Akt信号通路、前列腺癌、糖尿病并发症中的AGE-RAGE信号通路、流体剪应力与动脉粥样硬化等;分子对接验证结果显示核心靶点与紫苏子核心成分之间有良好的结合活性。结论本研究表明紫苏子可能通过多靶点、多通路调控DMI,为进一步系统地开展紫苏子单体治疗糖尿病心肌病的研究及临床应用提供理论依据。

肺炎喘嗽的中医药治疗新进展

肺炎喘嗽是儿科呼吸系统常见病、多发病之一,其发生率与死亡率均为首位,被世界卫生组织列为三大重点儿科疾病之一。临床表现为发热、咳嗽、短气、胸满,甚者可出现呼吸困难,表现为鼻翼煽动、点头样呼吸、三凹征等。中医药副作用小,疗效好,降低气道反应,增加机体免疫能力,临床应用广泛,在治疗小儿肺炎喘嗽方面具有良好的前景。