基于数据挖掘及网络药理学探讨中医药治疗阻塞性睡眠呼吸暂停低通气综合征的临床用药规律与作用机制
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R767.13

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广东省中医药局中医药科研项目(20212248);广州中医药大学东莞医院(东莞市中医院)“拔尖人才”培养项目(东中医〔2022〕158 号);全国第七批老中医药专家学术经验继承项目(国中医药办人教函〔2021〕272号)


Explore the Clinical Medication Rules and Mechanisms of Traditional Chinese Medicine in the Treatment of Obstructive Sleep Apnea Hypopnea Syndrome Based on Data Mining and Network Pharmacology
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    摘要:

    目的:探讨中医药治疗阻塞性睡眠呼吸暂停低通气综合征(OSAHS)的组方规律,预测新方药物 组合的潜在作用机制。方法:通过中国生物医学、中国知网、万方、维普等文献数据库,检索建库至 2022 年 10 月所收录的有关中医药治疗 OSAHS 的临床随机对照试验文献,后应用中医传承辅助平台(V2.5)集成的数 据挖掘方法统计检索所获得的文献方药中药频次、性味归经、关联规则、新方组合等数据,并运用网络药理学 方法分析新方组合治疗 OSAHS 的活性成分、核心靶点、作用通路等,最后通过分子对接进行验证。结果:检 索并筛选最终获得有效方剂 78 首,其中茯苓、半夏、甘草、陈皮等使用频次最高;药性以温、寒、平为主, 药味以辛、苦、甘为主,主要归肺、脾、胃经,常用药物组合有“半夏+茯苓”“甘草+茯苓”等,并挖掘核心 组合 4 个,组合成新方 2 首。其中新方组合“川芎-石菖蒲-郁金-当归-桔梗-柴胡-赤芍-红花”与 OSAHS 的 活性成分包括山奈酚、槲皮素、豆甾醇、β-谷甾醇等,作用于白细胞介素-6(IL-6)、趋化因子配体 2(CCL2)、 IL-1β、肿瘤坏死因子(TNF)、内皮型一氧化氮合酶(NOS3)、人 CXC 趋化因子配体 8(CXCL8)、IL-10 等核 心靶点,通过 TNF、IL-17、核转录因子-κB(NF-κB)、Toll 样受体、缺氧诱导因子-1(HIF-1)等多条通路 发挥作用。分子对接结果提示关键活性成分与核心靶点结合性良好。结论:中医药治疗 OSAHS 新方用药多以 化痰顺气、祛瘀开窍为主,并运用网络药理学预测其可能通过多个活性成分,作用于多靶点、多通路发挥疗 效,为其治疗 OSAHS 提供临床理论依据及科学研究方向。

    Abstract:

    Abstract: Objective: To explore the medication rules of traditional Chinese medicine (TCM) in the treatment of obstructive sleep apnea hypopnea syndrome (OSAHS),and predict the potential mechanism of action of new prescription drug combinations. Methods:By using literature databases such as China Biomedical Science, CNKI, Wanfang, and VIP, we searched for clinical randomized controlled trials related to the treatment of OSAHS with TCM,which were included in the database from construction to October 2022. Then,we used data mining methods integrated with the TCM Inheritance Support System (TCMISS,V2.5) to statistically analyze the data obtained from the search,including the frequency of TCM prescriptions,their properties,flavors,meridian tropism,association rules,and combinations of new prescriptions. And network pharmacology methods were used to analyze the active ingredients, core targets,and action pathways of the new combination therapy for OSAHS,and finally verified them through molecular docking. Results: After searching and screening, 78 effective prescriptions were obtained, among which Poria,Pinelliae Rhizoma,Glycyrrhizae Radix et Rhizoma,and Citri Reticulatae Pericarpium were used the most frequently.The medicinal properties were mainly warm, cold, and mild, and the medicinal flavors were mainly acrid, bitter, and sweet. It mainly belongs to the lung, spleen, and stomach meridians. Common drug combinations include " Pinelliae Rhizoma +Poria" and " Glycyrrhizae Radix et Rhizoma +Poria ",and four core combinations have been excavated to form two new prescriptions. The active ingredients of the new combination "Chuanxiong Rhizoma- Acori Tatarinowii Rhizoma- Curcumae Radix-Angelicae Sinensis Radix-Platycodonis Radix-Bupleuri Radix-Paeoniae Radix Rubra- Carthami Flos" and OSAHS include Kaempferol,Quercetin,Stigmasterol,β-glutinosterol,etc.,which acted on core targets such as IL- 6, CCL2, IL- 1β, TNF, NOS3, CXCL8, IL- 10, and passed through multiple pathways such as TNF, IL-17, NF- κB, Toll-like receptors and HIF-1 play the function role. The molecular docking resultes indicate good binding between key active ingredients and core targets. Conclusion:New prescriptions for the treatment of OSAHS with TCM mainly focus on resolving phlegm and promoting qi circulation, removing blood stasis and opening the orifices. Network pharmacology predicts that it may exert therapeutic effects through multiple active ingredients acting on multiple targets and pathways, providing clinical theoretical basis and scientific research direction for its treatment of OSAHS.

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谢燕小,周谨希,孟星汝,蒋紫云,连乐燊.基于数据挖掘及网络药理学探讨中医药治疗阻塞性睡眠呼吸暂停低通气综合征的临床用药规律与作用机制[J].新中医,2023,55(15):17-27

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  • 在线发布日期: 2023-08-13
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