Analysis of Medication Rules and Mechanism of Modern Renowned Traditional Chinese Medicine Physician in Treating Pediatric Enuresis Based on Data Mining and Network Pharmacology
Abstract:Objective:To analyze the medication rules of modern renowned traditional Chinese medicine (TCM) physicians in treating pediatric enuresis based on data mining, and to investigate its mechanism using network pharmacology. Methods: Relevant literature on the treatment of pediatric enuresis by modern renowned TCM physicians was retrieved from the China National Knowledge Infrastructure (CNKI),Wanfang Data Knowledge Service Platform (Wanfang),and China Science and Technology Journal Database (VIP). The search period spanned from the inception of each database to December 31,2024. After screening,the distribution of frequency of herb use and the herb properties,flavors,and meridian tropisms were statistically analyzed. Association analysis,correlation analysis, and cluster analysis were performed to identify the core prescription. The main active components of the core prescription were screened via the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and the HERB database, and their corresponding targets were predicted. Disease targets for enuresis were identified using the DrugBank, The Human Gene Database (GeneCards), Therapeutic Target Database (TTD), and Online Mendelian Inheritance in Man (OMIM) databases. Overlapping targets shared between the drug components and the disease were obtained using R software. The Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database was used to construct a protein-protein interaction (PPI) network for the overlapping targets. Gene Ontology (GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were further conducted using R software. Finally,molecular docking was performed using AutoDock Tools and PyMOL software to validate the binding affinity between the core active components and key disease targets. Results:A total of 132 prescriptions involving 195 distinct Chinese herbal medicines were included. The herbs used were predominantly warm in property and neutral in nature,with sweet,bitter,and pungent being the most common flavors. They primarily attributed to the kidney and lung meridians. Association analysis, correlation analysis, and cluster analysis identified the core prescription consisting of six herbs: Alpiniae Oxyphyllae Fructus, Dioscoreae Rhizoma, Linderae Radix,Mantidis Oötheca ,Acori Tatarinowii Rhizoma,and Astragali Radix. Network pharmacology analysis identified 51 active components from the core prescription,corresponding to 728 targets,and 238 disease targets for enuresis, resulting in 49 overlapping targets. The main active component identified was Boldine. The five key targets were neuronal acetylcholine receptor subunit alpha-4 (CHRNA4), 5-hydroxytryptamine receptor 2A (HTR2A), opioid receptor mu 1 (OPRM1),dopamine receptor D2 (DRD2),and solute carrier family 6 member 4 (SLC6A4). GO functional enrichment analysis mainly involved the G protein-coupled receptor signaling pathway, synaptic membrane, and G protein-coupled amine receptor activity. KEGG enrichment analysis primarily involved signaling pathways such as neuroactive ligand-receptor interaction, serotonergic synapse, and endocrine resistance. Molecular docking results indicated that Boldine had good binding affinity with all five key targets. Conclusion:Modern renowned TCM physicians commonly use herbs that are warm in property,sweet in flavor,and primarily attribute to the kidney and lung meridians for treating enuresis. The core prescription is composed of Alpiniae Oxyphyllae Fructus,Dioscoreae Rhizoma, Linderae Radix, Mantidis Oötheca, Acori Tatarinowii Rhizoma, and Astragali Radix. Further network pharmacology analysis suggests that this core prescription may exert its therapeutic effect on urinary control by regulating neural signaling transmission and sleep-wake modulation pathways. Boldine, a component found in Linderae Radix, may be its key active substance.