| 吴嘉宝,赵霞,汪受传,等.基于数据挖掘及网络药理学探讨运脾法治疗儿童便秘的用药规律及机制[J].浙江中医药大学学报,2024,48(8):1033-1049. |
| 基于数据挖掘及网络药理学探讨运脾法治疗儿童便秘的用药规律及机制 |
| Analysis of Medication Rules and Mechanism in Treatment of Children with Functional Constipation by Activating the Spleen Based on Data Mining and Network Pharmacology |
| DOI：10.16466/j.issn1005-5509.2024.08.020 |
| 中文关键词: 数据挖掘 网络药理学 运脾法 儿童 功能性便秘 中医药 |
| 英文关键词: data mining network pharmacology activating the spleen children functional constipation Chinese medicine |
| 基金项目:江苏省中医药领军人才项目(SLJ0224)；江苏高校优势学科建设工程资助项目(035062005001)；江苏省中医院第三批高峰学术人才培养对象(Y2021RC21)；江苏省研究生科研与实践创新计划项目(SJCX21_0722) |
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| 中文摘要: |
| [目的] 结合数据挖掘及网络药理学，探讨运脾法治疗儿童功能性便秘的用药规律及作用机制。[方法] 收集562例功能性便秘患儿病案，采用SPSS Statistic 24.0软件进行聚类分析，SPSS Modeler 18.0软件进行关联规则分析，Liquorice软件进行复杂网络分析，得出核心方药。运用中药系统药理学数据库与分析平台(Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform，TCMSP)、中药分子机制生物信息学分析工具(Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine，BATMAN-TCM)数据库筛选核心方活性成分及靶点，通过基因组注释数据平台(Genome Annotation Database Platform，GeneCards)数据库筛选功能性便秘相关靶点，取交集后获得预测靶标。基于蛋白质基因相互作用分析(Search Tool for the Retrieval of Interacting Genes/Proteins，STRING)数据库构建靶基因蛋白互作网络(protein-protein interaction，PPI)，利用Cytoscape 3.8.0软件建立核心方成分-便秘-靶点网络图，借助Network Analyzer工具进行拓扑分析，确定核心靶点。基于STRING数据库，使用R语言4.2.2进行基因本体(gene ontology，GO)功能富集与京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes，KEGG)通路富集分析。[结果] 所纳病案包含1 121诊次方药记录，各疗程的症状改善率在86%～97%，便秘三大主症的改善率均在90%左右。涉及中药119味，药性以寒、平为主，药味以苦、甘居多，归经多属胃、脾。通过药物关联、聚类和复杂网络分析得到9味药物构成的核心组方。核心组方调治便秘的主要活性成分为槲皮素、甲基庚烯酮、胆汁三烯、烟酸、木犀草素、山柰酚、汉黄芩素。关键靶点包括前列腺素内过氧化物合酶2(prostaglandin-endoperoxide synthase 2，PTGS2)、V-Jun肉瘤病毒17癌基因同源物(V-Jun sarcoma virus 17 oncogene homolog，JUN)、蛋白激酶B1(protein kinase B1，AKT1)、磷酸肌醇-3-激酶调节亚基1(phosphoinositide-3-kinase regulatory subunit 1，PIK3R1)、磷脂酰肌醇-3-激酶α催化亚基(phosphatidylinositol-4，5-bisphosphate-3-kinase catalytic subunit alpha isoform，PIK3CA)。对炎症相关通路如磷脂酰肌醇-3-激酶/蛋白激酶B(phosphatidylinositol-3-kinase/protein kinase B，PI3K/AKT)的调节可能是核心组方改善便秘的作用机制。[结论] 运脾法治疗小儿便秘核心方包括麸炒枳实、厚朴、生白术、鸡内金、焦山楂、连翘、决明子、火麻仁、胡黄连，其主要成分可能通过影响炎症因子水平、修复肠道黏膜以恢复肠道平滑肌功能，改善便秘症状，对运脾法的临床应用及儿童功能性便秘的中医药治疗有一定借鉴意义。 |
| 英文摘要: |
| [Objective] To analyze the medication rules and mechanism in treatment of children with functional constipation(FC) by activating the spleen. [Methods] Collecting 562 cases of children with functional constipation， cluster analysis was conducted using SPSS Statistics 24.0 software， association rule analysis was performed using SPSS Modeler 18.0 software， and complex network analysis was carried out using Liquorice software to derive the core formula. The active ingredients and targets of the core formula were screened using Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP) and Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine(BATMAN-TCM)， the targets related to FC were screened by Genome Annotation Database Platform(GeneCards)， and the predicted targets were obtained after taking the intersection. Based on the Search Tool for the Retrieval of Interacting Genes/Proteins(STRING) database， the target gene protein-protein interaction(PPI) network was constructed， Cytoscape 3.8.0 software was used to build the core formula component-constipation-target network map， and topology analysis was performed with the help of Network Analyzer tool to identify the core targets. Based on the STRING database， gene ontology(GO) functional enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis were performed by using R language 4.2.2. [Results] The cases contained 1 121 prescriptions. The improvement rate of symptoms in each course was 86% to 97%， and the improvement rate of the three main symptoms of constipation was around 90%. Drug properties were mainly cold and flat， mostly were bitter and sweet. The drugs commonly belonged to the stomach and spleen. The core formula was obtained by drug association， clustering and complex network analysis， and was composed of nine drugs. The main active ingredients of the core formula were quercetin， methylheptenone， bile triene， niacin， lignan， kaempferol and baicalin. The key targets included prostaglandin-endoperoxide synthase 2(PTGS2)， V-Jun sarcoma virus 17 oncogene homolog(JUN)， protein kinase B1(AKT1)， phosphoinositide-3-kinase regulatory subunit 1(PIK3R1)， phosphatidylinositol-4，5-bisphosphate-3-kinase catalytic subunit alpha isoform(PIK3CA)， and the regulation of inflammation-related pathways such as phosphatidylinositol-3-kinase/protein kinase B(PI3K/AKT) may be the mechanism of action of the core formula relieving constipation. [Conclusion] The core formula for the treatment of pediatric constipation by activating-spleen includes Zhishi(Aurantii Fructus Immaturus)， Houpo(Magnoliae Officinalis Cortex)， Baizhu(Atractylodis Macrocephalae Rhizoma)， Jineijin(Galli Gigerii Endothelium Corneum)， Shanzha(Crataegi Fructus)， Lianqiao(Forsythiae Fructus)， Juemingzi(Cassiae Semen)， Huomaren(Cannabis Fructus)， Huhuanglian(Picrorhizae Rhizoma)， whose main components may affect the level of inflammatory factors and repairing the intestinal mucosa to restore the function of the intestinal smooth muscle， which has certain implications for the clinical application of the method of activating the spleen and the Chinese medicine treatment of FC in children. |
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