摘要
目的:基于“古籍验方-名医验案-计算分析”整合策略对治疗颤病的方剂和医案处方进行挖掘分析与药效预测评价,获得中医治疗颤病的核心方药,为临床应用和新药开发提供参考。方法:检索中国方剂数据库、中国知网(CNKI)获得中医治疗颤病的相关方剂和医案处方,建立颤病方药数据库;采用中医传承计算平台(V3.0)对药物频次、性味归经、中药功效、核心药物、组方关联等用药规律进行分析挖掘,基于网络稳健性的多靶标药物药效预测平台对获得的核心方药进行药效预测评价。在此基础上,整合古籍验方、名医验案、网络分析结果,对获得的核心组方进行综合评判,最终获得其开发的优先等级。结果:古籍验方中共筛选出81首方剂,涉及药物246味;名医验案中共筛选出171首处方,涉及药物278味。使用频次较高的中药多为温性和甘味药,归肝、脾、肾经,功效类别以补虚、平肝息风、活血化瘀、清热、解表药最为多见。通过关联规则和K均值聚类方法获得核心方药由甘草、人参、黄芪、白术、当归、茯苓、天麻、钩藤等高频使用中药组成,药物组合以益气养血为主,兼以息风通络。古籍验方、名医验案的核心组方聚类分析,以及多靶标药物药效预测显示,验案组合1对于疾病网络的扰动性得分最高,且通过进一步比较分析,其与古籍验方分析和名医验案分析结果均保持一致,体现理论传承性、人用经验的使用实践,提示具有最优的开发潜力。相比较而言,验方组合3、验方组合2、验方组合4在当今医家临床实践中应用较少,且网络扰动性得分排名靠后,其开发价值仍然值得深入探讨。结论:中医临床治疗颤病均重视肝、脾、肾的调理,在补虚药基础上辨证加用平肝息风、活血化瘀等药物。获得的以甘草、当归、白芍、黄芪、茯苓、白术(验案组合1)为基础的组方,具有最优的潜在开发价值,形成的“古籍验方-名医验案-计算分析”整合策略,可用于中药新药候选处方的筛选。
Objective:Based on the integrated strategy of"empirical prescriptions in ancient booksmedical cases by prestigious doctors-computational analysis",this study aims to explore and analyze the prescriptions and medical cases for treating tremors in traditional Chinese medicine (TCM), predict theirefficacy, and obtain the core prescriptions for treating tremors in TCM, providing references for clinicalapplication and new drug development. Method: The Chinese Medicine Prescription Database and the ChinaNational Knowledge Infrastructure (CNKI) were searched for relevant prescriptions and medical cases fortreating tremors in TCM to establish a database of prescriptions for tremors. The Traditional Chinese MedicineInheritance Computer System (V3.0) was used to analyze and explore the medication rules including drugfrequency, properties, flavor, meridian tropism, and pharmacological effects, as well as core drugs and formulaassociations. A multi-target drug efficacy prediction platform based on network robustness was used to evaluatethe predicted efficacy of the core prescriptions obtained. Based on the integration of ancient prescriptions,prestigious doctors' medical cases, and network analysis results, the priority level of the developed prescriptionswas determined through comprehensive evaluation. Result: A total of 81 ancient prescriptions were screened,involving 246 drugs, and 171 prescriptions were screened from prestigious doctors' medical cases, involving278 drugs. The frequently used TCM drugs were mostly warm in nature and sweet in flavor, mainly acting on theliver, spleen, and kidney meridians. In terms of efficacy, they were mainly effective in tonifying deficiency,soothing liver and extinguishing wind, activating blood and resolving blood stasis, clearing heat, and resolvingexterior. Through association rules and K-means clustering, the core prescriptions were composed of highfrequencydrugs such as Glycyrrhizae Radix et Rhizoma, Ginseng Radix et Rhizoma, Astragali Radix,Atractylodis Macrocephalae Rhizoma, Angelicae Sinensis Radix, Poria, Gastrodiae Rhizoma, and UncariaeRamulus Cum Uncis. Drug combinations mainly focused on tonifying Qi and nourishing blood, with theadditional functions of calming wind and dredging collaterals. Clustering analysis of core prescriptions fromancient prescriptions and prestigious doctors' medical cases, as well as multi-target drug efficacy prediction,showed that Combination 1 had the highest disturbance score on the disease network. Furthermore, comparativeanalysis revealed consistent results with both the analysis of ancient prescriptions and prestigious doctors'medical cases, indicating its optimal development potential based on theoretical inheritance and empiricalpractice. In comparison, Combinations 3, 2, and 4 were less utilized in contemporary clinical practice, withlower rankings in network disturbance scores, suggesting that their development value still warranted furtherexploration. Conclusion: TCM clinical treatment of tremors emphasizes the regulation of the liver, spleen, andkidney. In line of syndrome differentiation, drugs potent in soothing liver, extinguishing wind, activating blood,and resolving blood stasis are added based on deficiency-tonifying drugs. The core prescriptions based onGlycyrrhizae Radix et Rhizoma, Angelicae Sinensis Radix, Paeoniae Radix Alba, Astragali Radix, Poria, andAtractylodis Macrocephalae Rhizoma (combination 1) have the highest potential development value. Theintegrated strategy "empirical prescriptions in ancient books-medical cases by prestigious doctors-computationalanalysis" can be used for the screening of candidate prescriptions for new TCM drugs.
作者
王欢欢
常梦丽
李煜
张丰荣
徐核
张毅
唐仕欢
WANG Huanhuan;CHANG Mengli;LI Yu;ZHANG Fengrong;XU He;ZHANG Yi;TANG Shihuan(Hospital of Integrated Chinese and Western Medicine,Tianjin University of Traditional Chinese Medical,Tianjin 300100,China;Institute of Chinese Materia Medica,China Academy of Chinese Medical Sciences,Beijing 100700,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2024年第12期194-202,共9页
Chinese Journal of Experimental Traditional Medical Formulae
基金
中国中医科学院科技创新工程项目(CI2021A03705
CI2023E001TS)
国家重点研发计划项目(2018YFC1704101)。
关键词
颤病
古籍验方
名医验案
计算分析
用药规律
tremor
empirical prescriptions in ancient books
medical cases by prestigious doctors
computational analysis
medication rule
