摘要
目的总结国医大师丁樱治疗IgA肾病的用药规律,提取核心基础方,预测核心基础方治疗IgA肾病的潜在作用机制。方法收集整理丁樱教授治疗IgA肾病的门诊电子病历,提取方药信息,对纳入中药的使用频数、性味归经进行统计,并对其进行关联规则分析和系统聚类分析,总结用药规律及挖掘核心基础方。利用网络药理学和分子对接技术探究核心基础方治疗IgA肾病的潜在作用机制。结果共纳入199首处方,涉及113味中药,总频数为3074次。频数统计发现,丁樱教授治疗IgA肾病用药特点为性寒,味甘、苦,归肝、肺、脾经药物居多,以补虚药、清热药、止血药、活血化瘀药、收涩药为主;关联规则和系统聚类分析获得核心基础方为当归、地黄、黄芩、连翘、墨旱莲、茜草、仙鹤草、牡丹皮、小蓟、大蓟、女贞子、白及、甘草。用网络药理学方法获得核心基础方的活性成分184个,446个药物相关靶点,疾病潜在作用靶点593个,共得到25个交集共同靶点。通过蛋白质-蛋白质相互作用网络(PPI)分析确定了5个核心靶点,依次为IL-6、IL-1β、IL-10、FN1、PTGS2。靶点基因富集于AGE-RAGE、TNF、JAK-STAT等信号通路。对关键靶点与核心药物活性成分进行分子对接,显示二者具有较好的结合活性。结论丁樱教授临证治疗IgA肾病时紧扣“热(毒)、虚、瘀”病机特点,治以清热凉血、益气养阴、活血化瘀为主。核心基础方可能通过槲皮素、山柰酚和木犀草素等多种成分,介导IL-6、IL-1β、IL-10、FN1等核心靶点,AGE-RAGE、JAK-STAT、TNF等多条信号通路,从而发挥治疗IgA肾病的作用。
Objective To summarize the medication patterns of national traditional Chinese medicine(TCM)master Ding Ying in treating IgA nephropathy(IgAN),extract the core prescription,and predict the potential therapeutic mechanisms underlying this core formulation.Methods Electronic medical records of Professor Ding Ying’s clinical treatment of IgAN were collected and analyzed.Herbal prescriptions were extracted,and the frequency,properties,flavors,and meridian tropism of the included herbs were statistically analyzed.Association rule analysis and systematic clustering were employed to identify medication patterns and the core prescription.Network pharmacology and molecular docking techniques were utilized to explore the potential mechanisms of the core formulation in treating IgAN.Results A total of 199 prescriptions involving 113 herbs were included,with a cumulative frequency of 3074.Frequency analysis revealed that Professor Ding Ying predominantly used herbs with cold properties,sweet and bitter flavors,and contribute to the liver,lung,and spleen meridians.The main categories of herbs were tonics,heat-clearing agents,hemostatics,blood-activating and stasis-resolving agents,and astringents.Association rule analysis and systematic clustering identified the core prescription as follows:Angelicae Sinensis Radix,Rehmanniae Radix,Scutellariae Radix,Forsythiae Fructus,Ecliptae Herba,Rubiae Radix et Rhizoma,Agrimoniae Herba,Moutan Cortex,Cirsii Herba,Cirsii Japonici Herba,Ligustri Lucidi Fructus,Bletillae Rhizoma,Glycyrrhizae Radix et Rhizoma.Network pharmacology analysis identified 184 active components,446 drug-related targets,and 593 disease-associated targets,with 25 overlapping targets.Through protein-protein interaction(PPI)network analysis,five core targets were identified:IL-6,IL-1β,IL-10,FN1,and PTGS2.Gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment revealed that these targets were primarily associated with the AGE-RAGE,TNF,and JAK-STAT signaling pathways.Molecular docking confirmed strong binding affinity between the core targets and the active components of key herbs.Conclusion Professor Ding Ying’s clinical treatment of IgAN emphasizes the pathogenesis of“heat(toxin),deficiency,and blood stasis”employing heat-clearing and blood-cooling,qi-tonifying and yin-nourishing,blood-activating and stasis-resolving strategies.The core prescription likely exerts therapeutic effects by regulating multiple active components(e.g.,quercetin,kaempferol,and luteolin)through core targets(IL-6,IL-1β,IL-10,FN1)and signaling pathways(AGE-RAGE,JAK-STAT,TNF).
作者
郑肖庆
丁樱
徐闪闪
郭婷
王龙
白惠文
赵亚格
ZHENG Xiaoqing;DING Ying;XU Shanshan;GUO Ting;WANG Long;BAI Huiwen;ZHAO Yage(Pediatric Hospital of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000 Henan,China;Medical College of Pediatrics,Henan University of Traditional Chinese Medicine,Zhengzhou 450000 Henan,China)
出处
《中药新药与临床药理》
北大核心
2025年第10期1776-1789,共14页
Traditional Chinese Drug Research and Clinical Pharmacology
基金
国家自然科学基金青年基金项目(82305311,82305310)
国医大师传承工作室建设项目(国中医药办人教函〔2022〕245号)。
关键词
IGA肾病
中医药治疗
丁樱
临床经验
数据挖掘
网络药理学
清热凉血
益气养阴
活血化瘀
IgA nephropathy
traditional Chinese medicine therapy
Ding Ying
clinical experience
data mining
network pharmacology
heat-clearing and blood-cooling
qi-tonifying and yin-nourishing
blood activating and stasis-resolving
