摘要
目的:基于数据挖掘技术对马君蓉教授治疗儿童抽动障碍的用药经验进行归纳总结。方法:选取2018年1月至2022年12月西南医科大学附属中医医院收治的儿童抽动障碍的病例数据为研究对象,利用Microsoft Office Excel 2021、SPSS Modeler 18.0、SPSS Statistics 29.0等软件对数据进行中药频次、中药属性、关联规则、聚类分析及数据可视化。根据结果进行网络药理学分析,利用TCMSP、Batman-TCM、Genecards、OMIM、TTD等数据库筛选获取核心中药活性成分及疾病相关靶点,运用STRING数据库和Cytoscape 3.9.1软件构建中药-活性成分-核心靶点及蛋白质互作网络图。运用Metascape数据库对交集靶点进行GO功能及KEGG通路富集分析。利用AutoDock Vina 1.1.2软件对筛选的主要活性成分及核心靶点进行分子对接,最后运用PyMOL 2.4软件进行可视化处理。结果:共收录中药处方1095张,涉及中药161种,药性以温性为主,药味多见辛、苦、甘,以肝经、脾经为主,功效类别则多见平肝息风药、补虚药、解表药。关联规则分析得到药物组合216对,聚类分析得到4组核心药物组合,功效以补脾柔肝、平肝息风、疏肝清热、滋阴活血为主。使用频次排名前8的中药有炙甘草、全蝎、柴胡、蜈蚣、郁金、伸筋草、钩藤、白芍,共筛选出核心活性成分148个及靶点1539个,疾病靶点2472个,交集靶点396个。GO功能富集分析得到生物过程1199条,细胞组成171条,分子功能237条,KEGG通路170条。核心药物的主要活性成分诺卡酮、香芹酮、长叶薄荷酮等可能通过作用于BDNF、AKT1、ALB等核心靶点,调节神经活性配体-受体相互作用、cAMP、多巴胺能神经突触等多条信号通路,发挥治疗儿童抽动障碍的作用。分子对接结果显示,主要活性成分与核心靶点有较强的结合活性。结论:马君蓉教授认为儿童抽动障碍属本虚(脾虚)标实(肝旺),应“从脾论治”,以“补脾调肝法”为指导,标本兼治,用药精和,为川南地区医务人员治疗儿童抽动障碍提供宝贵经验和思路。
Objective:To explore Professor Ma Junrong s medication rules and mechanism in the treatment of children with tic disorder based on data mining and network pharmacology.Methods:Collected the case data of Professor Ma Junrong s treatment of children with tic disorder in the pediatric outpatient department of the Southwest Medical University Affiliated Traditional Chinese Medicine Hospital from January 2018 to December 2022,and use software such as Microsoft Office Excel 2021,SPSS Modeler 18.0,SPSS Statistics 29.0 to perform frequency analysis of traditional Chinese medicine,analysis of traditional Chinese medicine attributes,association rule analysis,clustering analysis,and data visualization.According to the results,network pharmacological analysis was conducted,and the core TCM active ingredients and disease-related targets were screened using databases such as TCMSP,Batman-TCM,Genecards,OMIM,and TTD.The network diagram of TCM-Active ingredient-Core target and protein interaction was constructed by using STRING database and Cytoscape 3.9.1 software.Perform GO function and KEGG pathway enrichment analysis on intersection targets using the Metascape database.AutoDock Vina 1.1.2 software was used for molecular docking of the main active ingredients and core targets,and finally PyMOL 2.4 software was used for visualization processing.Results:A total of 1,095 traditional Chinese medicine prescriptions were collected,involving 161 types of traditi onal Chinese medicine.The drug properties were primarily warm,with flavors often seen as spicy,bitter,and sweet.The channels of entry were mainly the Ganjing and Pijing.The efficacy categories were primarily composed of Pingganxifengyao,Buxuyao,Jiebiaoyao.216 pairs of drug combinations were obtained through association rule analysis,and 4 core drug combinations were obtained through cluster analysis.The main effects were Bupirougan,Pingganxifen,Shuganqingre,Ziyinhuoxue.The top 8 traditional Chinese medicines with the highest frequency of use were Zhigancao,Quanxie,Chaihu,Wugong,Yujin,Shenjincao,Gouteng,Baishao.A total of 148 core active ingredients and 1,539 targets were selected,with 2,472 disease targets and 396 intersection targets.GO functional enrichment analysis revealed 1,199 biological processes,171 cellular compositions,237 molecular functions,and 170 KEGG pathways.The main active components of core drugs,such as Nootkatone,Carvone and Pulegone,may regulate several signaling pathways such as Neuroactive ligand-receptor interaction,cAMP and Dopaminergic synapse by acting on core targets such as BDNF,AKT1 and ALB,and play a role in the treatment of tic disorders in children.The results of molecular docking showed that the main active ingredients had strong binding activity with the core target.Conclusion:Professor Ma Junrong believes that children s tic disorders belong to the original deficiency(spleen deficiency)and the standard(liver prosperity),which should be“treated from the spleen”,guided by the“spleen and liver leveling method”,treating both the symptoms and the root causes,and using the essence of medicine,so as to provide valuable experience and ideas for the medical staff in southern Sichuan to treat children s tic disorders.
作者
张霞
冉志玲
王君霞
马君蓉
余勇
ZHANG Xia;RAN Zhi-ling;WANG Jun-xia;MA Jun-rong;YU Yong(Children s Diagnosis and Treatment Center,the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University,Luzhou 646000,Sichuan,China)
出处
《川北医学院学报》
2025年第12期1516-1524,1535,共10页
Journal of North Sichuan Medical College
基金
四川省中医药管理局项目(2023MS441)。
关键词
抽动障碍
马君蓉
数据挖掘
作用机制
用药经验
Tic disorders
Ma junrong
Data mining
Mechanism of action
Medication experience
