目的 挖掘中药专利复方调治慢性萎缩性胃炎（CAG）用药规律，预测其核心药物组合并揭示潜在作用机制。方法 检索国家专利数据库调治CAG的中药复方，经筛选及规范化处理，利用R语言进行数据分析。应用Cytoscape软件，筛选主要活性成分和核心靶点；通过基因本体（GO）和京都基因与基因组百科全书（KEGG）富集分析，探究核心药物组合治疗的生物学过程和相关通路，阐明作用机制；运用分子对接技术验证关键活性成分与核心靶点。结果 共纳入227项专利，涉及498种中药；频数≥30的中药共有27味，排名靠前的中药分别为白术、甘草、黄芪、莪术、白芍；高频中药以补虚药和理气药为主，性味以温性、苦味为主，多归脾经；关联规则分析得到23条核心关联规则；结合聚类分析确定核心药对为莪术-黄芪-白术。其主要活性成分为槲皮素、山柰酚、芒柄花素；核心靶点为AKT1、TNF、IL6、JUN、IL-1β等；主要涉及PI3K-Akt通路、p53通路、MAPK通路、FoxO通路、NF-κB通路等。分子对接结果显示关键活性成分能够与核心靶点有效结合。结论 调治CAG的中药专利配伍以补虚健脾为核心，辅以行气活血与滋阴清热。核心药对“莪术-黄芪-白术”通过多成分、多靶点、多通路协同调控细胞凋亡与增殖，减轻氧化应激与胃黏膜炎症，为CAG的中医药防治提供了理论支持。

Objective To explore the medication rules of traditional Chinese medicine (TCM) patent formulas in the treatment of chronic atrophic gastritis (CAG), predict the core drug combinations, and reveal potential mechanisms of action. Methods TCM patent formulas for the treatment of CAG were searched from the national patent database. After screening and standardization, data analysis was conducted using R language. Cytoscape software was used to screen key active ingredients and core targets; GO and KEGG enrichment analyses were performed to investigate the biological processes and related pathways of the core drug combinations, elucidating the mechanisms of action; molecular docking technology was used to validate the key active ingredients with core targets. Results A total of 227 patents were included, involving 498 TCMs; 27 TCMs had a frequency of ≥30, with Atractylodis Macrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma, Astragali Radix, Curcumae Rhizoma, and Paeoniae Radix Alba ranking highest; High-frequency drugs primarily comprised tonifying and regulating qi herbs, characterized mainly by warming properties and bitterness, predominantly aligned with the spleen meridian; association rule analysis yielded 23 core association rules; Combined with clustering analysis, the core drug pair was determined to be Curcumae Rhizoma-Astragali Radix-Atractylodis Macrocephalae Rhizoma. The key active ingredients were quercetin, kaempferol, and ligustrazine; core targets included AKT1, TNF, IL6, JUN, and IL-1β, mainly involving the PI3K-Akt pathway, p53 pathway, MAPK pathway, FoxO pathway, and NF-κB pathway. Molecular docking results showed that the key active ingredients could effectively bind with core targets. Conclusion The rules for the compatibility of TCM patents in treating CAG are based on tonifying deficiency and strengthening the spleen, complemented by regulating qi and invigorating blood, with the additional aspect of nourishing yin and clearing heat, highly conforming to the principles of TCM differential diagnosis and treatment. The Curcumae Rhizoma-Astragali Radix-Atractylodis Macrocephalae Rhizoma combination serves as the core drug pair for treating CAG, which exerts efficacy by regulating the balance of cell apoptosis/proliferation, alleviating oxidative stress, and improving gastric mucosal inflammation through multiple components, targets, and pathways, providing a theoretical basis for the prevention and treatment of CAG in TCM.

R975

国家重点研发计划“中医药现代化”重点专项（2023YFC3503600）；中国中医科学院望京医院高水平中医医院建设项目-中医药临床循证研究专项（WJYY-XZKT-2023-06）