目的 探讨急性缺血性卒中溶栓治疗后使用益气活血类方剂干预的用药规律，预测核心药物防治脑缺血再灌注损伤的潜在作用机制。方法 检索中国知网、万方、维普和PubMed数据库中急性缺血性卒中溶栓治疗后使用益气活血类方有效干预的文献，对方中使用的药物进行频数、聚类及关联分析，依据关联规则选取置信度和支持度最高的核心药物，构建核心药物-活性成分-交集靶点网络图，并进行基因本体（gene ontology，GO）功能富集和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 共筛选纳入232篇文献，涉及中药处方177首，包含中药119味，累计使用频次1903，以黄芪为首的高频药物28味，所有药物按功效可分为16种，药味总频次191，归经总频次292。高频药物聚类分析得到5个聚类，关联规则分析得到20组支持度较高的中药组合，其中支持度与置信度最高的二联药物组合为“黄芪-川芎”，三联药物组合为“黄芪-川芎-地龙”。网络药理学分析收集黄芪、川芎、地龙的活性成分30个；筛选“黄芪-川芎”防治脑缺血再灌注损伤的靶点91个，“黄芪-川芎”-地龙防治脑缺血再灌注损伤的靶点34个；主要涉及癌症相关通路、丝裂原活化蛋白激酶（mitogen activated protein kinases，MAPK）信号通路、微小RNAs（microRNAs）、磷脂酰肌醇-3-羟激酶（phosphatidylinositol-3-hydroxykinase，PI3K）/蛋白激酶B（protein kinase B，Akt）信号通路、肿瘤坏死因子（tumor necrosis factor，TNF）信号通路。结论 益气活血类方治疗急性缺血性卒中的核心药物为黄芪、川芎和地龙，KEGG通路富集分析表明核心药物防治脑缺血再灌注损伤涉及多条信号通路，为指导临床采用益气活血法防治缺血性卒中提供依据，并为研发相关创新药物提供数据参考。

Objective To investigate the medication rules of invigorating qi and activating blood prescriptions after thrombolytic therapy for acute ischemic stroke, and to predict the potential mechanism of core drugs in the prevention and treatment of cerebral ischemia reperfusion injury. Methods The literature on effective interventions with invigorating qi and activating blood prescriptions after thrombolytic therapy for acute ischemic stroke was retrieved from CNKI, Wanfang, VIP and PubMed. The drugs were subjected to frequency, clustering and association analyses. According to the association rules, the core drugs with the highest confidence and support were selected to construct the core drugs-active ingredients-intersection targets network diagram. The gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis were performed on the intersection targets. Results A total of 232 articles were included, involving 177 traditional Chinese medicine (TCM) prescriptions, including 119 TCMs with a total of 1903 frequencies, including 28 high frequency drugs. All drugs could be classified into 16 kinds according to their efficacy, with a total of 191 frequencies of flavours and 292 frequencies of meridian. The clustering analysis of high frequency drugs yielded five clusters, and the association rule analysis yielded 20 groups of TCM combinations with high support, among which the binomial association drugs with the highest support and confidence was “Huangqi (Astragali Radix)-Chuanxiong (Chuanxiong Rhizoma)” and the three association drugs was “Astragali Radix-Chuanxiong Rhizoma-Dilong (Pheretima)”. The network pharmacological analysis collected 30 active ingredients from Astragali Radix, Chuanxiong Rhizoma and Pheretima, and screened 91 intersectional targets of “Astragali Radix-Chuanxiong Rhizoma”-cerebral ischemia reperfusion injury and 34 intersectional targets of “Astragali Radix-Chuanxiong Rhizoma”-Pheretima-cerebral ischemia reperfusion injury. They were mainly involved in cancer-related pathways, mitogen activated protein kinases (MAPK), microRNAs, phosphatidylinositol-3-hydroxykinase (PI3K)/protein kinase B (Akt) and tumor necrosis factor (TNF) signaling pathways. Conclusion The core drugs of invigorating qi and activating blood prescriptions in the treatment of acute ischemic stroke were Astragali Radix, Chuanxiong Rhizoma and Pheretima. The enrichment analysis of KEGG pathway showed that the prevention and treatment of cerebral ischemia-reperfusion injury by the core drugs involved multiple signaling pathways, which provided the basis for guiding the clinical treatment of ischemic stroke by invigorating qi and activating blood circulation, and provided data reference for the research and development of related innovative drugs.

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国家自然科学基金项目（82174167）；湖南省自然科学基金面上项目（2021JJ30499）；湖南省教育厅优秀青年项目（22B0354）；湖南省卫健委一般项目（D202303077508）；湖南省国内一流培育学科中西医结合开放基金项目（2020ZXYJH63）；湖南中医药大学研究生科研创新项目（2021CX63）