[关键词]
[摘要]
目的 运用中医传承辅助平台V3.0软件探析中医药治疗肺纤维化的组方用药规律,获取核心药物组合;运用网络药理学探析其干预新型冠状病毒感染后遗症肺纤维化作用机制。方法 筛选2000年1月—2023年6月中医药治疗肺纤维化的临床研究文献,利用中医传承辅助平台的统计分析、关联规则分析等功能,归纳出中医药治疗肺纤维化的用药特点及核心药物组合,并运用网络药理学方法探寻核心药物组合干预新型冠状病毒感染及其后遗症肺纤维化的潜在有效成分、作用靶点及信号通路。结果 共筛选出118首有效处方,使用中药185味,使用频次前20位中药以补气类与活血化瘀类为主,在支持度≥10、置信度≥0.6时筛选出21味重要中药组合。确定在支持度≥20、置信度≥0.8时的药物组合“黄芪-当归-川芎”为中药核心药物组合,共含有38个有效成分,121个共同靶点,涉及蛋白激酶B1(protein kinase B1,AKT1))、丝裂原活化蛋白激酶(mitogen-activated protein kinase,MAPK)14、MAPK1、AP-1转录因子亚基(AP-1 transcription factor subunit,JUN)等关键靶点,核心中药成分包括槲皮素、山柰酚、川芎哚等。结论 临床上中医药治疗肺纤维化以活血化瘀法及补气类、活血化瘀类中药为主,中药核心药物组合“黄芪-当归-川芎”可能通过晚期糖基化终末产物-晚期糖基化终末产物受体(advanced glycation end products- receptor for advanced glycation end products,AGE-RAGE)信号通路、白细胞介素-17(interleukin-17,IL-17)信号通路、肿瘤坏死因子(tumor necrosis factor,TNF)信号通路、流体剪切力与动脉粥样硬化信号通路干预新型冠状病毒感染后遗症肺纤维化。
[Key word]
[Abstract]
Objective To explore the prescription rules of traditional Chinese medicines (TCMs) in the treatment of pulmonary fibrosis and obtain the Core drug combination based on the Traditional Chinese Medicine Inheritance Auxiliary Platform (TCMIAP) software V3.0. And the mechanism of its intervention on pulmonary fibrosis in sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was explored by network pharmacology. Methods The clinical research literatures of TCMs in the treatment of pulmonary fibrosis were searched from January 2000 to June 2023, through the TCMIAP V3.0. Using the statistical analysis and association rule analysis and other functions of TCMIAP, the characteristics of TCMs in the treatment of pulmonary fibrosis and the core drug combinations were summarized. Network pharmacology was used to explore the potential active ingredients, targets and signaling pathways of core drug combinations in the intervention of SARS-CoV-2 infection and pulmonary fibrosis in its sequela. Results A total of 118 prescriptions were selected and 185 TCMs were used. The top 20 TCMs used frequently were mainly tonifying qi and promoting blood circulation and removing blood stasis. With a support degree ≥ 10 and confidence degree ≥ 0.6, a total of 21 important combinations were screened. When support degree ≥ 20 and confidence degree ≥ 0.8, the drug combination “Huangqi (Astragali Radix)-Danggui (Angelicae Sinensis Radix)-Chuanxiong (Chuanxiong Rhizoma)” was confirmed to be the core drug combination of TCMs. The drug combination contained 38 active compounds and 121 common targets, involving protein kinase B1 (AKT1), mitogen-activated protein kinase (MAPK) 14, MAPK1 and AP-1 transcription factor subunit (JUN) and other key targets, with core compounds of quercetin, kaempferol and perlolyrine. Conclusion Clinical TCMs treatment of pulmonary fibrosis was mainly based on the method of promoting blood circulation and removing blood stasis and the TCMs of tonifying qi and promoting blood circulation and removing blood stasis. And the core combination “Astragali Radix-Angelicae Sinensis Radix-Chuanxiong Rhizoma” may intervene pulmonary fibrosis in sequelae of SARS-CoV-2 infection through advanced glycation end products- receptor for advanced glycation end products (AGE-RAGE) signaling pathway, interleukin-17 (IL-17) signaling pathway, tumor necrosis factor (TNF) signaling pathway, fluid shear force and atherosclerosis signaling pathway.
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[基金项目]
国家自然科学基金项目(82074294);国家中医药管理局第五批全国中医临床优秀人才研修项目(国中医药人教函 [2022] 239号)