世界中医药

作者	单位
白子兴1，董永丽1，蔡静怡1，魏戌1，高云2	1 中国中医科学院望京医院，北京，101002； 2 中国中医科学院眼科医院，北京，100040

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中文摘要:

目的：构建独活寄生汤干预腰椎间盘突出症的“方药-靶基因-病种”生物预测模型，明确独活寄生汤作用于腰椎间盘突出症的核心靶点及作用通路。方法：首先，通过中药系统药理学数据库与分析平台（TCMSP）中的靶点预测功能收集独活寄生汤的化学成分及靶点，利用UniProt蛋白质数据库确定基因靶点简称；其次，对在线人类孟德尔遗传数据库（OMIM）、疾病相关的基因与突变位点数据库（DisGeNET）、比较基因组数据库(CTD)等数据库进行腰椎间盘突出症疾病靶标查询；最终，综合提取中药复方与疾病的核心作用靶点，借助STRING数据库的蛋白质相互作用分析平台和Cytoscape软件的拓扑分析功能，获取“方药-靶基因-病种”的关系网络，使用R语言进行基因本体（GO）富集分析和京都基因和基因组百科全书（KEGG）富集分析，以及蛋白质-蛋白质相互作用（PPI）网络分析，确定独活寄生汤干预腰椎间盘突出症的核心靶点与关键通路。结果：筛选出独活寄生汤202个有效化学成分，276个潜在基因靶点，其中与腰椎间盘突出症的共同靶点基因88个。PPI网络分析发现AKT1、IL6、JUN、MAPK、VEGFA、IL1B是独活寄生汤干预腰椎间盘突出症的核心靶点。GO富集分析明确了107个富集条目，主要涉及蛋白酶的激活、细胞因子的结合、DNA结合转录与RNA聚合酶Ⅱ特异性的富集形态；KEGG通路注释及富集分析筛选出了153条与独活寄生汤相关的蛋白通路，差异蛋白表达靠前的通路包括慢性炎症作用通路IL-17、促炎通路TNF及细胞凋亡信号转导通路等。结论：独活寄生汤配伍科学严谨，靶点覆盖全面，体现了中医的辨证论治与现代医学的“精准治疗”的科学内涵。独活寄生汤通过多靶点、多通路作用于腰椎间盘突出症，主要起到抗炎症免疫反应、细胞修复的作用，后期当进一步通过从分子、动物、临床等层面，借助计算机、体内、体外的一系列技术进行验证，为临床用药组方提供新思路。

English Summary:

To clarify the core targets and pathways of Duhuo Jisheng Decoction for lumbar disc herniation by constructing a biological predictive model of “prescription-target gene-disease” of Duhuo Jisheng Decoction for intervening lumbar disc herniation.Methods:Firstly，by searching the target predicting function in the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP)，the chemical component and targets of Duhuo Jisheng Decoction were collected，and the UniProt protein database was used to determine the gene target abbreviations; Secondly，the disease targets of lumbar intervertebral disc herniation were retrieved through the disease databases，including OMIM，DisGeNET，CTD，etc.Finally，the core targets of traditional Chinese medicine compound prescriptions and diseases were extracted with the help of the protein interaction analysis platform of STRING database and the topological analysis function of Cytoscape to obtain the network of “prescription-target gene-disease”.R language was used to perform GO and PPI analysis of KEGG，determining the core target and key pathway of Duhuo Jisheng Decoction in the intervention of lumbar disc herniation.Results:A total of 202 effective chemical components and 276 potential gene targets of Duhuo Jisheng Decoction were screened out，of which 88 are common target genes for lumbar disc herniation.PPI network analysis found that AKT1，IL6，JUN，MAPK，VEGFA，and IL1B are the core targets of Duhuo Jisheng Decoction in the intervention of lumbar disc herniation.GO enrichment analysis identified 107 enrichment items，mainly related to protease activation，cytokine binding，DNA binding transcription and RNA polymerase Ⅱ specific enrichment morphology; KEGG pathway annotation and enrichment analysis screened out 153 protein pathways related to Duhuo Jiesheng Decoction and the pathways with the highest differential protein expression include chronic inflammation pathway IL-17，pro-inflammatory pathway TNF，and the apoptosis signal transduction pathway.Conclusion:Duhuo Jisheng Decoction is scientifically rigorous in compatibility with comprehensive target coverage，which embodies the scientific connotation of TCM syndrome differentiation and treatment and modern medical “precision treatment”.Duhuo Jisheng Decoction acts on lumbar intervertebral disc herniation through multiple targets and multiple pathways.It mainly plays the role of anti-inflammatory immunity and cell repair.Further research from aspects of the molecular，animal，and clinical practice are needed，with the help of computing technology，in vivo，and in vitro to innovate for clinical prescriptions.

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