| 引用本文:陶诗怡1，陈颖1，于林童1，杨德爽1，张兰鑫2，孙梓宜1，黄力3，邵明晶3.中药治疗冠状动脉微血管疾病的用药规律与作用机制研究[J].世界中医药,2023,(09):. |
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| 中药治疗冠状动脉微血管疾病的用药规律与作用机制研究 |
| Medication Laws and Mechanism for Chinese Medicine in the Treatment of Coronary Microvascular Disease |
| 投稿时间：2021-10-06 |
| DOI：10.3969/j.issn.1673-7202.2023.09.019 |
| 中文关键词: 冠状动脉微血管疾病 微血管性心绞痛 心脏X综合征 中医药 数据挖掘 用药规律 网络药理学 作用机制 |
| English Keywords:Coronary microvascular disease Microvascular angina Cardiac syndrome X Traditional Chinese medicine Data mining Medication laws Network pharmacology Mechanism |
| 基金项目:国家自然科学基金项目（2017-GZR-011）——基于LncRNA H19与自噬、炎症信号通路揭示升陷祛瘀中药治疗糖尿病心肌病疗效靶点及其信号机制研究；中日友好医院“菁英计划”人才培育工程（ZRJY2021-GG10）——基于ncRNA探索益气活血中药对I型心肾综合征疗效的临床和实验研究 |
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| 中文摘要: |
| 目的：基于文献统计和网络药理学分析中药治疗冠状动脉微血管疾病（CMVD）的用药规律和作用机制。方法：计算机检索8个数据库，收集中药治疗CMVD相关文献，采用SPSS Statistics 20.0和SPSS Modeler 18.0统计软件对中药汤剂用药进行关联规则分析、复杂网络图分析和聚类分析，并构建核心药物组合-活性成分-交集靶点-通路图。结果：纳入文献184篇，共涉及中药汤剂70首，包括中药132味、中成药41种、注射剂13种。常用中药汤剂包括血府逐瘀汤、二陈汤、瓜蒌薤白半夏汤等，常用口服中成药包括通心络胶囊、麝香保心丸等，常用中药注射剂包括丹红注射液等。中药汤剂中高频用药包括川芎、当归、丹参、柴胡、甘草等34味，功效可归为补虚、理气、解表、活血化瘀等18类，药味多甘、辛、苦，药性多温、平，多归肝、脾、肺经。关联规则分析得到20组关联规则，高频药物聚类分析得到7个聚类方。共收集核心药物组合活性成分14个，核心药物组合-CMVD交集靶点29个，京都基因和基因组百科全书（KEGG）富集分析得到10条主要信号通路。结论：中医药治疗CMVD以气血为要，活血化瘀、理气化痰散结的同时辅以益气通阳扶正是其主要治则治法。核心药物组合可能通过蛋白激酶A催化亚基（PRKACA）、雌激素受体（ER）1、热激蛋白90 α家族A成员1（HSP90AA1）或核受体辅激活物1（NCOA1）等靶点，借助癌症、雌激素信号、甲状腺激素信号等通路达到治疗CMVD的目的，可为临床预防和治疗CMVD提供参考。 |
| English Summary: |
| To analyze medication laws and mechanism of Chinese medicine in the treatment of coronary microvascular disease(CMVD) based on literature statistics and network pharmacology.Methods:Eight databases were searched for the literature on Chinese medicine against CMVD.SPSS Statistics 20.0 and SPSS Modeler 18.0 were used for association rule analysis，complex network diagram analysis，and cluster analysis of Chinese medicinal decoctions，and a core drug combination-active component-intersection target-pathway network was constructed.Results:A total of 184 research articles were screened out，with 70 prescriptions of Chinese medicinal decoctions involved，including 132 drugs，41 Chinese patent medicines，and 13 injections.Xuefu Zhuyu Decoction，Erchen Decoction，and Gualou Xiebai Banxia Decoction were reported frequently.The common oral Chinese patent medicines were Tongxinluo Capsules and Shexiang Baoxin Pills.The common Chinese medicinal injections included Danhong Injection.In Chinese medicinal decoctions，34 high-frequency drugs were included Chuanxiong Rhizoma，Angelicae Sinensis Radix，Salviae Miltiorrhizae Radix et Rhizoma，Bupleuri Radix，and Glycyrrhizae Radix et Rhizoma，with 18 types of functions of tonifying deficiency，regulating qi，releasing exterior，activating blood to resolve blood stasis，etc.The drugs were mainly sweet，pungent，and bitter in flavor，and warm and plain in property，acting on the liver，spleen，and lung meridians.Association rule analysis yielded 20 association rules.As revealed by cluster analysis，high-frequency drugs were classified into seven categories.Fourteen active components of core drug combinations were screened out，and there were 29 intersection targets of core drug combinations and CMVD.KEGG enrichment yielded 10 signaling pathways.Conclusion:Qi and blood play a vital role in the treatment of CMVD by traditional Chinese medicine(TCM)，and the therapeutic principles of TCM against CMVD are activating blood，resolving blood stasis，regulating qi，resolving phlegm，and dissipating mass combined with invigorating qi，activating yang，and reinforcing healthy qi.The core drug combinations can play an anti-CMVD role by regulating key targets such as PRKACA，ESR1，HSP90AA1，and NCOA1 through cancer pathway，estrogen signaling pathway，thyroid hormone signaling pathway，providing a reference for the prevention and treatment of CMVD. |
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