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基于名老中医医案探索儿童变应性鼻炎核心处方及潜在作用机制的真实世界研究

Exploring the Core Prescription and Underlying Mechanism of Traditional Chinese Medicine in Treating Allergic Rhinitis in Children: A Real- World Study Based on an Illustrious Senior Traditional Chinese Medicine Practitioner.

机构信息

Beijing University of Traditional Chinese Medicine, Beijing, China.

Dongfang Hospital of Beijing University of Traditional Chinese Medicine, Beijing, China.

出版信息

Comb Chem High Throughput Screen. 2023;26(1):207-223. doi: 10.2174/1386207325666220406105633.

Abstract

BACKGROUND

Traditional Chinese medicine (TCM) is widely used to treat allergic rhinitis (AR) in China, especially in children. However, due to the complicated composition rules and unclear underlying mechanisms, effective herbal prescriptions' popularization and application are limited.

PURPOSE

This study tried to detect the core prescription of herbs in treating AR in children, reveal its mechanism based on the ingredients' network, and explore the main signaling pathways.

METHODS

We screened medical records of children patients with AR who were treated by TCM in DongZhiMen Hospital from Aug 2009 to Jan 2020 and adopted a descriptive analysis method on herbal characteristics. We used association rules to mine core prescriptions and used network pharmacology to establish the ingredient-target-pathway network through online databases and TCMSP, Genecards, KEGG pathway, Excel, R-Studio, and Cytoscape software.

RESULTS

The analysis of 1,092 clinical visits highlighted that the principle of formulating prescription was as follows: 'pungent and warm herbs were used more frequently while cold-natured herbs were paid equal attention as warm-natured herbs.' The core prescription was formed by FangFeng, BaiZhi, CangErzi, and ChanTui. These herbs covered 130 underlying targets and 141 signaling pathways of AR, which mainly had an effect on signal transduction and immunoregulation.

CONCLUSION

The core prescription based on these real-world clinical records includes FangFeng, BaiZhi, CangErzi, and ChanTui. It principally acts on targets of signal transduction pathways and immune pathways.

摘要

背景

中医药(TCM)在治疗过敏性鼻炎(AR)方面在中国被广泛应用,尤其是在儿童中。然而,由于其组成规则复杂且潜在机制不明确,有效的草药处方的推广和应用受到限制。

目的

本研究旨在检测治疗儿童 AR 的草药核心处方,基于成分网络揭示其机制,并探讨主要的信号通路。

方法

我们筛选了 2009 年 8 月至 2020 年 1 月在北京东直门医院接受 TCM 治疗的儿童 AR 患者的病历,并采用描述性分析方法对草药特征进行分析。我们使用关联规则挖掘核心处方,并通过在线数据库和 TCMSP、Genecards、KEGG 通路、Excel、R-Studio 和 Cytoscape 软件,使用网络药理学建立成分-靶-通路网络。

结果

对 1092 次临床就诊的分析表明,处方制定的原则如下:“温性草药使用更频繁,而寒性草药与温性草药同等重视”。核心处方由防风、白芷、苍耳子和蝉蜕组成。这些草药涵盖了 130 个 AR 的潜在靶点和 141 条信号通路,主要作用于信号转导和免疫调节。

结论

基于这些真实临床记录的核心处方包括防风、白芷、苍耳子和蝉蜕。它主要作用于信号转导通路和免疫通路的靶点。

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