摘要
目的探析中药治疗高危型人乳头瘤病毒(high-risk human papilloma virus,HR-HPV)感染的组方规律。方法搜集中国知网、维普数据库、万方数据库建库至2023年7月10日符合纳排标准的中药治疗HR-HPV感染的复方数据,运用Excel 2007、Cytoscape 3.9.1、Rstudio 4.3.2、R 4.3.2等软件对处方数据进行数据建模、证型分析、用药频次分析、聚类分析、关联规则分析和数据可视化,探究中药治疗HR-HPV感染的组方规律。结果最终纳入治疗HR-HPV感染的复方231首,涉及中药225味,药物使用总频次2450次;常见的临床主治证候为脾虚肝郁证(39.39%)和湿热下注证(37.67%);用药频率前10名的中药为黄柏、白术、黄芪、土茯苓、白花蛇舌草、甘草、薏苡仁、党参、苦参、苍术;进行药物功效类别分析,排名前3位的是清热类(38.98%)、补虚类(23.10%)和利水渗湿类(10.24%);聚类分析共得到7个药物组合,其中可提供临床处方与新药开发的新处方2个,对药3组;中药核心复杂共现网络筛选得到核心药物黄芪-白术-黄柏;关联规则分析共得到数据37条(对药组合6条、角药组合31条),常用对药组合有白术-党参、黄芪-党参、黄柏-苍术等,常用角药组合有白术-党参-黄芪、白术-黄芪-土茯苓、黄柏-白花蛇舌草-薏苡仁等。结论HRHPV的基本病机为脾虚肝郁、湿热下注,病性属本虚标实,处方多用白术、黄芪、党参等药补益中气以益其虚,防邪深入,再配伍土茯苓、黄柏、白花蛇舌草等清热祛湿药化其标,与临床用药相符。通过多元数据挖掘统计分析所得基础复方及药对组合,可为临床诊治HR-HPV感染用药及新药开发提供参考。
Objective To explore the formulation rules in the TCM treatment of high-risk human papilloma virus(HR-HPV)infection.Methods TCM compound formulas for treating HR-HPV infection that met the inclusion and exclusion criteria were collected from CNKI,VIP Database,and Wanfang Database until July10,2023.Softwares such as Excel 2007,Cytoscape 3.9.1,Rstudio 4.3.2,and R 4.3.2 were used for data modeling,pattern analysis,medication frequency analysis,cluster analysis,association rule analysis,and data visualization,so as to investigate the formulation rules for treating HR-HPV infection.Results A total of 231 compound formulas for treating persistent HR-HPV infection were included,involving 225 Chinese medicines,with a total medication frequency of 2450.The most common clinical patterns were spleen deficiency and liver qi stagnation pattern(39.39%)and damp heat downflow pattern(37.67%).The top 10 frequently used Chinese medicines were Huangbo(Phellodendri Chinensis Cortex),Baizhu(Atractylodis Macrocephalae Rhizome),Huangqi(Astragali Radix),Tufuling(Smilacis Glabrae Rhizome),Baihuasheshecao(Hedyotis Diffusa),Gancao(Glycyrrhizae Radix et Rhizome),Yiyiren(Coicis Semen),Dangshen(Codonopsis Radix),Kushen(Sophorae Flavescentis Radix),and Cangzhu(Atractylodis Rhizome).As to the categories of medicinal effects,the top three were heat clearing(38.98%),deficiency tonifying(23.10%),and urination-promoting and dampness-draining(10.24%)categories.Cluster analysis identified seven combinations of Chinese medicines,including two novel formulas available for clinical use and new drug development and three medicine pairs.The core complex co-occurrence network identified the core Chinese medicines of Huangqi(Astragali Radix)-Baizhu(Atractylodis Macrocephalae Rhizoma)-Huangbo(Phellodendri Chinensis Cortex).Association rule analysis yielded 37 medicinal combinations(6 paired combinations and 31 triple combinations).The commonly used paired medicines were Baizhu(Atractylodis Macrocrphalae Rhizoma)-Dangshen(Codonopsis Radix),Huangqi(Astragali Radix)-Dangshen(Codonopsis Radix),Huangbo(Phellodendri Chinensis Cortex)-Cangzhu(Atractylodis Rhizome),etc.The commonly used triple medicinal combinations were Baizhu(Atractylodis Macrocrphalae Rhizoma)-Dangshen(Codonopsis Radix)-Huangqi(Astragali Radix),Baizhu(Atractylodis Macrocrphalae)-Huangqi(Astragali Radix)-Tufuling(Smilacis Glabrae Rhizoma),Huangbo(Phellodendri Chinensis Cortex)-Baihuasheshecao(Hedyotis Diffusa)-Yiyiren(Coicis Semen),etc.Conclusion The basic pathogenesis of HR-HPV is spleen deficiency,liver qi stagnation,and damp heat downflow,and the disease nature is deficiency in root and excess in manifestation.Accordingly,Chinese medicines such as Baizhu(Atractylodis Macrocrphalae),Huangqi(Astragali Radix),and Dangshen(Codonopsis Radix)have been mostly used in the formulas to tonify qi of the spleen and stomach,so as to benefit the deficiency and prevent pathogenic factors from impenetrating;meanwhile,they have been combined with heat-clearing and dampness-drying medicines such as Tufuling(Smilacis Glabrae Rhizoma),Huangbo(Phellodendri Chinensis Cortex),and Baihuasheshecao(Hedyotis Diffusa)to relieve the manifestations,which is consistent with clinical medication.To sum up,the fundamental compound formulas and medicinal combinations have been obtained through multidimensional data mining and statistical analysis,which can provide reference for clinical treatment of HR-HPV infection and new drug development.
作者
林雪儿
梁怀枫
李道成
LIN Xue'er;LIANG Huaifeng;LI Daocheng(Guangzhou University of Chinese Medicine,Guangzhou,Guangdong 510405,China;The First Hospital ofGuangzhou University of Chinese Medicine,Guangzhou,Guangdong 510405,China)
出处
《湖南中医药大学学报》
CAS
2024年第1期86-92,共7页
Journal of Hunan University of Chinese Medicine
基金
国家中医药传承创新中心科研专项重点项目(2022ZD10)
广东省中医药局面上项目(20211139)。
关键词
高危型人乳头瘤病毒
中药复方
数据挖掘
用药规律
黄柏
白术
黄芪
high-risk human papilloma virus
TCM compound formulas
data mining
medication rule
Huangbo(Phellodendri Chinensis Cortex)
Baizhu(Atractylodis Macrocephalae Rhizome)
Huangqi(Astragali Radix)
