中医药心脑血管疾病同治的方剂用药规律分析
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摘要
为探究心脑血管疾病中成药的用药规律,以方剂用药为出发点,提取对于以脑卒中为代表的脑血管疾病和以冠状动脉疾病为代表的心血管疾病有共同治疗作用的核心药组,并分析其在治疗不同疾病时使用的一致性和差异性。该研究搜集主治功效分别为治疗脑血管疾病、心血管疾病和心脑血管疾病同治的市售中成药共388首,运用中医传承辅助平台分别进行"药频分析""配伍分析""网络分析",发现临床使用成药中药味的显性和隐性规律。综合3部分数据发现,丹参、川芎、红花、黄芪4味中药在治疗脑病、治疗心病、同时治疗脑心疾病中均有高使用频率,且配伍出现频繁。通过数据挖掘确认治疗脑心同发的血管性疾病的核心药物组合,揭示中医药心脑血管疾病用药规律的异同,为中成药临床合理使用提供了依据,并且为今后开发针对不同适应证的脑心疾病方剂组合指出新的方向。
To explore the regularity of traditional Chinese medicine(TCM) prescriptions for cardio-cerebrovascular diseases,the core drug groups with common therapeutic effects on cerebrovascular diseases represented by stroke and cardiovascular diseases represented by coronary artery disease were extracted,and their consistency and difference in the treatment of different diseases were analyzed.A total of 388 Chinese patent medicines were collected for the treatment of cerebrovascular diseases,cardiovascular diseases and cardio-cerebrovascular diseases.The dominant and recessive patterns of Chinese patent medicines in clinical use were found by "frequency analysis","compatibility analysis" and "network analysis" respectively.According to the findings of the three parts,Salviae Miltiorrhizae Radix et Rhizoma,Chuanxiong Rhizoma,Carthami Flos and Astragali Radix have a high frequency of use in the treatment of brain disease,heart disease and both,with frequent combined medication.Data mining confirmed the core drug combinations for the treatment of cerebral and cardiac vascular diseases,so as to reveal the similarities and differences in the drug use of Chinese medicine for these diseases,and provide a basis for the rational use of traditional Chinese medicine in clinical practice.This analysis also defines a new direction for the future development of prescription combinations for different indications of cerebral and cardiac diseases.
To explore the regularity of traditional Chinese medicine(TCM) prescriptions for cardio-cerebrovascular diseases,the core drug groups with common therapeutic effects on cerebrovascular diseases represented by stroke and cardiovascular diseases represented by coronary artery disease were extracted,and their consistency and difference in the treatment of different diseases were analyzed.A total of 388 Chinese patent medicines were collected for the treatment of cerebrovascular diseases,cardiovascular diseases and cardio-cerebrovascular diseases.The dominant and recessive patterns of Chinese patent medicines in clinical use were found by "frequency analysis","compatibility analysis" and "network analysis" respectively.According to the findings of the three parts,Salviae Miltiorrhizae Radix et Rhizoma,Chuanxiong Rhizoma,Carthami Flos and Astragali Radix have a high frequency of use in the treatment of brain disease,heart disease and both,with frequent combined medication.Data mining confirmed the core drug combinations for the treatment of cerebral and cardiac vascular diseases,so as to reveal the similarities and differences in the drug use of Chinese medicine for these diseases,and provide a basis for the rational use of traditional Chinese medicine in clinical practice.This analysis also defines a new direction for the future development of prescription combinations for different indications of cerebral and cardiac diseases.
引文
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[29]江燕.黄芪药理作用及在方剂配伍方面的应用[J].中国实用医药,2015,10(1):226.
[30]王淳,刘丽梅,宋志前,等.心血管疾病常用中药注射液及相关中药有效组分研究概况[J].中草药,2015,46(15):2315.
[31]陈迪,唐仕欢,卢朋,等.基于数据科学的脑心同治机制研究[J].中国中药杂志,2015,40(21):4288.
[32]Chen J,Cao W,Asare P F,et al.Amelioration of cardiac dysfunction and ventricular remodeling after myocardial infarction by Danhong Injection are critically contributed by anti-TGF-β-mediated fibrosis and angiogenesis mechanisms[J].J Ethnopharmacol,2016,194:559.
[33]Zhao T,Chang L,Zhang B,et al.Specific combination of salvianolic acids as core active ingredients of Danhong Injection for treatment of arterial thrombosis and its derived dry gangrene[J].Front Pharmacol,2017,8:361.
[34]Lyu M,Yan C,Liu H,et al.Network pharmacology exploration reveals endothelial inflammation as a common mechanism for stroke and coronary artery disease treatment of Danhong Injection[J].Sci Rep,2017,7(1):15427.
[35]Orgah J,Yu J,Zhao T,et al.Danhong Injection reversed cardiac abnormality in brain-heart syndrome via local and remoteβ-adrenergic receptor signaling[J].Front Pharmacol,2018,9:692.
[2]陈伟伟,高润霖,刘力生,等.中国心血管病报告(2017年)概要[J].中国循环杂志,2018,33(1):1.
[3]Samuels M A.The brain-heart connection[J].Circulation,2007,116:77.
[4]Matsunaga M,Yatsuya H,Iso H,et al.Similarities and differences between coronary heart disease and stroke in the associations with cardiovascular risk factors:the Japan collaborative cohort study[J].Arterioscler Thromb Vasc Biol,2017,3(3):124.
[5]Abete P,Della-Morte D,Gargiulo G,et al.Cognitive impairment and cardiovascular diseases in the elderly:a heart-brain continuum hypothesis[J].Ageing Res Rev,2014,18:41.
[6]Ishikawa H,Tajiri N,Vasconcellos J,et al.Ischemic stroke brain sends indirect cell death signals to the heart[J].Stroke,2013,44:3175.
[7]赵涛,赵步长,贾立夫,等.“脑心同治”理论研究进展[J].中医临床研究,2015,7(27):8.
[8]陈迪,唐仕欢,卢朋,等.基于数据科学的脑心同治机制研究[J].中国中药杂志,2015,40(21):4288.
[9]赵步长,伍海勤,赵涛,等.中医脑心同治论[M].北京:人民卫生出版,2010.
[10]李耿,程煜华,郭宇博,等.中药大品种科技竞争力报告(2017版)[J].中国现代中药,2018,20(1):6.
[11]刘根,贺文彬,赵子强,等.基于中医传承辅助平台对老年性痴呆防治方剂核心药物组合的筛选研究[J].中国实验方剂学杂志,2016(7):223.
[12]侯王君,庄贺,薛一涛,等.应用中医传承辅助平台分析冠心病不稳定型心绞痛方剂的组方用药规律[J].中国药房,2017(32):4478.
[13]张敏,赵江鹏,张雪亮.基于中医传承辅助平台的古代抗衰老方用药规律分析[J].中国中医基础医学杂志,2018(3):393.
[14]中国药典.一部[S].2015.
[15]中华人民共和国卫生部药典委员会.中华人民共和国卫生部部颁标准中药成方制剂[S].北京:人民卫生出版社,1964.
[16]国家食品药品监督管理局.国产药品批准文号等信息查询[EB/OL].[2018-07-02].http://samr.cfda.gov.cn/WS01/CL0001/.
[17]卢朋,李健,唐仕欢,等.中医传承辅助系统软件开发与应用[J].中国实验方剂学杂志,2012,18(9):1.
[18]高丽娜,崔元璐,延阔,等.丹参红花配伍研究进展[J].中草药,2016,47(4):671.
[19]马丙祥,董宠凯.丹参的药理作用研究新进展[J].中国药房,2014,25(7):663.
[20]赵娜,郭治昕,赵雪,等.丹参的化学成分与药理作用[J].国外医药:植物药分册,2007,22(4):155.
[21]杜旌畅,谢晓芳,熊亮,等.川芎挥发油的化学成分与药理活性研究进展.[J].中国中药杂志,2016,41(23):4328.
[22]金玉青,洪远林,李建蕊,等.川芎的化学成分及药理作用研究进展[J].中药与临床,2013,4(3):44.
[23]朱尧,刘溦溦,顾宁,等.川芎的活性成分及其心血管系统保护作用研究进展[J].时珍国医国药,2016,27(7):1701.
[24]景晓杨,雷燕,修成奎.人参三七川芎提取物对衰老大鼠免疫器官及行为学的影响[J].中国实验方剂学杂志,2015,21(22):184.
[25]汪宏雷.红花的药理作用[J].中医药临床杂志,2014,26(5):519.
[26]杨玉霞,吴卫,郑有良.红花研究进展[J].四川农业大学学报,2004,22(4):365.
[27]吴发宝,陈希元.黄芪药理作用研究综述[J].中药材,2004,27(3):232.
[28]陈国辉,黄文凤.黄芪的化学成分及药理作用研究进展[J].中国新药杂志,2008,17(17):1482.
[29]江燕.黄芪药理作用及在方剂配伍方面的应用[J].中国实用医药,2015,10(1):226.
[30]王淳,刘丽梅,宋志前,等.心血管疾病常用中药注射液及相关中药有效组分研究概况[J].中草药,2015,46(15):2315.
[31]陈迪,唐仕欢,卢朋,等.基于数据科学的脑心同治机制研究[J].中国中药杂志,2015,40(21):4288.
[32]Chen J,Cao W,Asare P F,et al.Amelioration of cardiac dysfunction and ventricular remodeling after myocardial infarction by Danhong Injection are critically contributed by anti-TGF-β-mediated fibrosis and angiogenesis mechanisms[J].J Ethnopharmacol,2016,194:559.
[33]Zhao T,Chang L,Zhang B,et al.Specific combination of salvianolic acids as core active ingredients of Danhong Injection for treatment of arterial thrombosis and its derived dry gangrene[J].Front Pharmacol,2017,8:361.
[34]Lyu M,Yan C,Liu H,et al.Network pharmacology exploration reveals endothelial inflammation as a common mechanism for stroke and coronary artery disease treatment of Danhong Injection[J].Sci Rep,2017,7(1):15427.
[35]Orgah J,Yu J,Zhao T,et al.Danhong Injection reversed cardiac abnormality in brain-heart syndrome via local and remoteβ-adrenergic receptor signaling[J].Front Pharmacol,2018,9:692.