国际生殖健康/计划生育杂志 ›› 2025, Vol. 44 ›› Issue (2): 100-109.doi: 10.12280/gjszjk.20240544

• 论著 • 上一篇    下一篇

中药调周法治疗排卵障碍性不孕症的用药规律及核心药对的作用机制研究

李薇懿, 孟鑫婉, 焦雨帆, 何东杰, 韩永梅()   

  1. 450000 郑州,河南中医药大学第一附属医院生殖医学科
  • 收稿日期:2024-11-11 出版日期:2025-03-15 发布日期:2025-03-10
  • 通讯作者: 韩永梅,E-mail:fyj2007l@163.com
  • 基金资助:
    国家自然科学基金(82004406);2023年河南省科技厅科技攻关项目(232102311216);2024年河南省中医药科学研究专项课题(2024ZY3026)

Research on the Medication Rules of Core Drug Pairs in the Treatment of Ovulatory Dysfunction Infertility with Traditional Chinese Medicine Menstrual Cycle Regulation Method

LI Wei-yi, MENG Xin-wan, JIAO Yu-fan, HE Dong-jie, HAN Yong-mei()   

  1. Department of Reproductive Medicine, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou 450000, China
  • Received:2024-11-11 Published:2025-03-15 Online:2025-03-10
  • Contact: HAN Yong-mei, E-mail: fyj2007l@163.com

摘要:

目的: 基于数据挖掘、网络药理学及分子对接研究中药调周法治疗排卵障碍性不孕症(ovulatory dysfunction infertility,ODI)的用药规律及潜在作用机制。方法: 检索中国知网、万方数据库、维普中文期刊和中国生物医学文献服务系统内中药调周法治疗ODI的文献,归纳方药规律,网络药理学分析核心药对,并以分子对接技术加以验证。结果: 纳入133篇文献,共464个处方,涉及154味中药,功效共有19类。月经期主要为性温、味辛、归肝经的活血化瘀药、补血药以及理气药等,高频中药为当归、川芎及香附等,常用药对为当归、赤芍、香附。卵泡期主要是性温、味甘、归经的补阳药、补血药以及活血化瘀药等,高频中药为菟丝子、当归及熟地黄等,常用药对为菟丝子、何首乌。排卵期主要是性温、味辛、归肝经的活血化瘀药、补阳药以及补血药等,高频中药为当归、香附及菟丝子等,常用药对为当归、牛膝及川芎。以上3期的主要成分包括木犀草素、槲皮素和大黄素等,其治疗ODI的核心基因为蛋白激酶Bα(protein kinase B alpha,PKBα,又称AKT1)、白细胞介素-6(interleukin-6,IL-6)和肿瘤坏死因子(tumor necrosis factor,TNF)等,主要通路均为癌症信号通路、流体剪切应力与动脉粥样硬化通路及糖尿病并发症中的晚期糖基化终末产物(advanced glycation end product,AGE)/晚期糖基化终末产物受体(receptor for advanced glycation end product,RAGE)信号通路等。黄体期主要是性温、味甘、归肝经的补阳药、补血药以及补气药等,高频中药为菟丝子、熟地黄及当归等,常用药对为当归、川芎,主要成分为谷固醇、亚油酸乙酯、杨梅酮等,核心基因为雌激素受体1(estrogen receptor 1,ESR1)、胱天蛋白酶3(caspase 3,CASP3)、前列腺素-内过氧化物合酶2(prostaglandin-endoperoxide synthase 2,PTGS2)等,主要通路为癌症通路、雌激素信号通路及化学致癌-受体活化作用通路等。分子对接验证了主要活性成分与关键靶点有较好的结合能力,其中月经期木犀草素与TNF、卵泡期大黄素与TP53、排卵期槲皮素与TNF、黄体期川芎哚与PTGS2结合能最小。结论: 中药调周法各分期核心药对通过调控关键靶点影响相应信号通路,干预ODI的治疗机制。

关键词: 数据挖掘, 分子对接模拟, 排卵障碍性不孕症, 中药调周法, 用药规律分析, 网络药理学分析

Abstract:

Obejective: To study the medication rules and potential mechanism of traditional Chinese medicine (TCM) menstrual cycle regulation method in the treatment of ovulatory dysfunction infertility (ODI), based on data mining, network pharmacology and molecular docking. Methods: Literature on TCM menstrual cycle regulation for ODI was retrieved from the China National Knowledge Infrastructure, Wanfang Database, VIP Chinese Periodicals, and Chinese biomedical literature service system. Medication patterns were summarized, and core drug pairs were analyzed using network pharmacology. The molecular docking was employed for validation. Results: This study included a total of 133 references, covering 464 prescriptions involving 154 types of TCMs with 19 categories of therapeutic effects. During the menstrual phase, the primary medicines are warm, acrid, and liver-meridian-involved blood-activating and stasis-removing medicines, blood-tonifying medicines, and qi-regulating medicines, etc. The high-frequency TCMs include Angelica sinensis (Danggui), Ligusticum chuanxiong (Chuanxiong), and Cyperi Rhizoma (Xiangfu), etc. The commonly used medicine pairs are Angelica sinensis, Paeoniae Rubra (Chishao), and Cyperi Rhizoma. In the follicular phase, the main medicines are warm, sweet, and meridian-involved yang-supplementing medicines, blood-tonifying medicines, and blood-activating and stasis-removing medicines, etc. The high-frequency TCMs include Cuscutae Semen (Tusizi), Angelica sinensis, and Rehmanniae Preparata (Shudi Huang), etc. The commonly used medicine pairs are Cuscutae Semen and Polygoni Multiflori (Heshouwu). During the ovulation phase, the main medicines are warm, acrid, and liver-meridian-involved blood-activating and stasis-removing medicines, yang-supplementing medicines, and blood-tonifying medicines, etc. The high-frequency TCMs include Angelica sinensis, Cyperi Rhizoma, and Cuscutae Semen, etc. The commonly used medicine pairs are Angelica sinensis, Achyranthis Bidentatae (Niuxi), and Ligusticum chuanxiong. The main components in the above three phases include Luteolin, Quercetin, and Emodin, etc., and the core genes for treating ovulatory infertility are AKT1, IL-6, TNF, etc. The main pathways include the pathways related to cancer, fluid shear stress and atherosclerosis, as well as the AGE/RAGE signaling pathway in diabetic complications, etc. In the luteal phase, the main medicines are warm, sweet, and liver-meridian-involved yang-supplementing medicines, blood-tonifying medicines, and qi-supplementing medicines, etc. The high-frequency TCMs include Cuscutae Semen, Rehmanniae Preparata, and Angelica sinensis, etc. The commonly used medicine pairs are Angelica sinensis and Ligusticum chuanxiong. The main components are Sitosterol, Linoleate Ethyl Ester, Myricetin, etc., and the core genes are ESR1, CASP3, PTGS2, etc. The main pathways are the pathways related to cancer, estrogen signaling pathways, and chemical carcinogenesis-receptor activation, etc. Molecular docking verified that the main active components have good binding ability with key targets. Among them, the binding energy of luteolin with TNF during the menstrual period, emodin with TP53 during the follicular phase, quercetin with TNF during the ovulation period, and ligustrazine with PTGS2 during the luteal phase is the smallest. Conclusions: The core drug pairs in each phase of TCM menstrual cycle regulation affect mutiple pathways by regulating key targets, intervening in the treatment mechanisms of ODI.

Key words: Data mining, Molecular docking simulation, Ovulatory dysfunction infertility, Traditional Chinese medicine menstrual cycle regulation method, Analysis of medication rules, Network pharmacology analysis