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“异病同治”是指不同的疾病,病机相同,采用相同的方法进行治疗。中医学认为肥胖型多囊卵巢综合征(obese polycystic ovary syndrome,OPCOS)与肥胖型不孕(obese infertility,OI)是两种不同的疾病,但病因病机却相同,都是“恣于酒食”,致使“躯脂满溢,湿痰闭塞子宫”,辨证都可以辨为“痰湿阻滞证”。燥湿化痰是治疗痰湿证的重要法则。因此,利用燥湿化痰的方法治疗这两种疾病符合“异病同治”理论。二陈汤出自《太平惠民和剂局方》,由半夏、陈皮、茯苓、甘草四味中药构成,具有燥湿化痰,理气和中的功效,是治疗痰湿证的基础方。近年来,随着网络药理学研究的深入,“异病同治”成为了中药现代化研究的重要方向:项昌培[1]等研究了三七对糖尿病肾病、糖尿病脑病和糖尿病心肌病的“异病同治”;沈浮[2]等研究了追风透骨胶囊对类风湿关节炎和骨关节炎“异病同治”;丁珊珊[3]等进行了二陈汤治疗“慢性阻塞性肺病”、“多囊卵巢综合征”与“非酒精性脂肪肝”的“异病同治”研究。本文旨在利用网络药理学的方法探讨二陈汤“异病同治”肥胖型PCOS与肥胖型不孕的物质基础与作用机制,以期探讨二陈汤治疗肥胖型PCOS与肥胖型不孕的潜在机制。
Study of ErChen decoction on the treatment of obesity polycystic ovary syndrome and obesity infertility
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摘要:
目的 探究二陈汤治疗肥胖型多囊卵巢综合征和肥胖型不孕的潜在机制,为“异病同治”提供理论依据。 方法 利用TCMSP数据库获取二陈汤的活性成分与靶点,利用Genecard数据库获取肥胖型多囊卵巢综合征和肥胖型不孕的靶点。利用Cytoscape 3.7.1构建活性成分靶点网络,利用STRING获取蛋白互作网络与核心靶点。利用Cytoscape 3.7.1与线上软件进行GO与KEGG富集分析。 结果 获得二陈汤成分125个,靶基因218个;肥胖型不孕靶基因2 783个,肥胖型多囊卵巢综合征靶基因2 962个。二陈汤治疗肥胖型不孕和肥胖型多囊卵巢综合征的共有靶基因117个,体现了“异病同治”的原则;潜在的活性成分包括槲皮素、山奈酚、柚皮素、黄芩苷和刺芒柄花素。蛋白互作网络示STAT3、JUN、AKT1、MAPK3、MAPK1、MAPK14、IL-6和FOS为“异病同治”的核心靶点。分子对接结果显示,槲皮素、山奈酚等成分与JUN具有较好的结合能力。GO与KEGG富集分析显示,AGE-RAGE信号通路、IL-17信号通路、内分泌抵抗可能是二陈汤“异病同治”的关键通路。 结论 二陈汤“异病同治”肥胖型多囊卵巢综合征和肥胖型不孕涉及相同靶点以及通路,可为以后的实验研究提供参考。 Abstract:Objective To explore the potential mechanism of Erchen decoction in the treatment of obese polycystic ovary syndrome and obese infertility, in order to provide theoretical basis for “treating different diseases with same method”. Methods The active ingredients and targets of Erchen decoction were obtained from TCMSP database, and the targets of obese polycystic ovary syndromes and obese infertility were obtained from GeneCard database. Active ingredient-target network was constructed by Cytoscape 3.7.1, and protein-protein interaction network and core target were obtained from STRING. GO and KEGG enrichment analysis were performed by Cytoscape 3.7.1 and online software. Results 125 ingredients and 218 targets of Erchen decoction were obtained. There were 2 783 target genes for obese infertility and 2 962 target genes for obese polycystic ovary syndrome. Erchen decoction has a total of 117 target genes in the treatment of obese infertility and obese polycystic ovary syndromes, which proves the principle of “treating different diseases with same method”. Potential active ingredients include quercetin, kaempferol, naringin, baicalin and formononetin. PPI showed that STAT3, JUN, AKT1, MAPK3, MAPK1, MAPK14, IL-6 and FOS were the core targets of “treating different diseases with same method”. Molecular docking results showed that quercetin, kaempferol, etc. had good binding ability with JUN. GO and KEGG enrichment analysis showed that AGE-RAGE signaling pathway, IL-17 signaling pathway and endocrine resistance might be the key pathways for the “treating different diseases with same method” of Erchen decoction. Conclusion Erchen decoction treating "different diseases with same method" involves same targets and same pathways, which can provide reference for future experimental research. -
Key words:
- phlegm-dampness /
- infertility /
- polycystic ovary syndrome /
- molecular docking /
- network pharmacology
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