代谢综合征(Metabolic Syndrome, MetS)是一组复杂的代谢紊乱症候群,集多种代谢紊乱于一身,包括肥胖、高血糖、高血压、血脂异常等,是导致糖尿病心脑血管疾病的危险因素。秦克力教授从事临床工作40年,认为MetS病因病机复杂,累及多脏。从中医整体观念、辩证论治的角度出发,秦克力教授以湿邪弥漫三焦为本病的中医发病机制,临证时常以“分消走泄”为核心治法,效如桴鼓。本文探微秦克力教授基于分消走泄法治疗MetS的临床经验,以飨同道。Metabolic Syndrome (MetS) constitutes a complex cluster of metabolic disorders, integrating multiple metabolic abnormalities such as obesity, hyperglycemia, hypertension, dyslipidemia, etc., and serves as a risk factor for diabetes and cardiovascular cerebrovascular diseases. Professor Qin Keli, who has been dedicated to clinical work for 40 years, holds that the etiology and pathogenesis of MetS are intricate and involve multiple viscera. From the perspective of the holistic concept and the principle of syndrome differentiation and treatment in traditional Chinese medicine, the professor considers the pervasive dampness in the three burners as the TCM pathogenesis of this disease. In clinical practice, the core therapeutic approach of “dispersion and elimination” is often adopted, achieving remarkable results. This article explores Professor Qin Keli’s clinical experience in treating MetS based on the method of “dispersion and elimination” to share with colleagues.
目的 通过网络药理学技术预测益气温阳药治疗冠状动脉微循环功能障碍(coronary microvascular dysfunction,CMD)的作用靶点,了解益气温阳药治疗CMD的作用机制。方法 2022年7月至2023年7月,通过中药系统药理学数据库与分析平台(Traditional Chinese Medicine Systems Pharmacology,TCMSP)获得益气温阳药物活性成分,利用PubChem和Novopro数据库获取药物成分的SMILES值,通过SwissADME平台筛选药物成分,利用Target Prediction获取对应成分的靶点,筛选Probability> 0.1的靶点。利用GeneCards和在线人类孟德尔遗传(OnlineMendelianInheritanceinMan,OMIM)数据库分别获取CMD的疾病靶点,利用Venny在线平台获取药物成分靶点和CMD疾病靶点的交集靶点。将交集靶点数据导入STRING网站,获得蛋白质互作网络,并导入Cytoscape 3.10.1软件,筛选核心靶点,进行可视化,将核心靶点导入David数据库,进行基因本体(gene ontology,GO)和京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG)富集分析,并进行可视化。结果 筛选出药物活性成分34个,对应靶点552个,CMD靶点1 171个,药物靶点和疾病靶点的交集靶点175个,通过STRING和Cytoscape 3.10.1筛选核心靶点33个,主要包括肿瘤坏死因子(tumor necrosis factor,TNF)、丝氨酸/苏氨酸蛋白激酶1(serine/threonine kinase proteins 1,AKT1)、含半胱氨酸的天冬氨酸蛋白水解酶3(cysteinyl aspartate specific proteinase,CASP3)等;GO富集分析表明,益气温阳药可能影响镉离子细胞反应、一氧化氮生物合成正向调节等生物过程,影响一氧化氮合成反应、转录位点调控等分子功能,及膜筏、受体复合物等细胞成分;KEGG富集分析表明,益气温阳药主要通过PI3K/Akt信号通路、雌激素信号通路等发挥生物学效应。结论 益气温阳药可能通过多成分、多靶点、多途径治疗CMD。
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