中西医结合慢性病杂志

目的 总结全国老中医药专家吕延伟教授治疗糖尿病足的用药规律，预测核心中药组合治疗糖尿病足的潜在作用机制。方法 整理吕延伟教授诊治糖尿病足的门诊病历，并对纳入的中药复方进行整理分析，同时对其中中药的使用频次、性味归经进行统计，并总结用药规律及挖掘核心中药组合。利用网络药理学和分子对接技术探究核心中药组合治疗糖尿病足的潜在作用机制。结果 共纳入112例糖尿病足患者，279首处方和234味中药。关联规则和系统聚类分析获得核心中药组合为玄参-牡丹皮-赤芍。用网络药理学方法获得核心中药组合的活性成分28个，潜在作用靶点258个。通过蛋白质-蛋白质相互作用网络分析确定了10个核心靶点，包括丝氨酸/苏氨酸激酶1、非受体酪氨酸激酶、肿瘤坏死因子、表皮生长因子受体、雌激素受体1、缺氧诱导因子1α、热休克蛋白90α家族A类成员1、丝裂原活化蛋白激酶3、Jun原癌基因及过氧化物酶体增殖物激活受体γ等。通过京都基因与基因组百科全书通路分析发现，核心中药组合的活性成分主要与Ras蛋白信号通路、磷脂酰肌醇3激酶-蛋白激酶B信号通路、丝裂原活化蛋白激酶信号通路以及糖尿病并发症中的晚期糖基化终末产物-晚期糖基化终末产物受体信号通路等密切相关。结论 通过数据挖掘和网络药理学方法探究吕延伟教授治疗糖尿病足的用药规律及核心中药组合的潜在作用机制，为日后临床治疗提供数据支持，也为后期实验研究奠定了基础。

Objective To summarize the medication rule of Professor LYU Yanwei, an old Chinese medicine expert in China, in treating diabetic foot, and predict the potential mechanism of core Chinese medicine combination in treating diabetic foot. Methods The outpatient medical records of Professor LYU Yanwei's diagnosis and treatment of diabetic foot were sorted out, and the included Chinese herbal compounds were sorted out and analyzed. At the same time, the frequency of use of Chinese herbal medicines, the nature and taste of meridians were counted, and the medication rules were summarized and the core Chinese herbal combinations were excavated. Using network pharmacology and molecular docking technology to explore the potential mechanism of core Chinese medicine combination in the treatment of diabetic foot. Results Totally 112 patients with diabetic foot, 279 prescriptions and 234 Chinese herbs were included. The core combination of traditional Chinese medicine obtained through association rules and systematic clustering analysis is Xuanshen-Mudanpi-Chishao.Using network pharmacology methods, 28 active ingredients and 258 potential targets of the core traditional Chinese medicine combination were obtained. Ten core targets were identified through protein-protein interaction network analysis, including AKT serine/threonine kinase 1, non receptor tyrosine kinase, tumor necrosis factor, epidermal growth factor receptor, estrogen receptor 1, hypoxia inducible factor 1 alpha, heat shock protein 90 alpha family member A, mitogen activated protein kinase 3, Jun oncogene, and peroxisome proliferator activated receptor gamma. Through the pathway analysis of Kyoto Gene and Genome Encyclopedia, it was found that the active components of core Chinese medicine combinations were closely related to Ras signaling pathway, PI3K Akt signaling pathway, MAPK signaling pathway and AGE-RAGE signaling pathway in diabetes complications. Conclusion Through data mining and network pharmacology methods, we explore Professor LYU Yanwei's medication rule and the potential mechanism of core Chinese medicine combinations in the treatment of diabetic foot, providing data support for future clinical treatment, and laying a foundation for later experimental research.