目的 基于数据挖掘技术分析宋爱莉教授治疗乳腺癌骨转移的用药规律.方法 收集2019年6月至2022年6月山东中医药大学附属医院宋教授门诊及住院诊治的乳腺癌骨转移患者服用的中药处方,运用中医传承辅助平台[M]V2.5)分析其用药频次、药物功效、四气、五味、归经及用药规律.结果 筛选出中药处方145首,共涉及中药161味,用药频次居于前6味的是补骨脂、三七、枸杞子、黄芪、党参、莪术,药物类别以补肾、活血类药使用频率最高,药性以温、平为主,药味以甘、苦为主,归经以肝、脾、肾经为主,关联规则网络分析发现补骨脂、枸杞子、三七、白花蛇舌草、莪术、黄芪、党参、甘草、茯苓、当归10味药为宋教授治疗乳腺癌骨转移核心处方,基于熵聚类药物核心组合挖掘出潜在新方3个.结论 宋教授治疗乳腺癌骨转移以"补肾活血,益气养血"为核心治法,辅以化痰祛湿、理气、解毒抗癌等药物治疗.

目的 基于数据挖掘及网络药理学方法探讨宋爱莉教授治疗肉芽肿性小叶性乳腺炎(GLM)的用药规律及核心药对作用机制.方法 收集2021年6月—2022年6月山东省中医药大学附属医院宋爱莉教授门诊及住院诊治的GLM患者服用的中药处方.通过中医传承辅助平台挖掘相关用药规律,并利用网络药理学分析核心药对的作用机制.结果 共有248首中药处方纳入本研究,金银花-连翘药对为宋爱莉教授治疗本病的核心药对;金银花-连翘药对的重要活性成分有槲皮素、木犀草素、汉黄芩素等;金银花-连翘药对作用于GLM的关键靶点有肿瘤坏死因子(TNF)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、CXC趋化因子配体8(CXCL8)、趋化因子配体2(CCL2)等;药对活性成分调控的主要信号通路有白细胞介素-17(IL-17)信号通路、Toll样受体信号通路、TNF信号通路等.结论 宋爱莉教授辨证多从阳证论治GLM,以化痰散瘀、透脓解毒、益气养血为核心治法,金银花-连翘为核心药对,其可能通过调控IL-17信号通路、Toll样受体信号通路、TNF信号通路发挥治疗GLM的效果.

目的:基于数据挖掘及网络药理学总结中医药治疗男性乳房发育症的用药规律,探究核心药对的作用机制.方法:收集整理中国知网、万方数据库、维普数据库中关于中医药治疗男性乳房发育症的文献,筛选并构建数据库;运用Excel 2010、IBM SPSS Modeler 18.0、IBM SPSS Statistics 21.0软件进行数据挖掘,分析研究用药规律;并利用网络药理学方法获取核心药对有效成分、构建网络图和相关作用通路;利用SwissDock数据库对主要有效成分和核心靶点进行对接验证.结果:共纳入中药处方68首,中药135种,药性以寒、温、平为主;药味以苦、辛、甘为主;使用频数大于等于10的药物共27种.其中柴胡的使用频数最高.综合关联规则、聚类分析的结果,柴胡—白芍为中医药治疗男性乳房发育的关键药对,其主要作用成分为槲皮素、山柰酚、β-谷甾醇等.关键靶点为雌激素受体1(Estrogen Receptor 1,ESR1)、孕酮受体(Progesterone Receptor,PGR)、细胞色素P4503A4酶(Cytochrome P450 Family 3 Subfamily A Member 4,CYP3A4)、血管内皮生长因子A(Vascular Endothelial Growth Factor A,VEGFA)、丝氨酸/苏氨酸蛋白激酶1(Akt Serine/Threonine Kinase 1,AKT1)等.主要作用通路为类固醇激素生物合成通路、癌症通路、黏着斑信号通路、催乳素信号通路和PI3K-Akt信号通路等.分子对接结果显示,关键靶点与主要有效成分具有较好的结合活性.结论:男性乳房发育症以补肾疏肝为主要治法.方药以补虚药为核心,辅以化痰药,佐以活血理气药,其核心药对通过调控乳腺细胞增殖、血管生成、细胞凋亡等信号传导通路发挥作用.

目的 探讨脓肿期肉芽肿性小叶性乳腺炎(GLM)与哺乳期乳腺炎(LM)的中医用药规律及差异.方法 筛选自建库至2021年12月发表在中国生物医学文献服务系统、中国知网、万方数据库和维普网中关于中医药治疗脓肿期GLM、LM的文献,应用中医传承计算平台分析脓肿期GLM、LM核心用药及组方规律,并比较两者差异.结果 治疗脓肿期GLM、LM的方剂中,前10位高频次药物有7味相同,3味不同.两者四气、五味、归经比较,脓肿期GLM、LM的用药均寒温并用,以苦、甘味药为主.脓肿期GLM的温性、甘味用药占比高于脓肿期LM;两者用药归经均以肝、胃、肺经为主;用药分类中均以清热、补虚、化痰、活血化瘀类药物为主,脓肿期GLM的补虚、化痰、活血化瘀类药物用药占比高于脓肿期LM.进一步分析得到脓肿期GLM潜在药对6个,脓肿期LM潜在药对7个,并各得到一组核心药物组合.结论 脓肿期GLM和LM均以清热解毒、托里排脓为治疗原则,脓肿期LM需加强扶正补虚之功,并佐以化痰、活血之品;脓肿期LM则需加强清热凉血之功.

Objective: To evaluate clinical efficacy by traditional Chinese combined with western therapy to treat upper extremity edema after breast cancer surgery. The clinical efficacy was described by the effective rate and the change of peripheral diameter of the affected limb. Methods: National Knowledge Internet (CNKI), Wan Fang Digital Journals (Wan Fang), VIP Chinese periodical service platform (VIP), Chinese biomedical literature service system (CBM), PubMed and EMBASE were searched on computer. And clinical randomized controlled trials (RCT) of the treatment of upper extremity edema after breast cancer surgery with integration of Chinese and western treatment were selected. The time was from January 2011 to May 2020. Upper extremity edema after breast cancer surgery was the first key word and the second was traditional Chinese combined with western therapy. Note Express was used to screen and extract literature. Bias risks of all the literature included in the study were evaluated and analyzed by RevMan5.3 software. Results: 10 randomized controlled clinical tests, 644 patients in conformity to the inclusion criteria, 9 for the observation of curative effectiveness, 5 of changes in limb circumference. 322 cases were included in the observation group and the same number of cases in the control group, all of which were in Chinese. The results expressed that the curative effect in the observation group was 91.1％, and it was higher than the curative effect in the control group treated by single western treatment obviously, and it was only 68.9％ [95％ CI (1.22, 1.44), Z = 6.55, P < 0.00001]. The peripheral diameter shrinking degree of the affected limb in the observation group was also clearly higher than that in the control group which was healed by simple western treatment[95％ CI (-0.98, -0.64), Z = 9.40, P < 0.00001]. Conclusion: Traditional Chinese combined with western therapy treating upper extremity edema after the surgery of breast cancer had a notable clinical effect, which treated the disease and effectively lessened the peripheral diameter of the affected limb. The method was worthy of clinical application. However, owing to the low quality of the included documents, further discussion and learning were still needed.

目的:系统评价中医与西医结合治疗乳腺癌术后出现上肢水肿的疗效,临床效果用有效率和患肢周径的变化来描述.方法:借助计算机网络检索中国知网(CNKI)、万方(Wan Fang)、维普(VIP)网、中国生物医学文献服务系统(CBM)、PubMed、Embase,检索筛选中西医结合治疗乳腺癌术后上肢水肿的临床随机对照试验(RCT),查阅时间范围是2011年1月～2020年5月,检索关键词是乳腺癌术后上肢水肿、中西医治疗,管理软件Note Express用来进行文献筛选和数据提取,Meta分析借助于软件RevMan5.3操作,研究中所有需要的文献指标均被采纳.结果:10篇临床随机对照试验,644例患者符合纳入标准,9篇为治疗有效率观察,5项是患肢周径的变化研究,观察组322例,对照组322例,纳入的文献全部为中文文献.研究结果表明,对照组(单纯西医治疗)对于乳腺癌术后上肢水肿治疗的有效率为68.9％,明显低于观察组(中西医结合治疗)有效率91.1％[95％CI(1.22,1.44),Z=6.55,P<0.00001];观察组(中西医结合治疗)患肢周径减小程度明显高于对照组(单纯西医治疗)[95％CI(-0.98,-0.64),Z=9.40,P<0.00001].结论:中西医结合方法治疗乳腺癌术后上肢水肿的临床效果显著,可以明显提高水肿缓解率,有效减小患肢周径,在临床上值得推广和使用.但是,由于纳入文献的质量较低,因此仍需要进一步的研究与学习.