2025 年第 6 期 第 20 卷

探讨中药治疗椎间盘退变的用药规律及作用机制

The medication rules and mechanism of traditional Chinese medicine in the treatment of intervertebral disc degeneration

作者：董爽1李星萱1谢宗均1文天林1刘东华2

英文作者：Dong Shuang1 Li Xingxuan1 Xie Zongjun1 Wen Tianlin1 Liu Donghua2

单位：1北京中医药大学东直门医院骨伤科六区，北京101100；2江西省南昌市洪都中医院创伤三科，南昌330038

英文单位：1Department of Orthopedics Ⅵ Dongzhimen Hospital Beijing University of Chinese Medicine Beijing 101100 China; 2The Third Department of Trauma Nanchang Hongdu Hospital of TCM Jiangxi Province Nanchang 330038 China

关键词：椎间盘退变；网络药理学；数据挖掘；中医药

英文关键词：Intervertebraldiscdegeneration;Networkpharmacology;Datamining;TraditionalChinesemedicine

• 摘要：

• 目的 基于数据挖掘分析中医药治疗椎间盘退变（IVDD）的用药规律，运用网络药理学探讨核心药物组合治疗IVDD的作用机制。方法 以中国知网、万方数据库、维普期刊数据库为数据来源，使用Apriori算法对数据进行关联规则分析。在此基础上通过网络药理学分析核心药物治疗IVDD的作用机制，并借助分子对接验证核心成分与关键靶点之间互相作用关系。结果 共纳入167篇文献，筛选出复方52首，涉及中药109味。关联规则分析得到核心药物组合为“红花-桃仁-川芎-当归”。网络药理学分析得到核心活性成分27种，主要包括槲皮素、木犀草素、山柰酚、黄芩素、β-胡萝卜素、β-谷甾醇等；核心靶点73个，主要为血管内皮生长因子A（VEGFA）、细胞肿瘤抗原p53（TP53）、肿瘤坏死因子（TNF）、基质金属蛋白酶9（MMP-9）等。共涉及164条信号通路，主要为白细胞介素17通路、TNF信号通路、癌症信号通路等。分子对接结果表明网络药理学所预测核心靶点能与核心药组关键活性成分稳定结合。结论 “红花-桃仁-川芎-当归”药物组合中的槲皮素、木犀草素、山柰酚、黄芩素等多个成分可能是治疗IVDD的物质基础，能够作用于VEGFA、TP53、TNF、MMP-9等多个靶点，通过调节TNF信号通路、白细胞介素17信号通路、癌症信号通路等参与减少炎症反应、控制髓核细胞的凋亡、调控细胞外间质的代谢等途径来发挥治疗IVDD的作用。

• Objective To analyze the medication rules of traditional Chinese medicine in the treatment of intervertebral disc degeneration (IVDD) based on data mining, and to explore the mechanism of core drug combination in the treatment of IVDD using network pharmacology. Methods Apriori algorithm was used to analyze the association rules of the data based on CNKI, Wanfang database and VIP journal database. On this basis, the mechanism of core drugs in the treatment of IVDD was analyzed by network pharmacology, and the interaction between core components and key targets was verified by molecular docking. Results A total of 167 articles were included, and 52 compound formulas were screened, involving 109 Chinese herbs. Association rule analysis showed that the core drug combination was "safflower-peach kernel-Chuanxiong-Angelica". Network pharmacology analysis identified 27 core active ingredients, including quercetin, luteolin, kaempferol, baicalein, β-carotene, β-sitosterol, etc. There were 73 core targets, mainly vascular endothelial growth factor A (VEGFA), cellular tumor antigen p53 (TP53), tumor necrosis factor (TNF), matrix metalloproteinase 9 (MMP-9), etc. A total of 164 signaling pathways were involved, mainly interleukin-17 pathway, TNF signaling pathway, cancer signaling pathway, etc. Molecular docking results  showed that the core targets predicted by network pharmacology could stably bind to the key active components of the core drug group. Conclusions Quercetin, luteolin, kaempferol, baicalin and other components in the drug combination of "safflower-peach kernel-Chuanxiong-Angelica" may be the material basis for the treatment of IVDD, which can act on VEGFA, TP53, TNF, MMP-9 and other targets. It plays a role in the treatment of IVDD by regulating TNF signaling pathway, IL-17 signaling pathway, cancer signaling pathway and other pathways to reduce inflammatory response, control the apoptosis of nucleus pulposus cells, and regulate the metabolism of extracellular matrix.