目的 基于古今醫(yī)案云平臺(tái)分析中成藥治療慢性乙型病毒性肝炎的用藥規(guī)律，并基于網(wǎng)絡(luò)藥學(xué)方法探究核心藥材組合治療慢性乙型病毒性肝炎的潛在作用機(jī)制，為慢性乙型病毒性肝炎的臨床用藥提供參考。方法 收集藥融云數(shù)據(jù)庫(kù)中收錄的治療慢性乙型病毒性肝炎中成藥，對(duì)其所含藥味、功能主治等信息進(jìn)行摘錄，經(jīng)過(guò)數(shù)據(jù)篩選、標(biāo)準(zhǔn)化處理，建立標(biāo)準(zhǔn)化醫(yī)案數(shù)據(jù)庫(kù)，利用古今醫(yī)案云平臺(tái)，從中藥頻次、中藥屬性、聚類(lèi)分析、藥物關(guān)聯(lián)分析等方面進(jìn)行數(shù)據(jù)挖掘，總結(jié)慢性乙型病毒性肝炎用藥特點(diǎn)，篩選核心藥材組合。采用網(wǎng)絡(luò)藥理學(xué)方法對(duì)核心藥材進(jìn)行靶點(diǎn)預(yù)測(cè)、蛋白質(zhì)相互作用（PPI）分析、京都基因與基因組百科全書(shū)（KEGG）通路富集分析，構(gòu)建“藥材-成分-靶點(diǎn)-通路”網(wǎng)絡(luò)，預(yù)測(cè)核心藥材作用機(jī)制。結(jié)果 藥融云數(shù)據(jù)庫(kù)共收載治療慢性乙型病毒性肝炎中成藥114種，除去不同劑型，共計(jì)80種，涉及中藥材279味，其中用藥頻次較高的中藥有黃芪、丹參、虎杖、當(dāng)歸等15味中藥。藥性多見(jiàn)于寒、平、微寒、溫；藥味多屬甘、苦、辛味；歸于肝、脾、肺、心4經(jīng)的較多；藥物功效以清熱解毒占比最高。核心藥材組合虎杖-白花蛇舌草-丹參的17個(gè)主要活性成分可作用于132個(gè)核心靶點(diǎn)，調(diào)控包括HIF-1、IL-17、PI3-Akt、TNF、乙型肝炎等信號(hào)通路。結(jié)論 臨床中成藥治療慢性乙型病毒性肝炎以疏肝健脾、清熱利濕為主，同時(shí)兼以活血化瘀、補(bǔ)虛止痛，達(dá)到虛實(shí)同治的良好效果。核心藥材虎杖-白花蛇舌草-丹參通過(guò)多個(gè)成分干預(yù)多個(gè)靶點(diǎn)、進(jìn)而調(diào)控多條與慢性乙型病毒性肝炎相關(guān)的信號(hào)通路來(lái)發(fā)揮治療作用。

Objective Based on the cloud platform of ancient and modern medical records, the medication rules of Chinese patent medicines (CPM) in the treatment of chronic hepatitis B (CHB) were analyzed, and the potential mechanism of core herbs in the treatment of CHB was explored based on the network pharmacy method, so as to provide reference for the clinical medication of CHB. Methods The CPM for the treatment of CHB included in the Yaorongyun database were collected, and the information such as the herbs and function of the CPM were extracted. After data screening and standardization, a standardized medical case database was established. Using the ancient and modern medical case cloud platform, data mining was carried out from the aspects of frequency statistics, correlation analysis, cluster analysis and complex network analysis, etc., and the characteristics of CHB medication were summarized and the core herbs were screened. The target prediction, protein-protein interaction (PPI) analysis, KEGG pathway enrichment analysis and 'herb-component-target-pathway' network construction of core herbs were carried out by network pharmacology method to explain the mechanism of core herbs. Results A total of 114 kinds of CPM for the treatment of chronic hepatitis CHB were collected. After removing different dosage forms, 80 kinds of CPM were obtained, involving 279 kinds of herbs. Among them, 15 kinds of herbs with a higher frequency of use for treating CHB were Astragali Radix, Salviae Miltiorrhizae Radix et Rhizoma, Polygoni Cuspidati Rhizoma et Radix, Angelicae Sinensis Radix, etc. The medicinal properties were more common in cold, mild, slightly cold and warm; the taste of the medicine was mostly sweet, bitter and pungent; it was mainly attributed to the four meridians of liver, spleen, lung and heart. The efficacy of drugs was the highest in heat-clearing and detoxifying. Drug association analysis identified ten groups of drug combinations. Four groups of clustering were obtained by cluster analysis. The 17 main active components of the core herbs could act on 132 core targets and regulate signaling pathways including HIF-1, IL-17, PI3-Akt, TNF, hepatitis B and other signaling pathways. Conclusion Clinical CPM in the treatment of CHB is mainly based on soothing liver and invigorating spleen, clearing heat and removing dampness, and at the same time, promoting blood circulation and removing blood stasis, tonifying deficiency and relieving pain, so as to achieve the good effect of simultaneous treatment of deficiency and excess. The core herbs Polygoni Cuspidati Rhizoma et Radix-Hedyotis diffusa-Salviae Miltiorrhizae Radix et Rhizoma intervenes in multiple targets through multiple components and regulates multiple signaling pathways related to CHB to play a therapeutic role.

R285.5

河北省中醫(yī)藥管理局科研計(jì)劃項(xiàng)目（2019125）