目的 运用数据挖掘、网络药理学和分子对接的方法,探讨中药复方治疗中枢性性早熟（CPP）的用药规律和作用机制,为其临床治疗提供更多依据。方法 在中国知网（CNKI）、万方数据（Wanfang）、维普中文期刊（VIP）等数据库中检索从建库至2022年10月发表的中药复方治疗CPP的文献,用Excel 2021 收集整理临床治疗CPP的常用中药复方,并通过Excel 2021、SPSS Modeler 18.0、SPSS Statistics 25.0等软件对其进行频次、关联规律等分析,研究CPP治疗的用药规律。在上述基础上采用网络药理学的研究方法,筛选出高频药对的活性成分、作用靶点以及疾病的相关靶点,构建蛋白互作网络,并通过基因本体和京都基因 基因组百科全书通路富集分析来阐明药物的作用机制。最后运用 Autodock Vina 软件进行分子对接对结果验证。结果 共筛选出224篇文献,包含方剂133首,中药188味。发现18味使用超过25次的高频药物;清热类、补虚类的药物应用较多;药物性味以寒及苦为主;归经之中以肝经占比最高;进一步关联分析得到高频药对14个;核心处方4个。网络药理学结果显示,共得到44个活性成分、200个药物靶点、1 287个疾病靶点、70个共有靶点、573条GO富集条目及136条KEGG通路,药物主要成分槲皮素、山奈酚、β-谷甾醇作用于雌激素受体、黄体酮受体等核心靶点,通过内分泌抵抗、雌激素等信号通路发挥治疗作用。分子对接结果显示药物主要活性成分与相应核心靶点具有较好的结合能力。结论 中药复方治疗CPP多为滋阴清热、补虚类药物,与药性寒,药味苦、甘,归肝、肾经的药物配伍使用。其中高频药对“知母-黄柏”通过多成分、多靶点调控内分泌抵抗、雌激素信号通路发挥治疗作用。

Objective To explore the prescription rules and mechanism of traditional Chinese medicine（TCM） in the treatment of central precocious puberty（CPP）by using data mining,network pharmacology and molecular docking,so as to provide more evidence for clinical treatment．Methods Using the literature on the treatment of CPP with TCM compounds,which was retrieved from the databases of CNKI,Wanfang,VIP and other databases from the establishment of the database to October 2022 as the data sources．Excel 2021 was used to collect and summarize the commonly used TCM prescriptions for CPP,and conducted frequency analysis and association rules analysis of CPP by Excel 2021,SPSS Modeler 18.0,SPSS Statistics 25.0 and other software,so as to study the composition rule of prescriptions for CPP．On the basis of these results,network pharmacology method was used to screen out the active ingredients and action targets of high-frequency drugs,and then screen out the disease related targets to construct PPI network．Mechanism of drugs was clarified through GO and KEGG pathway enrichment analysis．Finally,the molecular docking of autodock Vina（Vina）platform was used to verify the results．Results A total of 244 documents met the search criteria,including 133 prescriptions and 188 traditional Chinese medicines．It had been found that 18 high-frequency Chinese medicines were used more than 25 times．The drugs mainly focused on clearing heat and supplementing deficiency．The medicinal flavors were mainly cold and bitter,which belonged to the liver channel．Further correlation analysis yielded 14 high-frequency drug pairs and 4 core prescriptions．The results of network pharmacological analysis showed that 44 active components,200 drug targets,1 287 disease corresponding targets,70 common targets,573 GO enrichment entries and 136 KEGG pathways targets were obtained．It has been found that the main components of the drugs,such as quercetin,kaempferol and β-sitosterol,act on the core targets of ESR1,PGR and play a therapeutic role through endocrine resistance and estrogen signaling pathways．Finally,molecular docking results showed that the main active ingredients of the drug had good binding ability with the corresponding core targets．Conclusions In the treatment of CPP,traditional Chinese medicine is mainly used types of nourish Yin,clear heat and replenish deficiency,which is compatible with the drugs with cold properties,bitter and pliant taste,and the liver and spleen channels．Among them,high-frequency drug pair “ZhiMu-HuangBai” play a therapeutic role in the regulation of endocrine resistance and estrogen signaling pathways through multi-components and multi-targets．

目的 探讨不同年龄儿童性早熟的影响因素及预防措施。方法 本文将2020年1月—2021年1月的性早熟儿童45例(观察组)与正常健康儿童45例(对照组)作为研究对象,通过问卷调查的形式了解所选儿童的家庭因素、饮食、生活方式与社会因素等方面的情况,通过单因素分析与多因素分析探讨相关影响因素。结果 观察组不同年龄段儿童在骨龄、身高、体质量、BMI方面存在统计学差异,P＜0.05;观察组性激素水平明显高于对照组,P＜0.05。结论 儿童性早熟的发生与生活习惯、家庭关系、饮食习惯、母亲初潮年龄等因素有关,帮助其养成科学合理的生活习惯与饮食习惯,改善家庭关系可很好的降低并预防儿童性早熟的发生。对于已经出现性早熟现象的儿童来说,学校与家庭要及时给予其合理的健康教育,包括心理方面与生殖健康方面,及时有效的疏导可有效避免性早熟对儿童心理方面造成不良影响。

Objective To explore the influencing factors and preventive measures of precocious puberty in children of different ages. Methods 45 cases of precocious puberty children (observation group) and 45 cases of normal healthy children (control group) from January 2020 to January 2021 were selected as the research objects. The family factors, diets, lifestyles and social factors of the selected children were investigated by questionnaire survey, and the related influencing factors were discussed by single factor analysis and multi factor analysis. Results There were statistical differences in bone age, height, weight and BMI among children of different ages in the observation group, P<0.05. The levels of sex hormones in the observation group were higher than those in the control group, P<0.05. Conclusion The occurrence of children's precocious puberty is related to living habits, family relations, eating habits, mother's menarche ages and other factors. To help them develop scientific and reasonable living habits and dietary habits and improve family relations can reduce and prevent the occurrence of children's precocious puberty. For children with precocious puberty, schools and families should give them proper health education in time, including psychological and reproductive health. Timely and effective counseling can effectively avoid the adverse effects of precocious puberty on children's psychology.