Objective  To explore the medication rules and mechanism of Xin'an physicians in the treatment of diabetes mellitus.

Methods  The prescriptions for the treatment of diabetes mellitus in Xin'an medical writings were collected. The core drug prescriptions were obtained by using IBM SPSS Modeler 18.0 for dispensing association rules as well as complex network analysis, and the cluster analysis of high-frequency traditional Chinese medicines was carried out by using IBM SPSS Statistics 25.0. The active ingredients and targets of the core drugs were extracted from the BATMAN-TCM database. The GeneCards database was used to search for diabetes gene targets, and after obtaining the intersecting targets, the STRING online platform was imported to construct the protein interactions network, and screened the core genes by using the Cytoscape 3.9.1 software, and imported into the DAVID database for GO function and KEGG pathway enrichment analysis.

Results  A total of 135 valid prescriptions were included, involving 184 flavors of traditional Chinese medicines, with cold and mild properties. Sweet, bitter and pungent flavors, and the main attributes of lung, spleen, kidney, stomach and heart meridians. The association rules mined 14 pairs of commonly used medicine pairs. Cluster analysis clustered the top 20 traditional Chinese medicines into five cluster groups. Complex network visualization analysis formed a core prescription consisting of honey-fried licorice root, ginseng, rhizoma anemarrhenae, ophiopogon japonicus, poria cocos. The core prescription drugs were screened for 164 effective active ingredients, 1,498 action targets, 1,995 diabetes gene targets, 404 intersecting targets, 10 core targets were extracted, and a total of 1,363 items covering BP were obtained from GO functional enrichment analysis, 129 items involving CC, 264 items containing MF, and 206 items of KEGG signaling pathway.

Conclusion  The prescriptions and medicines used by Xin'an doctors in the treatment of diabetes mellitus reflect the academic idea of "treating both the symptoms and the root cause" as well as the therapeutic thought of "using cold and warmth, supplementing with sweetness and warmth, opening up and lowering with bitterness, cultivating the earth and generating gold, and consolidating the root and cultivating the elements", which provide references for the treatment of diabetes mellitus in today's clinics.

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