Clinical Observation And Network Pharmacology Research On The Treatment Of Premature Ovarian Insufficiency Based On The Periodic Therapy Of Traditional Chinese Medicine

Objective:1.By comparing and observing the clinical effect of Guishenwan on Premature Ovarian Insufficiency of liver-kidney yin deficiency type,to verify that the effect of adding traditional Chinese medicine to patients with Premature Ovarian Insufficiency is better than the effect of hormone replacement therapy alone,showing the characteristics of traditional Chinese medicine.2.Based on the method of network pharmacology,study the mechanism of Guishenwan in treatment of premature ovarian insufficiency.Methods:1.57 patients were divided into observation group and control group according to the random number table.The observation group have 29 patients that treated with traditional Chinese medicine and domperidone,while the control group was treated with domperidone include 28 patients.The FSH,LH,E₂ and TCM symptom scores were recorded before treatment,at the end of treatment and 3 months after treatment.The results were analyzed and treated by statistical methods,and the clinical effects of the two groups were compared and observed.2.By TCMSP obtained the effective components and targets of Guishenwan,and Uniorot standardized the target naming.The network diagram of"traditional Chinese medicine-compound-target"is constructed by using the Cytoscape software.Obtaining targets related to premature ovarian insufficiency through databases such as Gene Cards;Acquiring the intersection of target points;Using String database to obtain protein-protein interaction（PPI）network diagram,and using Network Analysis to obtain key targets;David database was used for gene ontology（GO）analysis and Kyoto Encyclopedia of Genes and Genomes（KEGG）pathway enrichment analysis.Results:1.The differences of FSH,LH,E₂ and TCM symptoms between the two groups before and after treatment were statistical significance,indicating that the two methods have therapeutic effects on premature ovarian insufficiency;There was no significant difference in FSH,LH,E₂ and menstrual cycle between the two groups after treatment（P>0.05）.There was significant difference in menstrual period,menstrual volume,total score of main symptoms of traditional Chinese medicine and total score of secondary symptoms of traditional Chinese medicine after treatment（P<0.05）,indicating that the therapeutic effect of the observation group was better than that of the control group in TCM symptoms.There were statistically significant differences in FSH,LH,E2 and TCM symptoms between the two groups3 months after treatment and before treatment（P<0.05）,indicating that both methods can achieve long-term benefits in the treatment of premature ovarian insufficiency.There was no significant difference in menstrual cycle between the two groups 3 months after treatment（P>0.05）.the difference in FSH,LH,E2,menstrual period,menstrual volume,TCM main symptom total score and TCM secondary symptom total score was statistically significant（P<0.05）,indicating that the effect of the observation group was better than that of the control group in terms of long-term efficacy.2.We searched 139components and 183 targets of Guishenwan,212 hypertension targets,21 common targets and 11 key targets.The biological pathway mainly involves proteoglycan synthesis,vascular endothelial growth factor signal pathway,HIF-1 signal pathway,Toll-like receptor signal pathway,Fox O signal pathway,PI3K-Akt signal pathway,etc.Conclusion:1.The research results show that the observation group and the control group can treat premature ovarian insufficiency from the remission degree of each index,and the curative effect of the observation group is better than that of the control group in menstrual volume,menstrual period and other TCM symptoms of patients after treatment.In terms of long-term benefits,both groups can get long-term benefits,and the effect of the observation group is better than that of the control group.According to the above statistics,the observation group is better than the control group in treating premature ovarian insufficiency.2.Conclusion:Guishenwan may regulate ovarian granulosa cell autophagy by influencing PI3K/AKT and Fox O signaling pathway expression and other mechanisms to treat premature ovarian insufficiency.