Clinical Efficacy And Network Pharmacology Study Of Yiqi Guchong Decoction In The Treatment Of Spleen Deficiency Syndrome Metrorrhagia

Purpose: By observing Professor Chen Ying’s clinical patients with metrorrhagiadue to spleen deficiency syndrome,to verify the clinical efficacy of Yiqi Guchong Decoction in the treatment of metrorrhagiadue to spleen deficiency syndrome,and to provide real and reliable data for the clinical application of this prescription,based on the network pharmacology method,to explore the effective compounds,gene targets and mechanism of action of Yiqi Guchong Decoction in the treatment of metrorrhagiadue to spleen deficiency syndrome from the perspective of network pharmacology,and to establish a network model of "multi-component-multi-target",so as to provide a scientific basis for the treatment of this disease with Yiqi Guchong Decoction,better guide clinical practice,and lay the foundation for the research and development of new drugs and the clinical expansion and application of classical prescriptions.Material and method:Part Ⅰ: the clinical effect of spleen-deficiency type of metrorrhagia syndrome with Yiqi Guchong Decoction.Method:Using the method of self-control before and after,53 cases of metrorrhagia with spleen deficiency syndrome who met the inclusion and exclusion criteria were selected,3cases dropped out,a total of 50 cases.Yiqi Guchong Decoction is orally administered daily in the bleeding period.In the hemostasis period,calcined keel,calcined oyster and Agrimonia pilosa are added on the basis of the front,and Angelica sinensis,Codonopsis pilosula,Lycium barbarum,Cuscuta chinensis and other products for invigorating the spleen and tonifying the kidney,nourishing blood and regulating menstruation are added and subtracted according to different clinical symptoms.One bleeding cycle is a course of treatment.Three consecutive courses of treatment are taken to determine the efficacy and followed up.The clinical efficacy is evaluated from the short-term vaginal hemostatic effect,TCM score,TCM single symptom score.Results:1.Short-term efficacy of vaginal hemostasis: 50 patients,15 cases of rapid-acting hemostasis,28 cases of significant effect,6 cases of effective,1 case of ineffective,the overall response rate of treatment was 98%.2.TCM score: 50 patients,14.44 ± 4.422 before treatment,4.54 ± 2.915 after treatment,after paired t-test,the difference was statistically significant(P < 0.05).3.TCM single symptom score: Through paired t-test,the symptom scores of vaginal bleeding days,vaginal bleeding volume,fatigue,shortness of breath,lazy speech,scanty complexion,reluctant diet,and loose stools and diarrhea after treatment were significantly lower than those before treatment,with significant differences(P < 0.05).4.Efficacy of regulating menstruation: 50 cases,7 cases recovered(14%),20 cases were significantly effective(40%),22 cases were effective(44%),1 case was ineffective(2%),and the overall response rate was 98%.5.During the treatment of 50 patients,no drug toxicity or adverse events occurred.6.The recovered patients were followed up after 3 menstrual cycles of drug withdrawal,and no recurrence was observed.Conclusion :1.Professor Chen Ying believes that although metrorrhagiais different,spleen deficiency syndrome is rare,bleeding period is mainly to replenish qi and invigorate the spleen,Guchong hemostasis,the choice of Yiqi Guchong Decoction;hemostasis period attaches importance to invigorating the spleen and kidney,nourishing blood and regulating Chong,consolidating the root and regulating menstruation,on the basis of Yiqi Guchong Decoction addition and subtraction treatment.2.The total effective rate of vaginal hemostasis was 98%,indicating that Yiqi Guchong Decoction is effective in treating metrorrhagiaof spleen deficiency syndrome.3.Yiqi Guchong Decoction can significantly reduce the TCM score and significantly improve the TCM clinical symptoms of patients with metrorrhagiadue to spleen deficiency syndrome.4.The therapeutic effect of Yiqi Guchong Decoction on regulating menstruation is 98%,indicating that this prescription has a significant effect on adjusting menstrual cycle,menstrual period and menstrual volume during hemostasis.5.No drug toxicity and adverse events occurred during the whole treatment period,indicating that Yiqi Guchong Decoction is safe and effective.6.During follow-up,it was found that the recovered patients did not have recurrence,indicating that Yiqi Guchong Decoction is not easy to relapse in the treatment of this disease,and the long-term effect is good.Part Ⅱ:The Network pharmacology study of Yiqi Guchong Decoction in treatment of spleen-deficiency type of metrorrhagia syndrome.Method: Through multiple database retrieval and mining,the mechanism of Yiqi Guchong Decoction in treating metrorrhagia of spleen deficiency type was explored.The effective compound components corresponding to 11 herbs of Yiqi Guchong Decoction were excavated in TCMSP and TCMID databases,mapped in TCMSP and Stitch databases,the corresponding target genes were selected,the network diagram of herb-component-target relationship was constructed using Cyto Scape3.7.2 software,and the main components of the core compounds were obtained by analysis.The disease-related targets of metrorrhagia due to spleen deficiency syndrome were selected through the Genecards database,and the TCM gene targets and disease gene targets were mapped using the venny online mapping tool to obtain the intersection genes,and the selected intersection genes were imported into the String11.0database,the results were exported and the protein-protein interaction PPI network model was constructed using Cyto Scape3.7.2 software,and the network visualization analysis was performed through the plugin Cyto NAC to obtain the core target genes,and then the enrichment analysis was performed on the Metascape platform,followed by GO biological process enrichment analysis and KEGG pathway enrichment analysis of the intersection targets.Results:1.There are a total of 182 effective compound components of Yiqi Guchong Decoction acting on 155 target proteins of metrorrhagia of spleen deficiency type.Through TCMSP and TCMID database screening,it was found that the main active compounds of Yiqi Guchong Decoction in the treatment of spleen deficiency type metrorrhagia disease included eight core compounds such as mistletoe,santinol,isorhamnetin,and rhamnosine,and the top 20 key target proteins such as TP53,STAT3,JUN,IL6,TNF,VEGFA,and ESR1 were selected by multiple database searches.2.GO biological process enrichment analysis showed that Yiqi Guchong Decoction may cure metrorrhagia due to spleen deficiency syndrome through life activities such as coagulation-fibrin clot formation,coagulation,hemostasis,response to steroid hormones,positive regulation of cell motility,and apoptotic signaling pathways.3.KEGG pathway enrichment analysis showed that Yiqi Guchong Decoction mainly acts on signaling pathways such as vascular endothelial growth factor and ovarian steroidogenesis.Conclusion:1.Network pharmacology study and analysis obtained the main active components and key targets of Yiqi Guchong Decoction on metrorrhagia of spleen deficiency type.According to the results and complex network analysis diagram,different traditional Chinese medicine drugs in Yiqi Guchong Decoction act on the same compound components,and different compound components can also act on the same targets,so that the synergistic effect of multiple components and multiple targets of Yiqi Guchong Decoction can be fully verified,further demonstrating the characteristics of network pharmacology-"multiple components-multiple targets".2.GO biological process enrichment analysis speculated that Yiqi Guchong Decoction can regulate the biological process of the disease as a whole.3.KEGG pathway enrichment analysis showed that Yiqi Guchong Decoction synergistically produced hemostasis and regulated hormone levels through signaling pathways.