Clinical Observation And Network Pharmacological Study Of Liuwei Yangxue Mixture In Treating Hypomenorrhea Of Blood Deficiency Syndrome

Objective: The clinical efficacy and safety of Six Flavors Nourishing Blood Compound in the treatment of blood deficiency syndrome of menorrhagia were investigated through clinical control observation of Six Flavors Nourishing Blood Compound and Shengbao Compound,and an attempt was made to explore the molecular mechanism of action by using network pharmacology technology to provide new clinical protocols and theoretical basis for the diagnosis and treatment of menorrhagia,and to provide clinical basis and theoretical foundation for the research and development of new Chinese medicines.Methods: 1.Clinical study: Sixty-four patients who met the inclusion criteria were collected and assigned into 32 cases in the observation group and 32 cases in the control group using the randomized control method.The Six Flavors Nourishing Blood Compound treatment group was the observation group,and the Raw Blood Treasure Compound treatment group was the control group.The total clinical efficiency,PBAC score and endometrial thickness,TCM evidence score and serum FSH,LH and E2 levels of the two groups were analyzed by using SPSS 26.0 software.2.Network pharmacology study: the genes of targets related to menstrual hypomenorrhea were obtained in Genecards,OMIM,Pharm Gkb and Drug Bank databases,and the genes of targets related to menstrual hypomenorrhea were obtained in TCMSP The DAVID online assistant tool is commonly used for GO functional analysis and KEGG signaling pathway analysis of the intersecting genes.platform is used to construct PPI network maps composed of intersecting target genes,while Cytoscape tool software completes the analysis and screening of core genes and involves the formation of herbal compound networks.At the end,key therapeutic targets and related active components were selected for molecular binding and precise docking validation.By screening the active drug components of Liu Wei Nourishing Blood Compound,the potential targets and related signaling pathways of its action on menstrual cramps were predicted,and its molecular mechanism of action in the treatment of menstrual cramps was initially explored.Results: 1.Clinical study:(1)The total PBAC score and endometrial thickness increased to a certain extent in both groups after treatment,and the difference was statistically significant(P<0.05)as the observation group was higher than the control group.(2)The TCM symptoms scores of both groups decreased after treatment,and the degree of decrease was higher in the observation group than in the control group(P<0.05).(3)FSH levels decreased significantly and E2 levels increased significantly in both groups after treatment(P<0.05).The decrease in FSH level in both groups was comparable(P > 0.05),while the increase in E2 level in the observation group was better than that in the control group(P<0.05).There was no significant change in the LH level between the two groups before and after treatment.(4)The effective rates of the observation group and the control group after treatment were 86.67% and 76.67%,respectively,with the observation group slightly better than the control group,and the difference was statistically significant(P <0.05).2.Network pharmacological study:Liu Wei Nourishing Blood Combination contains a total of 62 active ingredients.The drug and the disease According to the PPI network and the network diagram of the Chinese medicine compound,the core targets are STAT3,TP53,AKT1,CYP1A1,ESR1 and MAPK1,etc.GO functional studies have shown that the response to drugs,regulation of gene expression,regulation of apoptosis,response to estradiol and transcription of RNA polymerase II promoter all play a role in biological processes.The results of the KEGG pathway enrichment analysis include PI3K-Akt signalling pathway,AGE-RAGE signalling pathway in diabetic complications,lipids and fluid shear stress and atherosclerosis,IL-17 signalling pathway and endocrine resistance,and TNF signalling pathway.The tight binding and stability of the key molecular targets to the relevant active ingredients was demonstrated in greater depth by molecular docking techniques.Conclusion: 1.Clinical study: In the treatment of menorrhagia with blood deficiency,Liu Wei Nourishing Blood Combination has certain advantages in improving the menstrual flow,endometrial thickness,TCM symptoms score and estradiol level,and is comparable to the control group in improving the FSH level,and the total clinical efficiency of the observation group is slightly higher than that of the control group(P<0.05),and no side effects occurred in all groups,indicating that the clinical efficacy of Liu Wei Nourishing Blood Combination in treating menorrhagia with blood deficiency is The clinical efficacy of Six Flavors Nourishing Blood Combination for the treatment of menorrhagia due to blood deficiency was accurate and safe.2.Network pharmacological studies: quercetin,mancozeb,kaempferol,β-sitosterol,as well as isorhamnetin,lignan and catechin,astragalus metaphyllin,paeoniflorin,and chuanxiongzine may be the main active ingredients of Liouwei nourishing blood combination for the treatment of menorrhagia,possibly through the regulation of STAT3,TP53,AKT1,CYP1A1,ESR1,MAPK1,and other key targets,focusing on the regulation of PI3K-Akt signaling pathway,AGE-RAGE signaling pathway in diabetic complications,blood lipids,and fluid shear stress and atherosclerosis,IL-17 signaling pathway and resistance to endocrine levels,and TNF signaling pathway.