Clinical And Network Pharmacology Study On The Treatment Of Polycystic Ovary Syndrome With Kidney Deficiency And Phlegm-dampness By Using Bushen Huatan Prescriptio

Purpose:To observe the clinical efficacy of Bushen Huatan Decoction combined with Yousiming in the treatment of polycystic ovary syndrome due to kidney deficiency and phlegm dampness.On the basis of symptomatic treatment in western medicine,the characteristics of TCM based on syndrome differentiation were brought into full play,so as to provide reliable data for the clinical application and promotion of this prescription.At the same time,based on the network pharmacology method,the effective chemical components,gene targets and action pathways of Bushen Huatan Recipe in treating polycystic ovary syndrome were discussed from the molecular point of view,so as to better guide the clinic.Materials and methods:Paper I: Clinical efficacy of Bushen Huatan Decoction in treating polycystic ovary syndrome with kidney deficiency and phlegm dampnessMethods:76 patients with polycystic ovary syndrome who met the acceptance criteria were enrolled.They were randomly assigned to observation group(which treated with Yousiming)and control group(which treated with Bushen Huatan Decoction and Yousiming),with 38 cases in each group.During the treatment period,both groups were given health education and physical exercise,with one month as a treatment cycle.A total of 3 cycles of treatment and follow-up.Clinical efficacy was evaluated from waist-to-hip ratio(WHR),body mass index(BMI),TCM syndrome score,serum sex hormone level,ovarian volume and lipid metabolism index.Results:1 Comprehensive curative effect: After treatment,the effective rate of the observation group was 86.8%,while that of the control group was 76.3%.The curative effect of the observation group was better than control group,with statistical difference(Z=-4.211,P=0.000).2 BMI,WHR: After treatment,there were differences in BMI and WHR between the two groups(P < 0.05);Compared with the two groups after treatment,the observation group has better curative effect in reducing BMI and WHR(P < 0.05).3 TCM syndrome score: After treatment,the total score and single score of TCM syndrome in observation group and control group were improved,and the difference was statistically significant(P < 0.05);After treatment,the observation group has a better curative effect in reducing the total score of TCM syndromes(P < 0.05),among which the two groups have the same curative effect in treating soreness of waist and knees and decreased libido(P > 0.05),and the other treatment effects of the observation group are better than those of the control group(P < 0.05).4 Sex hormone level: After treatment,LH,LH/FSH and T in all groups were improved with statistical difference(P < 0.05),while FSH values had no significant difference(P > 0.05);After treatment,the effect of improving LH,LH/FSH and T in the observation group was better than that in the control group,with statistical difference(P < 0.05).5 Lipid metabolism level: After treatment,LDL-C,HDL-C,TC and TG of the two groups were all improved,and the difference was statistically significant(P < 0.05),suggesting that both the observation group and the control group could improve their blood lipids.After treatment,the effect of LDL-C was similar between two groups(P > 0.05).The treatment effect of improving HDL-C,TC and TG in the observation group was better than that in the control group(P < 0.05).6 Ovarian volume: There was no significant change in ovarian volume in both groups after treatment(P > 0.05).Conclusion: Compared with western medicine alone,Bushen Huatan recipe combined with Yousiming is more effective in treating polycystic ovary syndrome with kidney deficiency and phlegm-dampness syndrome.Menstruation and clinical symptoms are obviously improved,and the hormone level and lipid metabolism level of patients are more effectively regulated.During the whole treatment period,Bushen Huatan recipe combined with Yousiming has no toxic and side effects and is safe.Therefore,choosing traditional Chinese medicine or combination of traditional Chinese and western medicine to treat polycystic ovary syndrome has a broad development prospect and is worth popularizing and applying.Paper II: The network pharmacological study of Bushen Huatan Recipe in treating polycystic ovary syndrome with kidney deficiency and phlegm dampness syndrome.Methods: The effective compounds and targets corresponding to 10 Chinese medicines of Bushen Huatan recipe were searched and screened through TCMSP database,and the related targets of PCOS diseases were obtained by Genecards、Disgenet and CTD database.Get the intersection targets of Bushen Huatan Recipe-PCOS by VLOOLKUP function of EXCEL.The intersection targets are imported into the STRING11.0 platform to obtain PPI protein interaction network,and the network topology is analyzed by the "Network Analysis"function of Cytoscape,so as to screen the core targets,and the PPI network is further analyzed by MCODE plug-in to obtain the protein function sub-module.The intersection targets of Bushen Huatan Recipe-PCOS was sent to the website of Metascape,and the GO Biological Processes,GO Molecular Functions,GO Cellular Components and KEGG were analyzed and the "active ingredient-targets-pathway" network was constructed..Results: 1 After searching and screening,99 effective compounds of Bushen Huatan Recipe were obtained,with 278 corresponding targets and 2605 PCOS targets.After the intersection,189 intersection targets were obtained.Through the analysis of Kupao science,it is found that the main components of Bushen Huatan recipe are quercetin,kaempferol,luteolin and so on.TP53,AKT1,JUN,TNF,EGFR,IL6 and other 32 targets are located in the main position in PPI network,which may be the key targets of Bushen Huatan recipe to achieve pharmacological effects.2 GO enrichment analysis shows that Bushen Huatan recipe can widely regulate the biological process of diseases from the aspects of molecular function,cell composition and biological process.3 The enrichment analysis of KEGG pathway shows that the main pathways of Bushen Huatan recipe in treating PCOS include AGE-RAGE signaling pathway,cancer pathway,IL-17 signaling pathway,EGFR tyrosine kinase inhibitor drug resistance,estrogen signaling pathway and so on.Conclusion: Through the research of network pharmacology,it is found that Bushen Huatan Recipe has the characteristics of multi-target and multi-pathway.It may play a therapeutic role in many ways,such as anti-inflammation,regulating glucose and lipid metabolism,and regulating immunity.