| Objective:(1)To observe the clinical effect of Bushen Yangjing Decoction combined with Femoston in the treatment of diminished ovarian reserve of kidney deficiency type;(2)The mechanism of Bushen Yangjing Decoction in the treatment of diminished ovarian reserve was analyzed based on network pharmacology.Methods:(1)A total of 60 patients with renal deficiency ovarian reserve dysfunction were randomly divided into treatment group and control group,with 30 cases in each group.The treatment group was given Bushen Yangjing decoction combined with Femoston;the control group was given only Femoston.Three menstrual cycles were a course of treatment,and the treatment group and the control group were treated with one course of treatment.Record two groups of patients before and after treatment of TCM syndrome score,sex hormone index and the number of double ovarian antral follicles,the data were statistically analyzed.(2)The effective components,related parameters and targets of Bushen Yangjing decoction were obtained by TCMSP;according to Uniprot,find the corresponding target protein name;based on Cytoscape software,the component target network was obtained;obtain disease target genes according to genecards of disease database;then the key target genes of Bushen Yangjing Decoction in the treatment of ovarian reserve dysfunction were obtained;based on the string database,the protein network interaction map is obtained;GO function enrichment analysis and KEGG pathway enrichment analysis were performed by DAVID database and Cluego software.Results:(1)(1)In terms of TCM syndrome score and curative effect,the TCM syndrome score of the two groups decreased significantly after treatment,and there were significant differences before and after treatment(P < 0.01).Compared with the two groups after treatment,the syndrome score of the treatment group was significantly lower than that of the control group(P < 0.01).After treatment,the total effective rate of the treatment group was 90.00 %;the total effective rate of the control group was 66.67 %,and the treatment group was better than the control group(P <0.01).(2)In terms of serological indexes,FSH,LH,FSH / LH,E2 and AMH in the two groups were significantly improved after treatment,and the difference was significant(P < 0.05).Compared with the control group,the treatment group was better in FSH,E2 and AMH,with statistical significance(P < 0.05).In terms of LH and FSH / LH,the improvement in the treatment group was not with the control group,and the difference was not statistically significant(P >0.05).(3)In improving the number of antral follicles,the AFC of the two groups were significantly improved after treatment,and the difference was statistically significant(P < 0.01).Compared with the control group,the AFC level in the treatment group was significantly improved,with statistical significance(P < 0.01).(2)198 effective components of Bushen Yangjing decoction were retrieved,and 1133 target components were obtained.1277 target genes for ovarian reserve dysfunction were retrieved,and 143 key targets were obtained.The interaction map of the key target gene network was obtained,which contained 113 nodes,834 interaction relationships,and8 nodes with Degree ≥ 20;GO enrichment results involved 758;KEGG pathway enrichment analysis obtained 353 pathways.Conclusion:(1)Bushen Yangjing decoction combined with Femoston in the treatment of kidney deficiency type of diminished ovarian reserve clinical curative effect is remarkable,can significantly improve the patient ’s TCM syndrome score;can also significantly improve serum FSH,E2 and AMH,increase the number of antral follicles;and no adverse reactions during medication,high safety factor,worthy of promotion.(2)In this study,through network pharmacology,it was found that quercetin,kaempferol,luteolin,β-sitosterol,naringin and other components in Bushen Yangjing Decoction could act on multiple targets such as TP53,AKT1,MAPK3,MAPK1,TNF,ESR1,IL-6,and treat ovarian reserve dysfunction through PI3K-Akt,AMPK and other signaling pathways,reflecting the characteristics of Bushen Yangjing Decoction as a compound multi-component,target,and pathway,and provided a theoretical basis for its application in clinical and subsequent experimental studies. |
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