| Objective: To use data mining methods to understand the connotation of three core syndromes of PCOS from TCM’s macro perspective and micro bioinformatics.1.The TCM syndrome and TCM medication rules of PCOS were summarized and analyzed,so as to provide reference for the standardized research on TCM syndrome diagnosis.2.To explore the molecular biological connotation of common core symptoms of PCOS and the molecular mechanism of prescription therapy for TCM symptoms,so as to provide a theoretical basis for molecular biology for follow-up research and scientific evidence and reference for the prevention and treatment of PCOS and screening of potential candidates for traditional Chinese medicine.Methods:1.Search PCOS-related clinical research literature in CNKI,Wanfang,VIP,CBM and other literature databases.Extract and sort out the data,which included TCM syndrome performance,TCM diagnosis,Western medical diagnosis and treatment prescription drugs of PCOS in literature,enter them into the TCM inheritance assistance platform,and use the platform and WPS Excel conducts statistical analysis of literature inclusion,statistical analysis of TCM syndromes,commonly used Chinese drugs and composition rules,and summarizes and analyzes the core symptoms of each common syndrome,its common therapeutic drugs,the core prescription of each syndrome and the association rules between drugs.2.In this study,the "disease-syndrome" association molecular interaction networks of various TCM syndromes of PCOS were constructed using the links among symptoms-related genes collected from TCMIP V2.0 and PCOS-related disease genes obtained from databases such as Gene Cards,OMIM,and Dis Ge Net;and the core targets of each syndrome of PCOS were calculated by these networks.Then,DAVID database performs was used to enrichment analysis the GO,KEGG and Reactome signal pathway of the "disease-syndrome" association core targets.In the next step,the potential targets of the prescription of various syndromes were obtained through searching the herb of each core prescription of various syndromes from the TCMIP V2.0 platform and the protein interaction of these targets were analyzed by the STRING database.Import the results into Cytoscape to build the PPI network and to calculate the core targets of the prescription of various syndromes of PCOS.And then,GO,KEGG,and Reactome signal pathway enrichment analyses were carried out on the prescription’s core targets obtained above.Results:1.A total of 469 articles were included,involving a total of 39 TCM syndromes,arranged in order of frequency from high to low,the most common syndromes are kidney deficiency and blood stasis syndrome,phlegm hygroblock syndrome,kidney deficiency and phlegm dampness syndrome,kidney deficiency and liver depression syndrome,kidney deficiency and sputum and blood stasis syndrome,spleen deficiency phlegm dampness syndrome,spleen and kidney deficiency syndrome,etc.Among the disease locationg factors,the most common factor is kidney,the second are spleen and liver,as well as,among the disease nature factors,the most common factor is deficiency,the second are phlegm wetness and blood stasis.The core symptoms of the top 4 common TCM syndrome are concluded.the main symptoms of kindney deficiency and blood stasis syndrome are as follow: oligomenorrhea,postponement of menstruation,and even amenorrhea,infertility,decreased female libido,waist and knee soreness,vertigo,tinnitu,menstrual color is dark or dull and with blood clots,abdominal pain refusal to press when menstrual period and the pain remit after the blood clots discharged,fatigue,anergy,pollakisuria,pale tongue with ecchymosis and petechiae,deep and sluggish of the pulse.The main symptoms of phlegm hygroblock are as follow: obesity,oligomenorrhea,postponement of menstruation,and even amenorrhea,infertility,large among of leucorrhea,chest tightness,vertigo,nausea,fatigue,hirsutism,increased phlegm,greasy mouth,fatigue,drowsiness,poor appetite,diarrheas,light menstrual color,acne,pale and light fat tongue with tooth marks on the edge,white greasy moss,smooth pulse.The main symptoms of kidney deficiency and phlegm dampness syndrome are as follow: obesity,oligomenorrhea,postponement of menstruation,and even amenorrhea,infertility,waist and knee soreness,vertigo,tinnitus,diarrheas,chest tightness,fatigue,decreased libido,large among of leucorrhea,sensation of chill,hirsutism,fatigue,greasy mouth,nausea,increased phlegm,poor appetite,light menstrual color,pale and light fat tongue,white greasy moss,deep and slender of the pulse.The main symptoms of kidney deficiency and liver depression syndrome are as follow: amenorrhea,infertility,oligomenorrhea,postponement of menstruation,abnormal uterine bleeding,waist and knees soreness,irritability,Metopic Depression,Vertigo,sore breast,tinnitus,acne,chest and flank distention,thin and white moss,tight pulse like a chord or deep weak pulse.The treatment and medication rules of the top 4common TCM syndrome of PCOS are as follows.The core prescription of kidney deficiency and blood stasis syndrome is mainly composed by dodder,prepared rehmannia root,angelica,ligusticum striatum,salvia miltiorrhiza,cornus officinalis,cyperus rotundus,epimedium,lycium barbarum,safflower and chinese yam.The core prescription of phlegm hygroblock syndrome is mainly composed by atractylodes lancea,cyperus rotundus,poria,tangerine peel,pinellia ternata,rhizoma arisaematis,fructus aurantii,liquorice,angelica,ligusticum striatum and dodder.The core prescription of kidney deficiency and phlegm dampness syndrome is mainly composed by dodder,pinellia ternata,poria,angelica,cyperus rotundus,tangerine peel,atractylodes lancea,prepared rehmannia root,ligusticum striatum,cornus officinalis,epimedium and liquorice.The core prescription of kidney deficiency and liver depression syndrome is mainly composed by dodder,angelica,cyperus rotundus,bupleurum chinense,prepared rehmannia root,white atractylodes rhizome,lycium barbarum,cornus officinalis,poria.2.The biological processes involved in the core targets of the three common syndrome of PCOS are jointly enriched in gene transcription,cell proliferation and apoptosis,organ development,protein phosphorylation and other processes,and the signaling pathways involved include the following 4 functions.First of all,It is related to the regulation of cell cycle,gene transcription and protein synthesis,affecting the basic function regulation of cells such as cell growth,proliferation and aging.Secondly,It is related to the metabolism and regulation of a variety of hormones in the human body.Thirdly,It is related to material energy metabolism and redox reaction.Last bu no least,It is related to the body’s immune system and inflammatory response.From the aspects of significant enrichment signal pathway and GO function,it can be found that the different syndroms of PCOS with different etiologies and pathogenesis show different emphasis.For example,Kidney deficiency and blood stasis syndrome is significantly enriched in pathways related to immune inflammatory response and thrombosis.Phlegm hygroblock syndrome is also significantly enriched in the related pathways that regulate energy metabolism,especially carbohydrate and lipid metabolism and immune inflammatory response.Kidney deficiency and liver depression syndrome is also significantly enriched in the related pathways that regulate blood coagulation and regulate the nervous system.The core formula of treating kidney deficiency and blood stasis syndrome has shown potential regulatory effects in promoting the metabolism of energy substances in the body,providing subtle nutrients,regulating the endocrine system,promoting the operation of blood and the smoothness of blood vessels,and improving the body’s immunity and anti-inflammatory response state.The core formula of treating phlegm hygroblock syndrome has shown potential regulatory effects in promoting the metabolism of energy substances in the body,especially the metabolism of carbohydrates and lipids,regulating the endocrine system,promoting the development and maturation of the body and the secretion of hormones,improving the body’s immunity and antiinflammatory response state.The core formula of treating kidney deficiency and liver depression syndrome has shown potential effects in regulating abnormalities in the nervous system,regulating the body’s energy metabolism,improving the absorption and metabolism of nutrients,regulating the body’s endocrine system,regulating the secretion and metabolism of hormones,improving the body’s immunity and anti-inflammatory response state.Conclusion:1.Among all the syndromes included in the study,most of them are composite types,reflecting the complexity of PCOS pathogenesis,but the distribution of PCOS is more concentrated,and the most common factors in the disease position are kidney,spleen and liver;Among the pathogenic elements,the most common are deficiency,sputum dampness,and blood stasis.Through the analysis of the composition law,it was found that the core formula for the treatment of kidney deficiency and blood stasis syndrome was mainly based on Yougui Pill and Siwu Soup;The core formula of phlegm hygroblock syndrome was mainly based on Qi Gong Pill and Atractylodes and Cyperus Phlegm-Abducting Pill,and flavored kidney tonic drugs;The core formula of kidney deficiency and phlegm dampness syndrome was mainly composed of Yougui Pill and Atractylodes and Cyperus Phlegm-Abducting Pill;The core composition of kidney deficiency and liver depression syndrome was mainly composed of Xiaoyao powder,Yougui Pill,and Siwu Soup.2.There are both differences and connections between the biological connotations of the three common syndromes of PCOS.The pathological changes of three common syndromes were all related to multiple molecular mechanisms of cell cycle regulation disorders,endocrine system disorders,energy and material metabolism disorders,and immune-inflammatory responses.Moreover,the pathological changes of kidney deficiency and blood stasis syndrome were closely related to immune inflammatory response and thrombotic mechanism.Besides,the pathological changes of phlegm hygroblock syndrome were closely related to carbohydrates and lipids energy metabolism disorders and the pathological changes of kidney deficiency and liver depression were closely related to nervous system abnormalities and circulatory system disorders.All the results above are basically consistent with the clinical interpretation of PCOS etiology and pathogenesis differentiation in TCM,which is conducive to understanding the essence of the syndrome.By acting on the core target of "disease-syndrome-formula",the core formula of treating various syndrome plays the role of promoting material energy metabolism,promoting the absorption of fine micronutrients,regulating the metabolism of endocrine hormones,improving the body’s immunity,alleviating inflammatory states,regulating nervous system abnormalities,promoting blood operation and regulating vasculature benefits.In order to improve the clinical symptoms of various PCOS’s syndromes. |
PDF Full Text Request