Study On The Network Pharmacology And Clinical Effect Of Shaoyao Gancao Decoction In The Treatment Of Hyperandrogenism In Polycystic Ovary Syndrome

Purpose:1.Network Pharmacology Research:By using network pharmacology to explore the action targets and related pathways of Shaoyao Gancao Decoction in the treatment of hyperandrogenemia in polycystic ovary syndrome（PCOS-HA）,and to analyze and predict its mechanism of action,which provides research direction for future clinical and experimental research,and provides data support for the clinical research part of this subject.2.Clinical research:By observing the clinical efficacy of Shaoyao Gancao Decoction combined with Tiaogan Dinggui Decoction in improving the hormone level and TCM Syndromes of PCOS-HA patients,this topic provides a new idea and method for the clinical treatment of PCOS-HA.Methods:1.Network Pharmacology Research:The active ingredients and targets of Shaoyao Gancao Decoction were screened by TCMSP database combined with oral bioavail ability（OB）,drug-like property（DL）,and half-life period.Genecards,Drugbank,and OMIM databases were used to obtain the treatment targets of hyperandrogenism in polycystic ovary syndrome."Chinese medicine-active ingredient-target"visualization network map was built by Cytoscape3.7.2 software.VENNY diagram was used to screen out common targets of drugs and diseases.The protein interaction network（PPI）was constructed by STRING online analysis tool and Cytoscape3.7.2 software.The David database performed functional gene ontology（GO）enrichment analysis and common enrichment analysis of the Kyoto Gene and Genomic Encyclopedia（KEGG）pathways for key targets.2.Clinical research:From November 2019 to November 2020,60 patients with PCOS-HA diagnosed as"liver depression and kidney deficiency"in the gynecological clinic of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into two groups.The observation group was treated with Shaoyao Gancao Decoction combined with Tiaogan Dinggui Decoction,and the control group was treated with Tiaogan Dinggui Decoction for 3 menstrual cycles.The therapeutic effects of body mass index（BMI）,sex hormone level,glucose metabolism index,hirsutism,acne,basic body temperature（BBT）and TCM syndrome score of the two groups were observed,and spss25.0 software was used for statistical analysis.Results:1.Network Pharmacology Research:Quercetin,kaempferol,7-methoxy-2-methyl isoflavone and formononetin were screened from Shaoyao Gancao Decoction,41 key targets such as MAPK3,MMP-9,STAT3,TNF,IL-6,and VEGF were founded.The key targets mainly involved in positive regulation of protein phosphorylation,lipopolysaccharide-mediated signaling pathway,positive regulation of NF-κB transcription factor activity,and cellular response to hypoxia and other biological processes,participated in TNF,HIF-1,Fox O,Toll-like receptors and other signaling pathways to treat hyperandrogenism in polycystic ovary syndrome.2.Clinical research:Before treatment,the difference was not statistically significant between the observation group and the control group in age,course of disease,BMI,sex hormone level,glucose metabolism index,hairiness,acne,BBT,menstrual cycle,menstrual period,TCM syndrome score,etc.,which was comparable（P>0.05）.The observation group and the control group were compared before and after treatment,the BMI,acne and hairiness of the two groups were significantly improved,and the difference was statistically significant（P<0.01）.Before and after treatment in the observation group,the difference was not statistically significant in estradiol（E₂）,fasting plasma glucose（FPG）（P>0.05）.The difference was statistically significant in follicle stimulating hormone（FSH）,luteinizing hormone（LH）,LH/FSH,testosterone（T）,fasting plasma insulin（FINS）,and homeostatic model assessment of insulin resistance（HOMA-IR）（P<0.01）.In the control group,the difference was not statistically significant in FSH,E2 and FPG before and after treatment（P>0.05）,but it’s was statistically significant in LH,LH/FSH,T,FINS and HOMA-IR（P<0.01）.After treatment,the differences in BMI,FSH,and acne scores between the two groups were statistically significant（P<0.05）,and the differences in LH,LH/FSH,T,FPG,and HOMA-IR were statistically significant（P<0.01）,E2,fins and polysilagina scores were not statistically significant（P>0.05）.The difference was statistically significant in menstrual cycle,menstrual period between the observation group and the control group before and after treatment（P<0.05）.After treatment,the difference of menstrual cycle score between the two groups was statistically significant（P<0.01）,and the difference of menstrual period score between the two groups was statistically significant（P<0.05）.After treatment,there were 22 cases of BBT double warm phase in the observation group,accounting for75.86%;there were 13 cases of BBT double warm phase in the control group,accounting for 46.43%,the observation group was better than the control group（P<0.05）.In terms of TCM syndrome efficacy,the total effective rate was 93.1%in the observation group and92.9%in the control group.Conclusion:1.Network Pharmacology Research:This network pharmacology study found that Shaoyao Gancao Decoction could act on TNF,HIF-1,Fox O,Toll-like receptors and other signaling pathways through TNF,IL6,STAT3,VEGFA and other targets to regulate glycolipid metabolism,protect vascular endothelium and participate in inflammatory response to reduce androgen synthesis and play a role in treating hyperandrogenism in polycystic ovary syndrome.2.Clinical research:Shaoyao Gancao Decoction combined with Tiaogan Dinggui Decoction can effectively improve the T level of PCOS-HA patients,and has significant advantages in regulating BMI,FSH,LH,LH/FSH,T,HOMA-IR,acne,menstrual cycle,menstrual period,BBT,etc.compared with Tiaogan Dinggui Decoction alone.Although there was no significant difference in improving FINS,hairiness,irritability and irritability between the two groups,it also has certain curative effect,and can effectively improve the TCM syndrome curative effect,with outstanding clinical curative effect,which is worthy of popularization and application.