Medication Rule And Network Pharmacology Study Of Menorrhagia In Adenomyosis Based On HIS System

Objective:To explore the medication characteristics in the clinical treatment of menorrhagia in adenomyosis,excavate the core drugs,and elaborate its action mechanism based on component-target-pathway,so as to provide the theoretical basis for further treatment of menorrhagia in adenomyosis.Methods:1.Case data of patients diagnosed with adenomyosis and menorrhagia in the Gynaecology Outpatient Department of Affiliated Hospital of Shandong University of Chinese Medicine from September 2020 to September2022 were collected,and the Traditional Chinese Medicine Inheritance Computer System V3.0 was used for drug frequency,meridian tropism of four qi and five flavors,association rules and clustering analysis to explore the potential laws of drugs and obtain the core prescription drugs.2.Network pharmacology is used to explore the action mechanism of core drugs.The active components of drugs were screened by TCMSP database,and the target was matched by uniprot database to construct a drug-component-target network.The disease targets of menorrhagia in adenomyosis were retrieved and intersected with drug targets to obtain potential targets.The PPI network diagram was constructed using Cytoscape software,and GO biological function analysis and KEGG signaling pathway analysis were performed.Results: 1.A total of 176 patients were included,and the onset age was mainly concentrated in the range of 35–48 years old.A total of 289 prescriptions were collected,involving 240 traditional Chinese medicines.The top 10 most frequently used prescriptions were Radix Codonopsis,Rhizoma Atractylodis Macrocephalae,Radix Angelicae Sinensis,Radix Paeoniae Alba,Herba Leonuri,Radix Astragali seu Hedysari preparata,Radix Glycyrrhizae Preparata,Rhizoma Cyperi,Concha Ostreae,and Eclipta prostrata.The drug was mainly sweet and warm in taste,with a large proportion in the meridians of liver,spleen and kidney.It was commonly used for deficiency type,promoting blood circulation to remove blood stasis type,heat type,hemostatic,regulating qi type of Chinese medicine Drug association rules mainly involved Radix Codonopsis,Rhizoma Atractylodis Macrocephalae,Radix Angelicae Sinensis,Radix Paeoniae Alba,Herba Leonuri,Radix Astragali seu Hedysari preparata,and Rhizoma Cyperi,and they were determined to be the core prescription composition.Clustering analysis was used to obtain five potential new formula combinations.2.Network pharmacology analysis: 66 active components of core prescription drugs and 250 corresponding targets were obtained through screening.There were 77 disease-related targets for menorrhagia in adenomyosis,and 26 drug-disease intersection targets.Quercetin,kaempferol,luteolin,7-O-methylisomucronulatol,isorhamnetin,are the core active components of the drug,and TP53,AKT1,MMP9,ESR1,VEGFA,and MMP2 are the key targets.GO analysis focuses on cellular response to chemical stress,hypoxia,smooth muscle cell proliferation and other biological processes.KEGG mainly involves fluid shear stress and atherosclerosis,tumor signaling pathway,estrogen signaling pathway,endocrine resistance,HIF-1 signaling pathway,EGFR tyrosine kinase inhibitor resistance pathway and other signaling pathways.Conciusion:1.Menorrhagia in adenomyosis belongs to the syndrome of deficiency in origin and excess in superficiality.The disease was located in liver,spleen,and kidney.Clinical medication tended to be sweet and warm,with tonifying qi as the main principle,resolving stasis and eliminating pathogen,combined with the methods of resolving phlegm,removing dampness,warming the interior,clearing heat,and detoxicating,and taking both manifestation and root cause into consideration.The core prescription components were Radix Codonopsis,Radix Angelicae Sinensis,Radix Astragali seu Hedysari preparata,Radix Paeoniae Alba,Rhizoma Cyperi,Rhizoma Atractylodis Macrocephalae,and Herba Leonuri.2.The effective components in the core prescription exert the therapeutic effects by acting on such targets as TP53,AKT1,MMP9,ESR1,VEGFA,and MMP2,regulating fluid shear stress and multiple signaling pathways such as atherosclerosis,tumor pathway,estrogen signaling pathway,endocrine resistance,and HIF-1 pathway,and intervening in the processes of cell proliferation and apoptosis,angiogenesis,hormone regulation,hypoxia,and inflammatory reaction and other processes.