Distribution Of TCM Syndrome Types In Menopausal Syndrome And Network Pharmacology Study Of Ningkun Jieyu Decoctio

Objective:This study conducted an investigation and analysis of menopausal syndrome(MPS)in Beijing to explore the current status of MPS’s quality of life,risk factors,and distribution of traditional Chinese medicine syndromes,providing a reference basis for MPS health management and clarifying the distribution characteristics of syndromes.Based on clinical experience and the distribution characteristics of MPS syndromes,Professor Li Hao created Ningkun Jieyu Decoction and use network pharmacology research methods to explore the potential target points of Ningkun Jieyu Decoction for treating MPS and carry out serum verification.Methods:The study selected MPS patients who met the inclusion criteria for a questionnaire survey,which included a general survey form,an improved Kupperman scale,a menopausal quality of life scale(MENQOL),and a traditional Chinese medicine clinical information collection form.The current status of MPS’s quality of life,influencing factors,and distribution of traditional Chinese medicine syndromes were statistically analyzed.The researchers used TCMSP and BATMAN-TCM databases to screen for the active ingredients and targets of Ningkun Jieyu Decoction.They used GeneCards and OMIM databases to search for disease targets of MPS and took the intersection of drug and disease target genes to obtain the potential targets of compound treatment for MPS.They constructed the "active ingredient-target-pathway-disease" network of Ningkun Jieyu Decoction through Cytoscape3.8.2 software,constructed the PPI protein interaction network through the String database,used the clusterProfiler program package in R language to perform GO and KEGG pathway enrichment analysis,and explored the potential targets of Ningkun Jieyu Decoction in treating MPS.Results:1.Clinical study results:(1)This study included 405 patients with MPS,with an average age of 51.31± 0.237 years,mainly engaged in mental work(53.33%),with a bachelor’s or college degree(49.63%),married(87.41%),and postmenopausal(60.74%).According to the modified Kupperman scale score,there were 168 cases(41.48%)of mild MPS,204 cases(50.37%)of moderate MPS,and 33 cases(8.15%)of severe MPS.The MENQOL scale showed high scores on vascular constriction dimension and psychosocial dimension.(2)Personality,breastfeeding situation,exercise situation,MPS understanding level,work and life stress will affect the severity of MPS symptoms,among which introverted personality,non-breastfeeding,no exercise,low level of understanding of MPS will increase the risk,while low work and life stress will reduce the risk.(3)Among the 405 MPS patients,the common symptoms were fatigue(68.4%),insomnia(61.23%),forgetfulness(59.26%),mental tension(58.27%),backache(56.05%),irritability(55.06%),palpitations(53.33%),hot flashes and sweating(47.16%),chest and rib pain(43.95%),and hot flashes and facial flushing(43.7%).The distribution of syndrome types was:liver depression transforming into heat syndrome(30.86%),spleen-kidney yang deficiency syndrome(16.05%),liver-kidney yin deficiency syndrome(15.80%),heart-kidney non-intersecting syndrome(14.32%),kidney yin deficiency syndrome(10.62%),kidney yin-yang deficiency syndrome(6.67%),and kidney yang deficiency syndrome(5.68%).Concurrent liver depression syndrome was present in 18.52%of cases,phlegm-dampness syndrome in 9.38%,spleen deficiency syndrome in 8.15%,blood stasis syndrome in 7.16%,and damp-heat syndrome in 3.70%.2.Network pharmacology and validation results:(1)Based on network pharmacology research,186 active drug ingredients and 124 potential drug targets were screened,and 95 therapeutic targets were obtained by intersecting with 4253 MPS disease targets.The core drug key active ingredients include wogonin,baicalein,methoxyisoflavone,glycyrrhizic acid A,β-carotene,β-sitosterol,and sophoricoside.The protein interaction network has 94 nodes and 1215 edges.Key targets include VEGFA,IL-8,AKT1,IL-6,TP53,TNF,CTNNB1,ESR1,MYC,CCND1.GO functional enrichment analysis yielded 1655 biological processes,144 molecular functions and 35 cellular components.KEGG pathway enrichment analysis yielded 164 signaling pathways including AGE-RAGE signaling pathway and IL-17 signaling pathway.(2)Experimental verification of key targets using enzyme-linked immunosorbent assay found that Ningkun Jieyu Decoction can significantly reduce the content of VEGF and IL-8 in the serum of MPS patients(P<0.05).Conclusions:1.MPS patients are greatly influenced by psychological and social factors.There is a significant correlation between factors such as personality,exercise habits,understanding of MPS,work-life stress and the severity of MPS symptoms.Early intervention for risk factors may be beneficial for the prevention and treatment of MPS.2.The traditional Chinese medicine compound Ningkun Jieyu Decoction may treat liver depression and heat syndrome in MPS by acting on multiple targets such as VEGF A,IL-8,IL-6 and so on through multiple active ingredients such as wogonin,baicalein and so on to regulate AGE-RAGE,IL-17 and other signaling pathways.