Adolescence dysfunctional uterine bleeding:perspectives from the combination of traditional Chinese medicine and modern medicine

Because their endocrine system is not yet developmentally mature,adolescent girls are prone to dysfunctional uterine bleeding caused by insufficiency of the hypothalamic-pituitary-gonadal axis.The view of modern medicine is mainly aimed at the secretory function of sex hormones,such as estrogen and progesterone.However,it causes distress to patients because of the susceptibility of their treatment to endocrine system disorders.Traditional Chinese medicine considers the damage to the function of the Conception Vessel and Thoroughfare Vessel as the key to the disease.In this way,we guide the use of traditional Chinese medicine and acupuncture and achieve good results.The pathogenesis and management of functional uterine bleeding in adolescence are discussed from two medical perspectives in this article.

The therapeutic efficacy and safety of Gongxuening capsule in dysfunctional uterine bleeding:a systematic review and meta-analysis

Background:Gongxuening capsule is a Chinese patent medicine for treating the dysfunctional uterine bleeding.We report a meta-analysis of the combination efficacy between conventional medicines with Chinese patent drug Gongxuening in the treatment of dysfunctional uterine bleeding.Materials and methods:Seven databases were used to retrieve the relevant research of Chinese patent drug Gongxuening treatment for dysfunctional uterine bleeding from the databases establishment to 2020.The data were extracted independently by 2 researchers according to the described selection research.The meta-analysis was performed using RevMan5.3 software.Results:This study included 23 randomized trials,with a total of 1,836 dysfunctional uterine bleeding patients.Chinese patent drug Gongxuening could significantly improve the effective rate,and reduce endometrial thickness,control bleeding time,complete hemostasis time and sex hormone level,and no serious adverse events.Based on sensitivity analysis and subgroup analysis,the heterogeneity sources of endometrial thickness,complete hemostasis time and sex hormone level were found.In follicle stimulating hormone and luteinizing hormone,there was no significant difference between the two groups when Chinese patent drug Gongxuening combined with desogestrel ethinylestradiol.Conclusion:Conventional medicines combined with Chinese patent drug Gongxuening can make patients with dysfunctional uterine bleeding achieve better effective rate,and no serious adverse events occurred.

Identification and verification of effective components of Huanghuai for dysfunctional uterine bleeding based on network pharmacology and molecular docking

Objective:The Huanghuai(HH),which is made from the dried roots of Scutellaria baicalensis(Huangqin in Chinese) and the dried flowers and buds of Sophora japonica(Huaihua in Chinese),is a traditional Chinese formula used to treat dysfunctional uterine bleeding(DUB)(Benglou in Chinese) and proven to treat hemostasis effectively in our previous study.Network pharmacology and molecule docking were performed to study the underlying mechanism of Huanghuai(HH),and pharmacodynamic experiments were conducted to verify its curative effect.Methods:TCMSP,UniProt,GeneCards,STRING,DAVID databases,and Cytoscape 3.7.2 were utilized for the construction of a compound-target-pathway network.Docking the potential effective components with potential targets.The HPLC analysis of the potential effective components was performed.In vivo,the hot plate test model was used to study the analgesic activity,the egg white was used to study the swollen reaction in the sole in mice,and the hemostasis effect was studied by the capillary method,tail-breaking method and abortion uterus test.Results:The results showed that six compounds(acacetin,beta-sitosterol,wogonin,baicalein,kaempferol and quercetin) and four potential targets(PTGS2,AKT1,TP53 and TNF) in the compound-targetpathway network were the potential material basis for HH to treat DUB.It can be seen that the binding energy of the acacetin,wogonin,baicalein,beta-sitosterol,kaempferol and quercetin in HH docked with the receptor proteins PTGS2,AKT1,TP53,and TNF were far less than-5.0 kJ/mol,which means the molecules have low conformational energy,stable structure and high binding activity.And the result of HPLC analysis showed that acacetin,wogonin,baicalein,kaempferol and quercetin were the potential effective components of the hemostasis mechanism of HH,beta-sitosterol was removed due to low content.In vivo testing of the potential effective components,it revealed that the group of potential effective components identified by HPLC could increase the pain threshold,inhibit the swelling hind paws of mice induced by egg white,reduce the bleeding time and clotting time,reduce uterine bleeding,decrease the uterine weight,increase the content of Ca and ET-1,and reduce the content of NO in uterine homogenate tissue,and decrease of E_(2) and P content in uterine serum in aborted rats,whose efficacy was equal to HH.Conclusion:The results indicated that HH and potential active ingredient groups obtained from network pharmacology can treat DUB and play a hemostatic effect.The results obtained by network pharmacology have certain reliability.This study provides new indications for further mechanism research of HH on DUB and the development of HH or its components as an alternative therapy for patients with DUB.At the same time,the application of network pharmacology strategy may provide a powerful tool for exploring the mechanism of traditional Chinese medicine and discovering new biologically active ingredients.