Medication Rule and Molecular Mechanism of Chinese Medicine in the Treatment of Diminished Ovarian Reserve Based on Data Mining and Network Pharmacology

  OBJECTIVE  To explore the medication patterns of traditional Chinese medicine in treating diminished ovarian reserve (DOR), summarize the characteristics of the disease and medication ideas, and reveal the material basis and mechanism of action of commonly used medicines in clinical practice by data mining technology and network pharmacology approach.

  METHODS  Collect clinical literature related to the treatment of DOR from China National Knowledge Infrastructure (CNKI). Extract prescription information, establish a medication database, and analyze the distribution of syndrome types and medication patterns. Use network pharmacology methods to elucidate the key targets and molecular mechanisms of high-frequency medicine combinations with the effects of tonifying the kidney and nourishing Yin and blood in the treatment of DOR with liver and kidney Yin deficiency syndrome.

  RESULTS  64 prescriptions and 120 traditional Chinese medicines were screened from the database. The commonly used and strongly correlated medicines for DOR treatment were Cuscuta chinensis, Rehmanniae Radix Praeparata, Angelica, Radix Paeoniae Alba, Epimedium brevicornu Maxim, Fructus Lycii. The combination of six high-frequency medicines contains 40 active components and 163 targets for treating DOR with liver and kidney Yin deficiency syndrome, involving PGR, ESR1, VEGFA, etc. The key signaling pathways mainly include cancer pathways, interactions between cytokines and their receptors, progestogen-mediated oocyte maturation, etc.

  CONCLUSION  This paper preliminarily analyzed the compatibility law of traditional Chinese medicine in treating DOR, adhering to the essence of "kidney deficiency", with nourishing liver and kidney essence and blood as the main treatment principle, and supplemented by regulating qi, resolving blood stasis, strengthening the spleen, and soothing the liver. At the molecular level, the mechanism of high-frequency medicine combination treatment for DOR with liver and kidney Yin deficiency syndrome was revealed, which provided a theoretical basis for the development and clinical application of subsequent DOR medicine.