Investigating the mechanisms of Xiaoyaosan on premenstrual dysphoric disorder using metabolomics technology

Abstract

BackgroundXiaoyaosan has been used to treat mental disorders in China for thousands of years. Xiaoyaosan may also provide a potential therapeutic advantage in the treatment of premenstrual dysphoric disorder (PMDD) with few adverse events, but its mechanism of action remains unclear. Aim of this studyThe present study explored the clinical efficacy of the Xiaoyaosan in the treatment of patients with PMDD. Additionally, the metabolomic features and small-molecule marker compounds related to PMDD pathogenesis were investigated. MethodsThirty patients with PMDD were recruited as the treatment group, and sixteen healthy individuals were recruited as the control group. The treatment group was treated with Xiaoyaosan for three menstrual cycles. The Daily Record of Severity of Problems and the PMDD symptom score scale of traditional Chinese medicine were used to evaluate the clinical efficacy of Xiaoyaosan. The urine of all patients was collected for metabolomics analysis using ultra-liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF MS). ResultsTreating PMDD using Xiaoyaosan had significant clinical efficacy compared to the control group. Compared to the control group, urine UPLC-Q-TOF MS test results showed that 39 endogenous differential metabolites were detected in patients with PMDD, which were mainly enriched in ABC transporter proteins, amino acid and nucleotide sugar metabolism, galactose metabolism, fructose and mannose metabolism, arginine and proline metabolism, and the C-type lectin receptor signalling pathway. Compared with the pre-treatment period, 14 endogenous differential metabolites were detected after Xiaoyaosan treatment, which were primarily enriched in riboflavin metabolism, the AMPK signalling pathway, and the caffeine metabolism pathway. ConclusionXiaoyaosan has a curative effect on PMDD. The therapeutic mechanism of Xiaoyaosan may be related to regulating energy metabolism in the nervous system.