Treatment Of Primary Dysmenorrhea Research Articles

Exploring the Mechanisms of Yuanhu Zhitong Oral Liquid for Primary Dysmenorrhea through Network Pharmacology, Molecular Docking, and Molecular Dynamics Simulation

Objective: Primary dysmenorrhea (PD) is a prevalent gynecological disorder. Yuanhu Zhitong oral liquid (YHZT) presents a promising alternative treatment for PD. However, the mechanisms underlying its efficacy remain unclear. This study aims to investigate the potential targets and mechanisms of action of YHZT in treating PD using network pharmacology, molecular docking, and molecular dynamics simulations. Methods: Potential compounds from YHZT were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and the Traditional Chinese Medicine Information Database (TCMID). The relevant targets of these compounds were identified using the similarity ensemble approach (SEA) and the Swiss Target Prediction database. PD-related targets were retrieved from the Genecards, DrugBank, and Disgenet databases. ClusterProfiler was utilized for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. The compound-target-pathway (CTP) network was constructed to facilitate the identification of key compounds, core targets, and signaling pathways. Finally, molecular docking and molecular dynamics simulations were performed to evaluate the interactions between the targets and compounds. Results: A total of 153 putative compounds and 129 targets of YHZT were identified. Network topology analysis revealed eight core targets and six key compounds. The effects of YHZT were mediated by genes associated with hormone and steroid metabolism, as well as pathways involved in steroid hormone biosynthesis and cytochrome P450 enzymes. Docking results showed free-binding energies ranging from -6.06 to -10.85 kcal/mol, indicating strong binding affinity between the compounds and targets. Molecular dynamics simulation results further confirmed the stability of these interactions. Conclusion: This study demonstrates that YHZT treats PD by suppressing inflammatory reactions and modulating hormone and cytochrome P450 concentrations. Key compounds such as ferulic acid, (R)-canadine, (S)-canadine, canadine, and asristolone are implicated in this process. These findings offer insights into the mechanisms underlying the action of YHZT and provide a foundation for further research in this area.

Efficacy of acupuncture-related therapy in the treatment of primary dysmenorrhea: A network meta-analysis of randomized controlled trials

ObjectivesIn order to compare and rank the most effective acupuncture therapy for primary dysmenorrhea and provide evidence-based medical support for clinical treatment of this disease. MethodsA comprehensive search was conducted on China National Knowledge Infrastructure (CNKI), Wanfang Database, Information Chinese Journal Service Platform (VIP), China Biomedical Literature Service System (SinoMed), PubMed, Web of Science, Embase, and Cochrane Library databases from their inception to May 1, 2023. The Cochrane Collaboration Risk of Bias Tool was used to evaluate bias risk, and the GeMTC package of Stata 15.1 software and R 4.3.1 software was used to perform network Meta-analysis. Results70 studies were included, including 5772 patients with primary dysmenorrhea, involving 25 kinds of acupuncture techniques commonly used in clinic. The quality of the included literature was low, most of them did not mention the registration information of clinical trial centers, and the specific sample size estimation method was unclear. Some literature did not explain the specific random method, distribution concealment and blindness, so there was a certain publication bias and small sample effect. Results showed that for improving the clinical effective rate, the top three treatments were salt-separated moxibustion, massotherapy + acupoint patching, acupuncture + heat-sensitive moxibustion. In terms of reducing the visual analogue scale(VAS), the top three treatments were massotherapy + acupoint patching, acupuncture + acupoint patching and warm acupuncture. In terms of alleviating cox menstrual symptom scale (CMSS), the top three treatments were acupuncture + acupoint patching, acupoint patching and point embedding. In relieving TCM symptom score, the top three treatments were acupoint patching + heat-sensitive moxibustion, acupoint patching and moxibustion. ConclusionDifferent acupuncture therapies have more advantages than oral analgesics in improving the clinical effective rate, reducing VAS score, reducing CMSS score, and alleviating TCM symptom score. Among them, massage therapy + acupoint patching, acupuncture + acupoint patching and acupoint patching may be the best solutions for the treatment of primary dysmenorrhea. However, more large-sample, multi-center and high-quality randomized controlled trials are needed to demonstrate.

Exploration of new models for primary dysmenorrhea treatment: low-power visible-light-activated photodynamic therapy and oral contraceptives

Exploration of new models for primary dysmenorrhea treatment: low-power visible-light-activated photodynamic therapy and oral contraceptives

Progress of Clinical Research on the Treatment of Primary Dysmenorrhea by Traditional Chinese Medicine

Progress of Clinical Research on the Treatment of Primary Dysmenorrhea by Traditional Chinese Medicine

Evaluation of the Efficacy and Safety of Dienogest in the Treatment of Primary Dysmenorrhea: A Study in a District-Level Hospital in Bangladesh

Background: Dysmenorrhea is a common symptom secondary to various gynecological disorders, but it is also represented in most women as a primary form of disease. Pain associated with dysmenorrhea is caused by hypersecretion of prostaglandins and an increased uterine contractility. The primary dysmenorrhea is quite frequent in young women and remains with a good prognosis, even though it is associated with low quality of life. Objectives: The aim of this study is to evaluate of the efficacy and safety of dienogest in the treatment of primary dysmenorrhea: a study in a district-level hospital in Bangladesh. Methods: The cross-sectional observational study was conducted in the Department of Gynae and Obs, Naogaon Sadar Hospital from July 2022 to June 2023. A total of 100 subjects who received DNG (1 mg/day, orally) were included in the study. Data were collected by face-to-face interview and analyzed by appropriate computer based programmed software Statistical Package for the Social Sciences (SPSS), version 24. Results: In this study, most of the patients 43% lies between 21 years to 25 years and body weight of 24% patients were between 51 to 55 kg. In this study, most of the patients 41% body mass index were 18.5 – 24.9 kg/m2. Most of the patients’ clinical symptoms were cramping pain in the lower abdomen (89%), low back pain (86%), pain spreading down to the leg (73%), fatigue (64%). About (56%) adverse effects were body weight gain and irregular uterine bleeding occurred in 35 of 100 cases (35%). Conclusion: Primary dysmenorrhea is one of the most common illnesses in women of childbearing age. When severe, it may interfere with the activities of daily living and may lead to school and work absenteeism. Primary dysmenorrhea is also one of the most underdiagnosed diseases, so clinicians should suspect the diagnosis in a timely manner and provide appropriate treatment.

Effectiveness of pineapple and papaya leaf combination for dysmenorrhea pain relief in mice (<i>Mus musculus</i>)

Dysmenorrhea is a common gynecological condition in women, often attributed to excessive prostaglandin production, significantly impacting daily activities. Papaya leaves, known for their medicinal properties, are a chosen herbal remedy, albeit with a bitter taste, necessitating combination with pineapple fruit. This study aimed to assess the effectiveness of a combination of papaya leaf extract and pineapple fruit as an alternative treatment for primary dysmenorrhea. In an experimental research design employing the posttest-only control group, 32 male mice were divided into seven groups, injected with acetic acid as a pain inducer, and their writhing responses were recorded for 45 minutes at 15-minute intervals. Data analysis using the ANOVA test revealed significant differences in the number of writhing responses in mice (p <0.05) compared to the positive control group, followed by the Duncan test. The percentage of analgesic protection was as follows: mefenamic acid (61.01%), pineapple fruit extract (62.78%), papaya leaf extract (63.39%), a combination of pineapple and papaya leaf extracts with a dose ratio of 3:1 (73.21%), 2:2 (47.32%), and 1:3 (37.78%). In conclusion, the combination of pineapple extract and papaya leaves in a dose ratio of 3:1 demonstrated the most effective pain reduction.

Effect of photobiomodulation on alleviating primary dysmenorrhea caused by PGF2α.

Photobiomodulation (PBM) has attracted widespread attention in suppressing various pain and inflammation. Primary dysmenorrhea (PD) primarily occurs in adolescents and adult females, and the limited effectiveness and side effects of conventional treatments have highlighted the urgent need to develop and identify new adjunct therapeutic strategies. In this work, the results of pain and PGs demonstrated that 850 nm, 630 nm, and 460 nm all exhibited pain inhibition, decreased PGF2α and upregulated PGE2 , while 630 nm PBM has better effectiveness. Then to explore the underlying biological mechanisms of red light PBM on PD, we irradiated prostaglandin-F2α induced HUSM cells and found that low-level irradiance can restore intracellular calcium ion, ROS, ATP, and MMP levels to normal levels. And, red light enhanced cell viability and promoted cell proliferation for normal HUSM cells. Therefore, this study proposes that red light PBM may be a promising approach for the future clinical treatment of PD.

The effect of yoga practice on pain intensity, menstruation symptoms and quality of life of nursing students with primary dysmenorrhea.

The researchers aimed to determine the effects of yoga on pain severity, menstrual symptoms and quality of life of undergraduate nursing students with primary dysmenorrhea. The 60 female students were divided into intervention (n = 30) and control groups (n = 30) by block randomization. In the study, data were evaluated with the Visual Analog Scale for Pain, the Menstruation Symptom Scale and the Short Form-36 Health Survey Scale. The 12-week intervention program, which included all components of Hatha yoga, was carried out twice a week for a total of 24 sessions of 60 min. The control group did not receive any intervention. The severity of menstrual pain and symptoms decreased in yoga group compared to control group, and there were significant improvements in quality of life (p < 0.001). The researchers shows that regular Hatha yoga may be a possible nonpharmacological treatment for primary dysmenorrhea in young women in this study.

The Relationship Between Knowledge Level and Accuracy of Primary Menstrual Pain Self-Medication in Tahfidz Qur'an Islamic Boarding School Students Nurul Huda Joyosuko Metro, Malang

Self-medication is the preferred method for treating minor illnesses based on individual decision. The method used is descriptive analysis. Distributing questionnaires directly to a sample of 85 respondents was used to collect data. This research is a correlational analysis research with a cross-sectional design. Samples were collected using a non-random sampling method with a total sampling method. The research results showed that 93% of respondents had a high level of knowledge, 3% had a medium level, and 4% had a low level. In terms of behavior or acquisition, 88.24% had a good rating, 10.59% had a medium rating, and 1.18% had bad behavior. Spearman's rank correlation analysis produced a calculated r value of 0.537 and a p value of 0.000, indicating a strong and significant positive relationship between knowledge of the adequacy of self-assessment and treatment of primary dysmenorrhea and the feasibility of self-treatment.

Peony Pollen Protects against Primary Dysmenorrhea in Mice by Inhibiting Inflammatory Response and Regulating the COX2/PGE2 Pathway.

Peony pollen contains multiple nutrients and components and has been used as a traditional Chinese medicine with a long history, but the effect of the treatment of primary dysmenorrhea remains to be clarified. The aim of this study is to investigate the therapeutic effect of peony pollen on primary dysmenorrhea mice and the potential mechanism. A uterus contraction model in vitro and primary dysmenorrhea mice were used to evaluate the treatment effect of peony pollen on primary dysmenorrhea. The primary dysmenorrhea mice were treated with 62.5 mg/kg, 125 mg/kg, or 250 mg/kg of peony pollen, and the writhing response, latency period, histopathological changes in the uterus, prostaglandin E2 (PGE2) and prostaglandin F2α (PGF2α) levels, and infiltration of neutrophils and macrophages were investigated. Protein expression of interleukin 1 β (IL-1β), interleukin 6 (IL-6), NOD-like receptor thermal protein domain associated protein 3 (NLRP3), cyclooxygenase-2 (COX-2), microsomal prostaglandin-E synthase 1 (mPGEs-1), BCL2-Associated X (Bax), B-cell lymphoma-2 (BCL-2), caspase-3, and cleaved caspase-3 were detected by Western blot, and the oxidative stress related marker malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and reactive oxygen species (ROS) were evaluated. Peony pollen could attenuate spontaneous or oxytocin-induced uterus contractions in vitro. Moreover, peony pollen decreased the writhing times, prolonged the writhing latency, and reduced the pathological damage of uterine tissues. Furthermore, the inflammatory cell infiltration and the protein expression of IL-1β, IL-6, and NLRP3 were decreased. The COX-2/PGE2 pathway was inhibited; oxidative stress and apoptosis in the uterus also improved in the uterus of primary dysmenorrhea mice. Peony pollen exerts a positive effect on primary dysmenorrhea by inhibiting the inflammatory response and modulating oxidative stress and apoptosis by regulating the COX-2/PGE2 pathway.

THE EFFECT OF ABDOMINAL MASSAGE AND KUNYIT ASAM HERBS TO REDUCE PRIMARY MENSTRUAL PAIN (DYSMENORRHEA)

Background: Menstrual pain (dysmenorrhea) is a cramp in the lower abdomen that occurs during menstruation, while menstrual pain that is experienced without any abnormality in the reproductive organ is called primary dysmenorrhea. Primary dysmenorrhea case experienced by the patient is complaints of pain in the lower part, sometimes spreading to the waist and feeling like pressure or squeezing which occurs within 1-2 days of menstruation. Purpose: Determine the effect of abdominal massage therapy and tamarind turmeric herbs on reducing primary dysmenorrhea. Case analysis: A case study for treating menstrual pain using abdominal massage and herbal methods. Abdominal massage therapy is performed on the abdominal area and herbal therapy is given to the patient, namely herbal turmeric (Curcuma longa Linn.) and tamarind fruit which have analgesic, antipyretic, and anti-inflammatory effects. Result: Turmeric and tamarind contain active compounds curcumin and anthocyanin which work together to inhibit cyclooxygenase (COX) reactions so that they can inhibit or reduce inflammation and uterine contractions which cause menstrual pain. The treatment for primary dysmenorrhea is abdominal massage therapy 14 times, once every 2 days for 30 days. Meanwhile, tamarind turmeric herbal therapy is given 2 times a day for 7 days before menstruation and the first 3 days during menstruation with a combination dose of 10 grams of turmeric rhizome and 5 grams of tamarind fruit. Conclusion: Abdominal massage therapy and tamarind turmeric herbs affect reducing menstrual pain in the case of primary dysmenorrhea.

[Therapeutic effect of Leonuri Herba aqueous decoction on primary dysmenorrhea in rats and its metabolomic analysis].

This study aimed to investigate the therapeutic effect of Leonuri Herba aqueous decoction on primary dysmenorrhea(PD) and explore the underlying mechanism in conjunction with untargeted metabolomics. Forty adult female rats were randomly divi-ded into a normal group, a model control group, ibuprofen(0.12 g·kg~(-1)) group, and high-and low-dose Leonuri Herba aqueous decoction(5 and 2.5 g·kg~(-1)) groups, with eight rats in each group. The PD rat model was prepared using intramuscular injection of estradiol benzoate combined with intraperitoneal injection of pitocin. Drugs were administered by gavage from the 4th day of modeling for 7 d. After the last administration, pitocin was injected intraperitoneally, and the writhing latency and writhing times within 30 min were recorded. The uterine and ovarian coefficients were determined. Estradiol(E_2), progesterone(Prog), oxytocin(OT), cyclooxyge-nase 2(COX-2), prostaglandin E_2(PGE_2), prostaglandin F_(2α)(PGF_(2α)), and Ca~(2+) levels in uterine tissues were measured by ELISA and biochemical kits. Morphological changes in uterine and ovarian tissues were observed by hematoxylin-eosin(HE) staining. The protein expression of oxytocin receptor(OTR), prostaglandin E_2 receptor 3(EP3), and estrogen receptor alpha(ERα) in uterine tissues was detected by immunohistochemistry. The mRNA expression of OTR, PGE_2 receptors 1-4(EP1, EP2, EP3, and EP4), and PGF_(2α) receptor(FP) in uterine tissues was detected by quantitative real-time PCR. Untargeted metabolomics analysis was performed by ultra-high-performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(LC-QTOF-MS) technology to screen potential biomarkers and enrich metabolic pathways. The results showed that Leonuri Herba was able to significantly reduce the writhing times in PD rats(P&lt;0.05 or P&lt;0.01), significantly reduce the uterine and ovarian coefficients(P&lt;0.01), and improve their histomorphology. After treatment with Leonuri Herba, PGE_2 content was significantly increased(P&lt;0.05), COX-2, PGF_(2α) and Ca~(2+) content, and PGF_(2α)/PGE_2 was significantly decreased(P&lt;0.05 or P&lt;0.01), and OT content was decreased, while E_2 and Prog content tended to further increase in uterine tissues of PD rats. Correspondingly, OTR and EP3 protein expression was significantly downregulated(P&lt;0.05 or P&lt;0.01) and ERα protein expression was upregulated(P&lt;0.05) in uterine tissues. The mRNA expression of FP and EP4 in uterine tissues was significantly downregulated(P&lt;0.01), and the mRNA expression of EP1, EP3, and OTR showed a decreasing trend. The untargeted metabolomics results showed that 10 differential metabolites were restored in the plasma of PD rats after Leonuri Herba treatment. The results indicate that Leonuri Herba is effective in the prevention and treatment of PD, and the underlying mechanism may be attributed to the regulation of PGs synthesis and corresponding receptor binding.

Clinical efficacy and safety of acupuncture at Houtian Baguapoint around umbilicus combined with acupoint massage in the treatment of primary dysmenorrhea

Clinical efficacy and safety of acupuncture at Houtian Baguapoint around umbilicus combined with acupoint massage in the treatment of primary dysmenorrhea

Title: Immediate Effect Of Physiotherapy Intervention In Subjects With Primary Dysmenorrhea – A Quasi-experimental Study

Background and objective- Primary dysmenorrhea (PD) is common among females, it is associate with menstrual pain with absence of an identifiable cause. Physiotherapy is beneficial to improve symptoms in females but there is limited evidence based on immediate effect of Physiotherapy interventions for the treatment of PD. Therefore, the present study was conducted to evaluate the immediate effect of physiotherapy interventions in subjects with PD. Methods- Sample size for this study was n=26 as it was based on previous studies. A single group experimental study was conducted among 26 healthy females with age between 18-25 years. The students were screened on the basis of inclusion and exclusion criteria. In order to assess the menstrual pain quality short- form McGill pain questionnaire was used. Results- Results revealed significantly reduction in the menstrual pain and symptoms after the intervention with p-value of 0.00 and 95% of confidence interval. The physiotherapy intervention was beneficial in reduction of pain and symptoms of primary dysmenorrhea among physiotherapy students. Conclusion- The results showed that physiotherapy intervention has highly significant for reducing the pain intensity and the symptoms in subjects with primary dysmenorrhea.

Research Progress on Pathogenesis and Treatment of Primary Dysmenorrhea

Primary dysmenorrhea is one of the common gynecological diseases of women of childbearing age, which can affect the work, study, and life of patients in severe cases. From the perspective of Western medicine, primary dysmenorrhea is caused by excessive secretion of prostaglandin and contraction of uterine smooth muscle, so the treatment focus of Western medicine is oral non-steroidal anti-inflammatory drugs or contraceptives, but its side effects cannot be ignored. From the perspective of Chinese medicine, primary dysmenorrhea is caused by qi-blood stagnation, so the focus of Chinese medication is dialectical treatment, which can improve qi-blood stagnation by acupuncture, decoction, moxibustion, etc., with fewer side effects and long-term clinical significance. The purpose of this paper is to analyze the relevant literature about the pathogenesis and treatment of primary dysmenorrhea in recent years, and to understand the research progress of primary dysmenorrhea in Western medicine and traditional Chinese medicine, so as to provide a reference for clinical treatment of primary dysmenorrhea.

[The skin surface microcirculation of conception vessel, governor vessel and thoroughfare vessel in patients with primary dysmenorrhea].

To observe the skin surface microcirculation of acupoints of conception vessel, governor vessel and thoroughfare vessel in patients with primary dysmenorrhea using laser speckle contrast imaging (LSCI), and provide acupoint selection basis of acupuncture-moxibustion for primary dysmenorrhea. Ninety-nine healthy female college students with regular menstrual cycles (normal group) and 94 female college students with primary dysmenorrhea (dysmenorrhea group) were recruited. Before menstrual period, on the first day of menstruation, and on the third day after menstruation, LSCI was used to observe the surface microcirculation at the abdominal acupoints of conception vessel, i. e. Yinjiao (CV 7), Qihai (CV 6), Shimen (CV 5), Guanyuan (CV 4), Zhongji (CV 3) and Qugou (CV 2), acupoints of thoroughfare vessel, i. e. Huangshu (KI 16), Zhongzhu (KI 15), Siman (KI 14), Qixue (KI 13), Dahe (KI 12), Henggu (KI 11) and acupoints of lumbosacral region of governor vessel, i. e. Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3), Yaoshu (GV 2) as well as two non-acupoints. Before menstrual period, there was no significant difference in the surface blood perfusion of the acupoints between the dysmenorrhea group and the normal group (P>0.05). On the first day of menstruation, the surface blood perfusion of Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3) and right Huangshu (KI 16) in the dysmenorrhea group was higher than that in the normal group (P<0.05, P<0.01). On the third day after menstruation, the surface blood perfusion of the right Henggu (KI 11) in the dysmenorrhea group was lower than that in the normal group (P<0.05). In patients with primary dysmenorrhea, on the first day of menstruation, the surface blood perfusion of Xuanshu (GV 5), Mingmen (GV 4), Yaoyangguan (GV 3) of governor vessel, and the right Huangshu (KI 16) of thoroughfare vessel is increased, while on the third day after menstruation, the surface blood perfusion of the right Henggu (KI 11) of thoroughfare vessel is decreased. These findings might provide a basis for acupoint selection in the acupuncture-moxibustion treatment of primary dysmenorrhea.

Retracted: Effects of Modified Wenjing Decoction Combined with Online Publicity and Education on the Treatment of Primary Dysmenorrhea of Cold Coagulation and Blood Stasis.

[This retracts the article DOI: 10.1155/2022/1899356.].

The non-pharmacological treatment of primary dysmenorrhea - efficiency and safety

Primary dysmenorrhea  is the most common, though often underdiagnosed, gynecological disorder of women of reproductive age. The disease presents with painful abdominal cramps associated with menstrual bleeding in the absence of pelvic abnormalities. Symptoms are caused primarily by increased levels of prostaglandins produced by the endometrium, which provides hypercontraction of the uterine muscles, ischemia, and pain.  Dysmenorrhea is usually treated pharmacologically with non-steroidal anti-inflammatory drugs or hormonal contraception. In particularly severe cases, surgical treatment is also possible. Nonetheless, an increasing amount of studies on non-pharmacological treatments have been published recently. Methods like Transcutaneous Electrical Nerve Stimulation (TENS), acupuncture, continuous topical heat, or exercise and yoga seem to be effective in reducing the symptoms of primary dysmenorrhea. All have an anti-inflammatory effect by lowering prostaglandin levels, but they also contribute to reducing symptoms through other mechanisms. TENS elevates the pain threshold and, together with acupuncture, causes the release of endogenous opioids. Heat, yoga, and acupuncture also lead to increased blood flow in the uterus, reducing hypoxia. Their additional advantage is the low cost and ease of self-use, except for acupuncture, depending on the patient's needs. Side effects of non-pharmacological treatments are usually mild and rarely reported.

Auricular therapy for primary dysmenorrhea: A protocol for systematic review and meta-analysis of randomized controlled trials.

Primary dysmenorrhea (PD) is a common problem among women. It is defined as any degree of perceived cramping pain during menstruation without any evident pathology. Auricular therapy (AT), a widely used alternative medical treatment method as part of traditional Chinese acupuncture, lacks reliable evidence to support its safety and effectiveness for PD. We aimed to conduct a meta-analysis to investigate the efficacy and safety of AT in PD and to investigate possible factors impacting the particular efficacy of AT in PD by meta-regression. This protocol followed the PRISMA guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols. The following 9 sources will be searched for randomized control trials of AT for PD: the Cochrane Central Register of Controlled Trials, PubMed, Medline, Embase, Web of Science, Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure, Chinese Science and Technology Periodicals (VIP) database and WanFang Database from inception to January 1, 2023. Primary outcomes include visual rating scales and clinical efficacy rates, while secondary outcomes include endocrine hormone indicators related to PD and adverse events. Two reviewers will work independently on study selection, data extraction, and coding, including the risk of bias assessment in the included studies. While conducting a meta-analysis, Review Manager version 5.3 will be employed. Otherwise, a descriptive analysis will be performed. The results will be displayed as a risk ratio with 95% confidence intervals for dichotomous data as well as weight mean difference or standardized mean difference with 95% confidence intervals for continuous data. This study's protocol will investigate the efficacy and safety of AT in the treatment of PD in a systematic way. This systematic evaluation will objectively and systematically assess the efficacy and safety of AT in PD based on the available evidence, as well as provides clinicians with evidence to support the treatment of the disease.

Quality marker discovery of Danggui Jianzhong decoction for treating primary dysmenorrhoea based on chinmedomics strategy

BackgroundDanggui Jianzhong Decoction (DGJZD) has been proven as an effective classical prescription for clinically treating primary dysmenorrhoea (PD). However, the industrialisation development and drug innovation of DGJZD remain limited due to its undefined effective constituents and quality markers (Q-markers). PurposeElucidating the Q-markers of DGJZD, which is related to clinical efficacy. MethodsIn accordance with chinmedomics strategy, we evaluated the therapeutic efficacy of DGJZD on the basis of the metabolomic profile and biomarker of a PD rat model to further identify the constituents of DGJZD in vivo that originated from the formula under the acting condition of DGJZD. The potential effective constituents and Q-markers were identified by mining the dynamic relation between the constituents in vivo and the biomarkers. ResultsSubsequently, 29 serum metabolites were characterized as biomarkers for PD, and DGJZD adjusted the levels of the primary biomarkers involved in arachidonic acid metabolism, glycerophospholipid metabolism, tryptophan metabolism as well as the synthesis of steroid hormones. Under the active condition of DGJZD, 20 prototype ingredients and 4 metabolites of DGJZD were found in vivo, five of which were mostly related with the efficacy of PD, namely, ferulic acid, zizyphusin, cinnamic acid, protocatechuic acid-3-glucoside, and azelaic acid. They were the potential pharmacodynamic constituents for treating PD, and they could be regarded as the Q-markers of DGJZD. ConclusionTaken together, the Q-markers of DGJZD identified in this research are credible and assist in solving problems related to quality control and drug innovation, accelerating industrialisation development. Besides, the efficacy, mechanism and active ingredients of DGJZD for the treatment of PD were innovatively elucidated for the first time on the basis of the chinmedomics strategy for uncovering the Q-markers of drugs from the system perspective.