Study on the mechanism of Baihe Dihuang decoction in treating menopausal syndrome based on network pharmacology.

Menopausal syndrome (MS) refers to a series of symptoms with autonomic nervous system dysfunction caused by decreased sex hormones before and after menopause. Baihe Dihuang (BHDH) decoction positively affects MS, but its mechanism remains unclear. This study aimed to reveal the underlying mechanism through network pharmacology. The components of the BHDH Decoction were found through HERB, while corresponding targets were obtained from the HERB, Drug Bank, NPASS, Targetnet, and Swisstarget databases. The MS targets were obtained from GeneCards and OMIM. STRING was used to construct the protein-protein interaction networks. OmicShare tools were used for Gene Ontology and Kyoto encyclopedia of genes and genomes analyses. Finally, Autodock Vina 1.1.2 software (https://vina.scripps.edu/downloads/) was used for molecular alignment to verify whether the main active ingredients and key targets had good binding activity. We screened out 27 active ingredients and 251 effective targets of BHDH Decoction, 3405 MS-related targets, and 133 intersection targets between BHDH Decoction and MS. Protein-protein interaction network identified tumor protein P53, Serine/threonine-protein kinase AKT, epidermal growth factor receptor, Estrogen Receptor 1, and jun proto-oncogene as critical targets. Gene ontology analysis showed that these targets were mainly involved in the cellular response to chemical stimulus, response to oxygen-containing compound, cellular response to endogenous stimulus, response to an organic substance, and response to chemical, etc. Kyoto encyclopedia of genes and genomes pathways were mainly enriched in endocrine resistance, pathways in cancer, and the ErbB signaling pathway, etc. Molecular docking results showed that emodin and stigmasterol are strongly associated with Serine/threonine-protein kinase AKT, Estrogen Receptor 1, epidermal growth factor receptor, sarcoma gene, and tumor protein P53. This study preliminarily revealed the multi-component, multi-target, and multi-channel mechanism of BHDH Decoction in treating MS. It provides a reference for in vitro and in vivo research and clinical application of BHDH Decoction in the treatment of MS.

The therapeutic effect of modified Huangqi Guizhi Wuwu Tang for multiple myeloma: An 18-year follow-up case report.

RATIONALE: Multiple myeloma (MM) is a hematologic malignancy characterized by proliferation of clonal plasma cells in the bone marrow. The median survival has increased to 6 years in recent years. But MM remains incurable. Some studies about the effects of Chinese herb medicine on MM have been carried out. Long survival in MM patients through Traditional Chinese Medicine (TCM) therapies has been reported rarely before. PATIENT CONCERNS: We report a case of a female patient who was diagnosed with MM in 2000 at the age of 49. She received 9 cycles of multiple chemotherapeutic regimens mainly based on melphalan from September 2000 to May 2001. Though her condition was under control in some degree, she discontinued treatment due to significant side effects such as fatigue, hyperhidrosis, fever, chill, larynx mucosa ulcers, pharynx mucosa ulcers, and poor appetite. Instead, she sought treatment with TCM alone. DIAGNOSES: Based on the TCM theory, the patient's condition was categorized as Xue Bi. INTERVENTIONS: Up to the present, the patient has been using modified Huangqi Guizhi Wuwu Tang (HGWT) continuously for 18 years. In this prescription, Radix Astragali is an important herb. When the patient's condition worsened, its dosage was increased from 30 to 120g. Besides, she has been eating Radix Astragali porridge or drinking Radix Astragali tea for almost 18 years at the same time. OUTCOMES: Throughout the period, no obvious side effects have been observed and her health condition remains stable. LESSONS: Polysaccharides isolated from Astragalus membranaceus (Radix Astragali) and Polyporus umbellatus could promote maturation of dendritic cells. Polysaccharides and flavonoids isolated from Astragalus membranaceus could regulate bone marrow microenvironment by inhibiting secretion of interleukin (IL)-6, IL-12 p40 and bidirectionally regulating the osteogenic capacity of osteoblasts. Besides, Rhizoma Atractylodis Macrocephalae, another important component of the prescription, has inhibitory effects on osteolytic bone lesions. This case suggests TCM treatment may have a positive therapeutic effect on MM. Modified HGWT, especially the Chinese herb medicine Radix Astragali could potentially be an alternative option for the treatment of MM. Both pharmacological studies and randomized clinical trials are needed in the future.