Lan Junjie, Wu Caiming, Liang Wen'na, Shen Jianying, Zhuo Zewei, Hu Liu, Ruan Luwei, Zhang Pengheng, Ye Xiangrong, Xu Leqin, Li Chengfu, Lin Shengyuan, Yang Chuanhui, Wu Siqi, Dong Yingjun, Ren Haixia, Huang Huiying, Gao Bizhen, Yao Hongwei, Lin Tianwei, Chen Xueqin, Li Candong
State Key Laboratory of Cellular Stress Biology, Innovation Center for Cell Signaling Network, State-Province Joint Engineering Laboratory of Targeted Drugs From Natural Products, School of Life Sciences, Xiamen University, Cancer Research Center of Xiamen University, Xiamen, China.
Research Base of TCM syndrome, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Front Pharmacol. 2021 Oct 25;12:744409. doi: 10.3389/fphar.2021.744409. eCollection 2021.
Two types of traditional Chinese formulas of botanical drugs are prescribed for treating perimenopausal syndrome (PMS), a disorder in middle-aged women during their transition to menopause. One is for treating PMS as kidney deficiency (KD) due to senescence and declining reproductive functions, and the other is for treating it as liver qi stagnation (LQS) in association with stress and anxiety. Despite the time-tested prescriptions, an objective attestation to the effectiveness of the traditional Chinese treatment of PMS is still to be established and the associated molecular mechanism is still to be investigated. A model for PMS was generated from perimenopausal rats with chronic restraint stress (CRS). The effectiveness of traditional Chinese formulas of botanical drugs and a combination of two of the formulas was evaluated based on H NMR plasma metabolomic, as well as behavioral and physiological, indicators. To investigate whether the formulas contained ligands that could compensate for the declining level of estrogen, the primary cause of PMS, the ligand-based NMR technique of saturation transfer difference (STD) was employed to detect possible interacting molecules to estrogen receptors in the decoction. Each prescription of the classical Chinese formula moderately attenuated the metabolomic state of the disease model. The best treatment strategy however was to combine two traditional Chinese formulas, each for a different etiology, to adjust the metabolomic state of the disease model to that of rats at a much younger age. In addition, this attenuation of the metabolomics of the disease model was by neither upregulating the estrogen level nor supplementing an estrogenic compound. Treatment of PMS with a traditional Chinese formula of botanical drugs targeting one of the two causes separately could ameliorate the disorder moderately. However, the best outcome was to treat the two causes simultaneously with a decoction that combined ingredients from two traditional prescriptions. The data also implicated a new paradigm for phytotherapy of PMS as the prescribed decoctions contained no interacting compound to modulate the activity of estrogen receptors, in contrast to the treatment strategy of hormone replacement therapy.
两种用于治疗围绝经期综合征（PMS）的中药植物配方被用于治疗中年女性向更年期过渡期间的一种疾病。一种用于治疗因衰老和生殖功能下降导致的肾阴虚（KD）型PMS，另一种用于治疗因压力和焦虑导致的肝郁气滞（LQS）型PMS。尽管这些配方经过了长期验证，但中药治疗PMS有效性的客观证据仍有待确立，相关分子机制仍有待研究。通过对围绝经期大鼠进行慢性束缚应激（CRS）建立了PMS模型。基于1H NMR血浆代谢组学以及行为和生理指标，评估了中药植物配方及其两种配方组合的有效性。为了研究这些配方是否含有能够补偿PMS主要病因雌激素水平下降的配体，采用基于配体的饱和转移差（STD）核磁共振技术检测汤剂中可能与雌激素受体相互作用的分子。每个经典中药配方都适度减轻了疾病模型的代谢组学状态。然而，最佳治疗策略是将两种针对不同病因的中药配方组合起来，将疾病模型的代谢组学状态调整到年轻得多的大鼠的状态。此外，疾病模型代谢组学的这种减轻既不是通过上调雌激素水平也不是通过补充雌激素化合物实现的。用针对两种病因之一的中药植物配方单独治疗PMS可适度改善该疾病。然而，最佳结果是用一种将两种传统方剂成分组合在一起的汤剂同时治疗这两种病因。数据还暗示了一种新的PMS植物疗法范式，因为与激素替代疗法的治疗策略不同，所开的汤剂不含调节雌激素受体活性的相互作用化合物。
