Study on the law of formation and molecular mechanism of traditional Chinese medicine in treating late-onset hypogonadism in male

doi:10.3877/cma.j.issn.2095-8757.2023.03.008

Abstract

Abstract:

Objective

To explore the medication patterns and core molecular mechanisms of traditional Chinese medicine in the treatment of late-onset hypogonadism in male (LOH).

Methods

Literature on the treatment of LOH with traditional Chinese medicine was searched in CNKI, Wanfang, and VIP databases up to August 31, 2022, and SPSS software was used to statistically identify the core drugs. The main active ingredients of core drugs and their targets were analyzed using network pharmacology methods. Protein-protein interaction network was constructed using STRING 11.5 online database to obtain the key targets. The mechanism of core drugs in treating LOH was obtained through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis.

Results

A total of 138 articles were included in the study, and 177 prescriptions were collected, involving a total of 202 flavors of traditional Chinese medicine, of which 31 were used with frequency higher than 1%. The medicinal properties were mainly cold and warm, and the taste was mostly sweet, mainly attributed to the kidney and liver meridians. The above high-frequency drugs could be classified into four clusters, which were Erxian Tang, Dihuang Tang, Xiaoyao Powder, and Buxin Dan. There are 18 association rules, and 8 core drugs, namely Poria cocos, Angelica sinensis, Paeonia lactiflora, Rehmannia glutinosa, Lycium barbarum, Epimedium, Chinese yam, and Cornus officinalis. Through Traditional Chinese Medicine Systems Pharmacology screening and disease target intersection, 111 common targets were obtained, among which AKT1, TP53, JUN, EGFR, TNF, IL-6 were core targets. GO analysis revealed a total of 1606 biological processes, 81 cell components, and 146 molecular functions involved; KEGG enriches a total of 200 entries, mainly including the pathway in cancer, AGE-RAGE signaling pathway, endocrine resistance, lipid and atherosclerosis, HIF-1 signaling pathway, PI3K-Akt signaling pathway, MAPK signaling pathway, cellular senescence, etc.

Conclusion

The treatment of LOH is mainly based on tonifying the kidney and soothing the liver, while also taking into account spleen strengthening, blood nourishing, and calming the nerves, which has the advantages of multi-components, multi-pathways, and multi-targets, and the efficacy of the treatment can involve the whole process of the disease, including the occurrence and development of the disease, improvement of the symptoms, and prevention of the complications.

Key words: Late-onset hypogonadism in male, Network pharmacology, Traditional Chinese medicine and pharmacy, Law of formation

Youtao Ge, Qiuzi Jiang, Tingsong Bian, Qianqian Xiao. Study on the law of formation and molecular mechanism of traditional Chinese medicine in treating late-onset hypogonadism in male[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2023, 10(03): 43-50.

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References 40

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药物	使用频次	使用频率（%）	药物	使用频次	使用频率（%）
茯苓	85	3.91	五味子	35	1.61
当归	79	3.64	炙甘草	34	1.57
白芍	74	3.41	知母	33	1.52
熟地黄	73	3.36	黄柏	32	1.47
枸杞子	66	3.04	牡蛎	32	1.47
淫羊藿	66	3.04	远志	31	1.43
山药	64	2.95	菟丝子	30	1.38
山茱萸	62	2.85	郁金	29	1.34
柴胡	60	2.76	大枣	27	1.24
甘草	53	2.44	女贞子	27	1.24
地黄	49	2.26	龙骨	26	1.20
酸枣仁	49	2.26	泽泻	26	1.20
白术	48	2.21	丹参	24	1.11
巴戟天	43	1.98	茯神	23	1.06
牡丹皮	39	1.80	麦冬	23	1.06
仙茅	37	1.70

药物	使用频次	使用频率（%）	药物	使用频次	使用频率（%）
茯苓	85	3.91	五味子	35	1.61
当归	79	3.64	炙甘草	34	1.57
白芍	74	3.41	知母	33	1.52
熟地黄	73	3.36	黄柏	32	1.47
枸杞子	66	3.04	牡蛎	32	1.47
淫羊藿	66	3.04	远志	31	1.43
山药	64	2.95	菟丝子	30	1.38
山茱萸	62	2.85	郁金	29	1.34
柴胡	60	2.76	大枣	27	1.24
甘草	53	2.44	女贞子	27	1.24
地黄	49	2.26	龙骨	26	1.20
酸枣仁	49	2.26	泽泻	26	1.20
白术	48	2.21	丹参	24	1.11
巴戟天	43	1.98	茯神	23	1.06
牡丹皮	39	1.80	麦冬	23	1.06
仙茅	37	1.70

组类	药组构成	功效
二仙汤类	知母、黄柏、仙茅、淫羊藿、巴戟天、熟地黄、	温肾阳、补肾精、泻肾火
地黄汤类	枸杞子、山药、山茱萸、牡丹皮、泽泻、女贞子	滋补肝肾，清退虚热
逍遥散类	柴胡、郁金、茯苓、白术、白芍、当归、菟丝子、炙甘草	疏肝解郁，养肾健脾
补心丹类	龙骨、牡蛎、酸枣仁、远志、麦冬、五味子、地黄、丹参、茯神、甘草、大枣	滋阴清热，养血安神

组类	药组构成	功效
二仙汤类	知母、黄柏、仙茅、淫羊藿、巴戟天、熟地黄、	温肾阳、补肾精、泻肾火
地黄汤类	枸杞子、山药、山茱萸、牡丹皮、泽泻、女贞子	滋补肝肾，清退虚热
逍遥散类	柴胡、郁金、茯苓、白术、白芍、当归、菟丝子、炙甘草	疏肝解郁，养肾健脾
补心丹类	龙骨、牡蛎、酸枣仁、远志、麦冬、五味子、地黄、丹参、茯神、甘草、大枣	滋阴清热，养血安神

核心药对	支持度（%）	置信度（%）
茯苓-白术	27.12	83.33
淫羊藿-巴戟天	24.29	88.37
淫羊藿-仙茅	20.90	100.00
黄柏-知母	18.64	84.85
知母-黄柏	18.08	87.50
柴胡-郁金	16.38	89.66
白芍-柴胡-茯苓	19.21	82.35
山药-山茱萸-茯苓	18.64	96.97
熟地黄-枸杞子-山茱萸	18.08	87.50
茯苓-白术-白芍	16.38	89.66
茯苓-白术-柴胡	16.38	86.21
山茱萸-牡丹皮-山药	15.82	92.86
淫羊藿-仙茅-巴戟天	15.25	100.00
枸杞子-淫羊藿-熟地黄	15.25	85.19
山茱萸-山药-熟地黄	22.60	82.50
白芍-柴胡-当归	22.03	87.18
当归-柴胡-白芍-茯苓	15.82	85.71
柴胡-白芍-当归-茯苓	15.82	85.71

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