Study on urinary metabolomics of premenstrual dysphoric disorder patients with liver-qi depression syndrome treated with Xiaoyaosan

Abstract

Introduction: Premenstrual dysphoric disorder (PMDD) is a serious form of premenstrual syndrome with mental symptoms as its main manifestation, which seriously affects women's health and daily life. Some basic research and clinical studies have shown that the Chinese herbal medicine of Xiaoyaosan can relieve the symptoms of mental disorders with few side effects. The aim of this study is to evaluate the clinical efficacy of Xiaoyaosan for treating PMDD with liver-qi depression syndrome. In addition, metabonomics and small molecular marker compounds closely related to the pathogenesis of PMDD are expected to be found, and mechanism of Xiaoyaosan is further explored from the metabolic level.Methods and analysis: This study is a clinical pilot trial. Thirty PMDD patients with liver-qi depression syndrome and thirty healthy participants will be recruited. Study participants will be assigned in a 1:1 ratio to 2 groups: a normal control group and Xiaoyaosan treatment group. The treatment group will receive the Chinese patent medicine of Xiaoyaosan for 3 menstrual cycles. The primary outcome is the syndrome change in the Daily Record of Severity of Problems (DRSP). The secondary outcome is improvement in TCM syndrome, which will be measured with TCM symptom score scale. Urine metabolism profiles of participants by liquid chromatograph-mass spectrometer (LC-MS) method will be measured to explore the mechanism of PMDD pathogenesis and action of Xiaoyaosan on PMDD.Discussion: This trial will evaluate the effectiveness and the therapeutic mechanism from the metabolomics level of Xiaoyaosan in individuals with PMDD. If successful, the outcome of this trial will provide a viable treatment option for PMDD patients and objective evidence on the efficacy of Xiaoyaosan for PMDD.Ethics and dissemination: The trial has been approved by the Institutional Ethics Committee of Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine (file number: DZMEC-KY-2019-73). Written informed consent will be obtained from all participants. The results of the study will be published in peer-reviewed journals or communicated via yearly reports to funding bodies.

Baicalin Prevents Myocardial Ischemia/Reperfusion Injury Through Inhibiting ACSL4 Mediated Ferroptosis

“…The infarct-limiting effects of baicalin in myocardial I/R damage are associated with the inhibition of mitochondrial damage-mediated apoptosis (Wang et al, 2013). Baicalin also rescued myocardial I/R-induced damage, decreased myocardial apoptosis and inflammation by activating PI3K/AKT, but inhibiting NF-κB and JAK/STAT pathway (Luan et al, 2019;Xu et al, 2020). Ferroptosis is an iron-dependent form of necrotic cell death which occurs in myocardial I/R injury (Doll et al, 2019;Ma et al, 2020).…”

Danzhi Xiaoyao Powder Promotes Neuronal Regeneration by Downregulating Notch Signaling Pathway in the Treatment of Generalized Anxiety Disorder

“…If GAD symptoms can be reversed in the early stage of the disease, it can not only greatly alleviate the great mental pain experienced by patients with GAD, but also avoid the occurrence of depression to a certain extent. DZXYS has been widely used in the clinical treatment of GAD and has a definite curative effect on the disease, but it has not received extensive international attention because of its unclear treatment mechanism ( Xu et al, 2020 ). Through this study, we found that the deep-seated molecular mechanism of DZXYS promotes neuronal regeneration in the hippocampus to treat GAD by downregulating the Notch signaling pathway, which not only opens up new ideas for the development of more effective anti-anxiety drugs in the future, but also lays a foundation for further exploration of the effective components in the prescription.…”

“…It originated from Xue Ji’s Internal Medicine Abstract during the Ming Dynasty. It was modified by the “Xiaoyao Powder.” The entire prescription consisted of 10 g danpi, 10 g gardenia, 15 g bupleurum, 10 g Poria cocos, 15 g fried Atractylodes macrocephala, 10 g Angelica sinensis, 10 g white peony, 10 g licorice, 3 g mint, and 9 g ginger, which is widely used in clinical and experimental research on anxiety and depression disorder ( Xu et al, 2020 ). Our team’s previous research found extensive neuronal apoptosis and neuronal regeneration disorders in the hippocampus of GAD rats.…”

Insights from the Perspective of Traditional Chinese Medicine to Elucidate Association of Lily Disease and Yin Deficiency and Internal Heat of Depression

“…TCM experts generally considered that depression is closely related to Qi and blood blockage and liver unreel distributing [ 25 , 26 ]. All kinds of negative emotional stimulation, such as mental panic, physical and mental exhaustion, and failure to achieve one's goals, can cause dysfunction of viscera, Qi, and blood and lead to depression.…”