Background
Iron supplement is the first-line treatment for gynecological anemia (GA). However, its performance is limited by common gastrointestinal reactions and some inadequate responses. Traditional Chinese medicine (TCM) has a long history in the treatment of gynecological conditions but has been restricted by limited high-quality research, unknown bioactive ingredients, and mechanisms.
Objectives
These studies aim to compare the clinical efficacy of Buxue Yimu Pills (BYP),ferrous sulfate, and the addition of BYP to ferrous sulfate on GA through oral administration, and to investigate the mechanisms of BYP using network pharmacology approach.
Design:
Prospective, open-label, comparative, randomized, multicenter clinical trial.
Setting:
Gynecology departments in three public hospitals.
Patients:
170 patients with hemoglobin of 70–110 g/L were recruited and randomized into three groups: BYP group, oral iron group, and combined BYP & oral iron group. After a four-week treatment, the complete blood count (CBC) along with the markers for iron metabolism were determined for 138 patients. Furthermore, network pharmacology was performed to identify the active ingredients and potential mechanisms of BYP.
Results
While iron-treated groups showed elevated hemoglobin in accompany with significant changes in iron metabolism biomarkers, the BYP group exhibited hemoglobin improvement without apparent changes in iron metabolism markers. The network pharmacology identified 27 bioactive compounds and 145 targets of BYP on GA. A number of biological processes and pathways were identified, including regulation of inflammation, regulation of steroid hormone, angiogenesis and hemostasis, response to decreased oxygen levels, effects on myeloma cell, and response to metal ions.
Conclusions
BYP contributes to the practical improvement of gynecological anemia potentially through multi-target mechanisms independent from increasing hemopoietic raw material-iron.