Insights & Discussion
The Chinese medicine formulas Zuo Gui Wan and You Gui Wan have the potential to treat premature ovarian failure through different pharmacological pathways.
This study used a public database to identify the active ingredients and potential targets of the Zuo Gui Wan and You Gui Wan compounds. These were analyzed in relation to premature ovarian failure (POF) related genes obtained from OMIM and GeneCards. A protein-protein interaction network was established using STRING, and a drug-active ingredient-target gene network was constructed. The study thus identified similarities and differences in potential targets, active ingredients, and enriched pathways between the two compounds.
Analyzing the drug-target-pathway network revealed that both compounds contain multiple common active ingredients, as well as unique components, and share several targets in the treatment of POF, showing similar core mechanisms of action. However, each compound also targets some unique pathways, which indicates their differential approaches to POF treatment.
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The present study indicated that acupuncture had an advantage over hormone replacement therapy in reducing serum FSH level and increasing serum E2 level in women with premature ovarian insufficiency.
2020 Journal of Acupuncture and Tuina Science Acupuncture for premature ovarian insufficiency: a systematic review and meta-analysis Yin, Yq., Xu, Hf., Fang, Yg. et al.
Systematic Review HRT Ovarian Function Ovarian Insufficiency
Eight eligible RCTs with a total of 496 POI patients were included in the meta-analysis. The pooled results showed that there was a significant reduction in the basal serum FSH level and a remarkable elevation in the basal E2 level in the acupuncture group when compared with the control. Subgroup analysis showed that compared with HRT, a significant decrease in the FSH level was observed in both acupuncture alone and acupuncture plus HRT, while a remarkable elevation of E2 was only found in acupuncture plus HRT. There was no significant difference in the LH level between acupuncture and HRT, only one trial reported AMH, and no significant difference was found between acupuncture and HRT.
Zuo Gui Wan combined with anti-osteoporosis drugs may have beneficial effects on osteoporosis with respect to bone mineral density and bone metabolism markers.
2020 Phytotherapy Research An evaluation of the effects and safety of Zuogui pill for treating osteoporosis: Current evidence for an ancient Chinese herbal formula Li J, Sun K, Qi B, Feng G, Wang W, Sun Q, et al.
Systematic Review Zuo Gui Wan
Our pooled results show that ZGP combined with anti-osteoporosis drugs may have beneficial effects on osteoporosis with respect to BMD and bone metabolism markers. There were no ADRs when using ZGP alone, but ADRs of ZGP combined with anti-osteoporosis drugs included gastrointestinal discomfort (nausea, diarrhoea), dizziness, and fatigue. However, a definite conclusion regarding other indicators cannot be drawn from the existing information. The results of this review demonstrate that ZGP is a potential candidate for osteoporosis treatment, although the quality of evidence remains weak.
In a meta-analysis of 14 trials with 1030 women, acupoint stimulation and Chinese Herbal Medicine were effective in improving menstrual cycles, perimenopausal symptoms, and sex hormone levels in comparison to Hormone Replacement Therapy.
2020 Complementary Therapies in Medicine Acupoint stimulation and Chinese herbal medicines for the treatment of premature ovarian insufficiency: A systematic review and meta-analysis Li Y, Xia G, Tan Y, Shuai J
Systematic Review Ovarian Insufficiency
In a meta-analysis involving 14 trials with 1030 women experiencing Premature Ovarian Insufficiency (POI), acupoint stimulation and Chinese Herbal Medicine (CHM) were found to offer benefits in normalizing menstrual cycles and improving perimenopausal symptoms, compared to Hormone Replacement Therapy (HRT). These treatments also effectively lowered follicle stimulating hormone levels and increased estradiol levels when compared to HRT. However, there were no significant differences in luteinizing hormone levels or adverse effects between the groups. The conclusion of the study is that acupoint stimulation and CHM can be considered complementary therapies for alleviating menstrual disorders, perimenopausal symptoms, and serum sex hormone levels in POI females.
Traditional Chinese medicine, especially Zuo Gui Wan, red raspberry leaves, and Orthosiphon stamineus, seems to control gestational diabetes effectively without reported toxicity.
2019 Journal of Diabetes Research Evaluating Traditional Chinese Medicine and Herbal Products for the Treatment of Gestational Diabetes Mellitus Xu YXZ, Xi S, Qian X
Review Article Gestational Diabetes Mao Xu Cao Raspberry Leaf
The study initiated a systematic search across PubMed, Web of Science, and Embase databases to pinpoint research discussing the impact of traditional Chinese medicine on pregnancy. The results were then further narrowed down to focus on any correlation with all forms of diabetes mellitus. The primary thread that emerged was the beneficial effect of three main herbal remedies: Zuo Gui Wan, red raspberry leaves, and Orthosiphon stamineus.
Based off of the results from this search, a focal review of these herbal elements and their associations with type 2 diabetes mellitus was undertaken. Across the board, these remedies demonstrated positive effects on metabolic health, especially among women dealing with gestational diabetes. No experimental models reported any toxicity or harmful side effects associated with these herbal treatments. The report calls out that current studies on both conventional and alternative interventions for gestational diabetes are immensely lacking, emphasizing the need for a standardized protocol to evaluate the efficacy of these herbal medicines.
Acupuncture may impact Luteinized Unruptured Follicle Syndrome (LUFS) by lowering FSH, increasing E2, and resuming menstruation.
2015 Evidence-Based Complementary and Alternative Medicine Effectiveness of Acupuncture for Primary Ovarian Insufficiency: A Systematic Review and Meta-Analysis Jo J, Lee YJ, Lee H
Systematic Review Ovarian Insufficiency
This systematic review and meta-analysis assessed the potential of acupuncture for treating Luteinized Unruptured Follicle Syndrome (LUFS) through Randomized Controlled Trials (RCTs). Analyzing 8 studies involving 620 participants, the review found that acupuncture, whether alone or combined with drugs, could lower follicle-stimulating hormone (FSH) levels and increase the likelihood of menstruation resumption. Serum estradiol (E2) levels significantly increased with acupuncture, while luteinizing hormone (LH) levels showed no clear changes. Limited data on adverse events (AEs) suggested acupuncture's relative safety. However, due to small sample sizes, risk of bias, and varying study methodologies, the overall evidence quality was rated as "low" or "very low." This suggests a potential benefit of acupuncture for LUFS, but further high-quality studies are necessary to establish its effectiveness and safety definitively.
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