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Wang Y, Yang L, Zhang X, Sun Y, Sun H, Yan G, Zhao Q, Han Y, Wang X. Quality marker discovery of Danggui Jianzhong decoction for treating primary dysmenorrhoea based on chinmedomics strategy. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2023; 115:154724. [PMID: 37087788 DOI: 10.1016/j.phymed.2023.154724] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/31/2023] [Accepted: 02/20/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND Danggui Jianzhong Decoction (DGJZD) has been proven as an effective classical prescription for clinically treating primary dysmenorrhoea (PD). However, the industrialisation development and drug innovation of DGJZD remain limited due to its undefined effective constituents and quality markers (Q-markers). PURPOSE Elucidating the Q-markers of DGJZD, which is related to clinical efficacy. METHODS In accordance with chinmedomics strategy, we evaluated the therapeutic efficacy of DGJZD on the basis of the metabolomic profile and biomarker of a PD rat model to further identify the constituents of DGJZD in vivo that originated from the formula under the acting condition of DGJZD. The potential effective constituents and Q-markers were identified by mining the dynamic relation between the constituents in vivo and the biomarkers. RESULTS Subsequently, 29 serum metabolites were characterized as biomarkers for PD, and DGJZD adjusted the levels of the primary biomarkers involved in arachidonic acid metabolism, glycerophospholipid metabolism, tryptophan metabolism as well as the synthesis of steroid hormones. Under the active condition of DGJZD, 20 prototype ingredients and 4 metabolites of DGJZD were found in vivo, five of which were mostly related with the efficacy of PD, namely, ferulic acid, zizyphusin, cinnamic acid, protocatechuic acid-3-glucoside, and azelaic acid. They were the potential pharmacodynamic constituents for treating PD, and they could be regarded as the Q-markers of DGJZD. CONCLUSION Taken together, the Q-markers of DGJZD identified in this research are credible and assist in solving problems related to quality control and drug innovation, accelerating industrialisation development. Besides, the efficacy, mechanism and active ingredients of DGJZD for the treatment of PD were innovatively elucidated for the first time on the basis of the chinmedomics strategy for uncovering the Q-markers of drugs from the system perspective.
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Affiliation(s)
- Ying Wang
- National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Heping Road 24, Harbin 150040, China
| | - Le Yang
- State Key Laboratory of Dampness Syndrome, The Second Affiliated Hospital Guangzhou University of Chinese Medicine, Dade Road 111, Guangzhou, China
| | - Xiwu Zhang
- National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Heping Road 24, Harbin 150040, China
| | - Ye Sun
- State Key Laboratory of Dampness Syndrome, The Second Affiliated Hospital Guangzhou University of Chinese Medicine, Dade Road 111, Guangzhou, China
| | - Hui Sun
- National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Heping Road 24, Harbin 150040, China.
| | - Guangli Yan
- National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Heping Road 24, Harbin 150040, China
| | - Qiqi Zhao
- National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Heping Road 24, Harbin 150040, China
| | - Ying Han
- National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Heping Road 24, Harbin 150040, China
| | - Xijun Wang
- National Chinmedomics Research Center, National TCM Key Laboratory of Serum Pharmacochemistry, Metabolomics Laboratory, Department of Pharmaceutical Analysis, Heilongjiang University of Chinese Medicine, Heping Road 24, Harbin 150040, China; State Key Laboratory of Dampness Syndrome, The Second Affiliated Hospital Guangzhou University of Chinese Medicine, Dade Road 111, Guangzhou, China; State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macao.
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Sima RM, Sulea M, Radosa JC, Findeklee S, Hamoud BH, Popescu M, Gorecki GP, Bobircă A, Bobirca F, Cirstoveanu C, Ples L. The Prevalence, Management and Impact of Dysmenorrhea on Medical Students' Lives-A Multicenter Study. Healthcare (Basel) 2022; 10:healthcare10010157. [PMID: 35052320 PMCID: PMC8775858 DOI: 10.3390/healthcare10010157] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/03/2022] [Accepted: 01/11/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction: Dysmenorrhea is defined as the presence of painful menstruation, and it affects daily activities in different ways. The aims of this study were to assess the prevalence and management of dysmenorrhea and to determine the impact of dysmenorrhea on the quality of life of medical students. Material and methods: The study conducted was prospective, analytical and observational and was performed between 7 November 2019 and 30 January 2020 in five university centers from Romania. The data was collected using an original questionnaire regarding menstrual cycles and dysmenorrhea. The information about relationships with family or friends, couples’ relationships and university activity helped to assess the effects of dysmenorrhea on quality of life. The level of significance was set at p < 0.05. Results: The study comprised 1720 students in total. The prevalence of dysmenorrhea was 78.4%. During their menstrual period, most female students felt more agitated or nervous (72.7%), more tired (66.9%), as if they had less energy for daily activities (75.9%) and highly stressed (57.9%), with a normal diet being difficult to achieve (30.0%). University courses (49.4%), social life (34.5%), couples’ relationships (29.6%), as well as relationships with family (21.4%) and friends (15.4%) were also affected, depending on the duration and intensity of the pain. Conclusion: Dysmenorrhea has a high prevalence among medical students and could affect the quality of life of students in several ways. During their menstrual period, most female students feel as if they have less energy for daily activities and exhibit a higher level of stress. The intensity of the symptoms varies considerably and, with it, the degree of discomfort it creates. Most student use both pharmacological and non-pharmacological methods to reduce pain (75.7%). University courses, social life, couples’ relationships, as well as relationships with family and friends are affected, depending on the duration and intensity of the pain.
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Affiliation(s)
- Romina-Marina Sima
- Department of Obstetrics and Ginecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-M.S.); (M.S.); (L.P.)
- The “Bucur” Maternity, “Saint John” Hospital, 040294 Bucharest, Romania;
| | - Mihaela Sulea
- Department of Obstetrics and Ginecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-M.S.); (M.S.); (L.P.)
| | - Julia Caroline Radosa
- Department for Gynaecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, Kirrberger Straße 100, Building 9, 66421 Homburg, Germany; (J.C.R.); (S.F.); (B.H.H.)
| | - Sebastian Findeklee
- Department for Gynaecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, Kirrberger Straße 100, Building 9, 66421 Homburg, Germany; (J.C.R.); (S.F.); (B.H.H.)
| | - Bashar Haj Hamoud
- Department for Gynaecology, Obstetrics and Reproductive Medicine, Saarland University Hospital, Kirrberger Straße 100, Building 9, 66421 Homburg, Germany; (J.C.R.); (S.F.); (B.H.H.)
| | - Mihai Popescu
- Department of Anaesthesia and Critical Care, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
| | - Gabriel Petre Gorecki
- The “Bucur” Maternity, “Saint John” Hospital, 040294 Bucharest, Romania;
- Faculty of Medicine, Titu Maiorescu University, 040441 Bucharest, Romania
| | - Anca Bobircă
- Department of Internal Medicine and Rheumatology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Correspondence: ; Tel.: +40-07-2615-7827
| | - Florin Bobirca
- Department of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Catalin Cirstoveanu
- Department of Pediatrics, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Pediatrics Department, ‘Maria Sklodowska Curie’ Emergency Children Clinical Hospital, 041451 Bucharest, Romania
| | - Liana Ples
- Department of Obstetrics and Ginecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (R.-M.S.); (M.S.); (L.P.)
- The “Bucur” Maternity, “Saint John” Hospital, 040294 Bucharest, Romania;
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Şentürk Ş. Relation between uterine morphology and severity of primary dysmenorrhea. Turk J Obstet Gynecol 2020; 17:84-89. [PMID: 32850181 PMCID: PMC7406897 DOI: 10.4274/tjod.galenos.2020.26032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/09/2020] [Indexed: 12/01/2022] Open
Abstract
Objective This study aimed to evaluate whether uterine dimensions including uterine volume, uterine shape, uterine length, cervix length, and cervix thickness measurements have a role in the severity of primary dysmenorrhea in virgin girls. Materials and Methods Enrollment included 90 virgin girls suffering from primary dysmenorrhea. The girls were divided into three groups according to the severity of dysmenorrhea, which was determined by the visual analog scale (VAS). Patients with VAS scores of 8-10 comprised the severe primary dysmenorrhea group (n=30), 4-7 the moderate primary dysmenorrhea group (n=30), and 1-3 the mild primary dysmenorrhea group (n=30). Uterine characteristics including uterine volume, uterine shape, uterine length, cervix length, and cervix thickness were measured by a high-resolution four-dimensional ultrasound device with real-time capacity. They were recorded to determine if they can be predictors of dysmenorrhea severity. Results Girls with severe primary dysmenorrhea were more likely to complain of midline pain as opposed to mild and moderate cases with lateral or diffuse pain. None of the uterine characteristics on ultrasonography examination were significant for predicting the severity of primary dysmenorrhea. There were no significant positive correlations between the dysmenorrhea severity and uterine corpus length, cervix length, and uterine volume degree. Any combination of the measured uterine features was not predictive for determining the severity of dysmenorrhea. Conclusion Ultrasonographic measurements of uterine dimensions in virgins have low accuracy for predicting the severity of pain in primary dysmenorrhea.
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Affiliation(s)
- Şenol Şentürk
- Recep Tayyip Erdoğan University Faculty of Medicine, Department of Obstetrics and Gynecology, Rize, Turkey
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The Effect of Anterior Uterocervical Angle on Primary Dysmenorrhea and Disease Severity. Pain Res Manag 2018; 2018:9819402. [PMID: 30305856 PMCID: PMC6166362 DOI: 10.1155/2018/9819402] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/26/2018] [Indexed: 11/17/2022]
Abstract
Background Primary dysmenorrhea, defined as painful menstrual cramps originating in the uterus without underlying pathology, is a gynecological disease that affects quality of life and school success. Our goal was to determine the effect of anterior uterocervical angle on primary dysmenorrhea and disease severity. Methods A total of 200 virgin adolescents, 16 to 20 years of age, were included in the study. The Andersch and Milsom scale was used to determine dysmenorrhea severity. Those with pathologies causing secondary dysmenorrhea were excluded from the study. Study subjects were grouped based on severity of pain. Demographic characteristics and uterocervical ultrasonographic measurements were compared among groups. Results Of the 200 participants enrolled in the study, 50 were healthy controls and 150 had primary dysmenorrhea. Those with primary dysmenorrhea had a significant family history of primary dysmenorrhea compared with controls (P < 0.001). Age (P=0.668), body mass index (P=0.898), menarche age (P=0.915), and length of menstrual cycles (P=0.740) were similar in all groups. The uterine corpus longitudinal axis, uterine corpus transverse axis, and uterine cervix longitudinal axis were also similar (P=0.359, P=0.279, and P=0.369, resp.). The mean uterocervical angle was 146.8 ± 6.0 in controls and 143.3 ± 7.3 in those with mild pain with no significant difference between the groups. In those with moderate pain, the mean uterocervical angle was 121.2 ± 7.3 compared with 101 ± 9.2 in those with severe pain, which was a significant difference. Additionally, there was also a significant difference in the uterocervical angle among those with mild, moderate, and severe pain (P < 0.001). Conclusion Our results indicate that a narrower anterior uterocervical angle is associated with primary dysmenorrhea and disease severity.
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Zebitay AG, Güngör ES, Ilhan G, Çetin O, Dane C, Furtuna C, Atmaca FFV, Tuna M. Cervical Conization and the Risk of Preterm Birth: A Population-Based Multicentric Trial of Turkish Cohort. J Clin Diagn Res 2017; 11:QC21-QC24. [PMID: 28511455 DOI: 10.7860/jcdr/2017/22996.9495] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 11/12/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Cold Knife Conization (CKC) is one of the most effective methods for the treatment of Cervical Intraepithelial Neoplasia (CIN). Some studies showed a relation between preterm birth and the treatment of CIN; on the other hand, other studies do not show such a relationship. AIM The present study was conducted with the aim to investigate the pregnancy outcomes of Turkish women regarding demographic characteristics, obstetric history, removed tissue, and residual cervical length after CKC and to determine the effect of removed cervical tissue volume and height on preterm birth. MATERIALS AND METHODS This study was a population-based, multicenter trial that was conducted on singleton pregnancies between January 2007 and December 2013. The control group comprised of 38,892 patients who gave birth during this period. On the other hand, patients who conceived after CKC during this period were invited to the hospital and included in the case group (n=20). The course of pregnancy following CKC was studied. Preterm birth rates, risk factors for preterm birth, conisation age, cervical smear and colposcopic biopsy results and the volume and height of the removed cervical tissue of those patients were evaluated. RESULTS There was no statistically significant difference in preterm birth rates between the case and the control groups. None of our cases had any identified preterm birth risk factor except for one case. The average height of removed cervical tissue was 12.6±5.4 mm and the average length of the residual cervix after birth was 28.7±4.3 mm. CONCLUSION Removal of cervical tissue of 12.6±5.4 mm in height and 2.35±2.27 cm3 in volume will not increase the risk of preterm birth of women who do not have any other preterm birth risk factors. If there is no other preterm birth risk factors, term birth is most probably possible after conisation.
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Affiliation(s)
- Ali Galip Zebitay
- Consultant, Department of Obstetrics and Gynaecology, Suleymaniye Research and Education Hospital, Istanbul, Turkey
| | - Emre Sinan Güngör
- Consultant, Department of Obstetrics and Gynaecology, Suleymaniye Research and Education Hospital, Istanbul, Turkey
| | - Gülsah Ilhan
- Consultant, Department of Obstetrics and Gynaecology, Suleymaniye Research and Education Hospital, Istanbul, Turkey
| | - Orkun Çetin
- Consultant, Department of Obstetrics and Gynaecology, Van Yusuncu Yıl University, Van, Turkey
| | - Cem Dane
- Consultant, Department of Obstetrics and Gynaecology, Haseki Research and Education Hospital, Istanbul, Turkey
| | - Canan Furtuna
- Consultant, Department of Obstetrics and Gynaecology, Suleymaniye Research and Education Hospital, Istanbul, Turkey
| | - Fatma Ferda Verit Atmaca
- Consultant, Department of Obstetrics and Gynaecology, Suleymaniye Research and Education Hospital, Istanbul, Turkey
| | - Merve Tuna
- Consultant, Department of Obstetrics and Gynaecology, Haseki Research and Education Hospital, Istanbul, Turkey
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