In traditional Chinese medicine, premature ovarian failure is attributed to the menstrual diseases such as amenorrhea, infertility, premenopausal and postmenopausal syndromes. The Zhejiang TCM gynecology schools are good at dialectical treatment of the above menstrual diseases similar to premature ovarian failure, especially Gynecology of Xiaoshan Zhulin Temple, Gynecology of Haining Chen Mushan, Gynecology of Ningbo Song's Family and Gynecology of Hangzhou He's Family. This paper summarizes the characteristics and experience of the four Zhejiang TCM gynecology schools in the dialectical treatment of premature ovarian failure, which can be used for reference.

Objective To explore the effective target and active ingredient prediction of premature ovarian insufficiency(POI)treated by Tiaojing decoction by ferroptosis pathway by network pharmacokogy and bioniformatics.Methods The active ingredients and target genes of Tiaojing decoction were obtained through traditional Chinese medicine systems pharmacology database and analysis platform(TCMSP)and bioinformatics analysis tool for molecular mechanism of traditional Chinese medicine databases,disease targets for POI were obtained by using GeneCards,therapeutic target database and Drugbank,and intersection targets were obtained by Venn.Core target gene network of Tiaojing decoction in treatment of POI were constructed through the ferroptosis pathway by ferroptosis database,Cytoscape and STRING software.Then,the DAVID database was used to perform gene ontology and biological pathway enrichment analysis on the predicted targets related to ferroptosis of POI treated with Tiaojing decoction.Subsequently,differential genes in biology related to POI were obtained through the gene expression omnibus(GEO)database for further extraction of key targets,and the binding affinity of active small molecule drug components were verified through molecular docking.Results A total of 154 active ingredients,101 targets related to POI and 23 genes related to ferroptosis were selected from 13 kinds of traditional Chinese medicines in Tiaojing decoction.The enrichment analysis showed that the main involved pathways were phosphatidylinositol-4,5-bisphosphate 3-kinase/protein kinase B(PI3K/Akt)signaling pathway and hypoxia inducible factor-1 signaling pathway.Through GEO database screening,the key targets of Tiaojing decoction in intervening POI through ferroptosis pathway were glycogen synthase kinase-3 β(GSK-3 β),caveolin-1(CAV1),mammalian target of rapamycin(mTOR)and protein kinase C alpha gene(PRKCA),all expression of which reduced in POI.The results of molecular docking showed that CAV1-quercetin and GSK-3β-luteolin had stable binding ability.Conclusion The network pharmacology results suggest that the ferroptosis pathway may be an important mechanism of Tiaojing decoction in treatment of POI,GSK-3β,CAV1,mTOR,PRKCA and other targets,as well as PI3K/Akt signaling pathway,may play important roles in them.