Chai-shen powder treated perimenopausal syndrome through the PI3K–Akt/cAMP signaling pathway: integrated clinical analysis, network pharmacology, microRNA and animal experiment

This study aimed to explore the pharmacological mechanism of Chai-shen powder (CSP) in the treatment of perimenopausal syndrome (PMS) and to evaluate its clinical efficacy via clinical data mining, network pharmacology, bioinformatics and experimental verification. A single-group before–after control study analyzed CSP efficacy in 100 PMS cases using data mining. PMS datasets were retrieved from the GEO database to screen for differentially expressed microRNAs (miRNAs). Their mRNA targets were predicted using miRDB and miRWalk. These targets were considered therapeutic targets for PMS. CSP targets were screened from databases. The active components and key targets were identified by network pharmacology. The most important targets were confirmed by molecular docking. The prediction results of network pharmacology were verified by experiment. Data mining showed that the effective rate of CSP was 87.33%. Through bioinformatics and network pharmacology, 10 targets and nine chemical components were screened. CSP regulates hormone levels and inhibits ovarian injury of PMS through PI3K–Akt and cAMP signaling pathways and three key targets (SRC, PIK3CA and PRKACA). The clinical effective rate of CSP in this study was 87.33%. CSP may alleviate PMS by regulating hormone levels, mitigating ovarian injury and acting through multi-pathway, multi-target mechanisms. This study investigated how Chai-shen powder (CSP), a traditional Chinese herbal formula, helps relieve menopausal symptoms such as hot flashes with sweating and emotional lability. By analyzing 100 patients’ treatment records, we found 87.33% of patients experienced symptom improvement. Using data analysis and laboratory tests, we discovered that CSP works by balancing hormone levels, protecting ovarian function and targeting multiple biological processes simultaneously. These findings bridge traditional medicine with modern scientific understanding for better menopausal care.