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Objective To investigate the mechanism of action of Xiaochaihu decoction in the treatment of hepatitis B based on network pharmacology. Methods The TCMSP database was used to obtain the main chemical components and action targets of the seven traditional Chinese medicines in Xiaochaihu decoction; the GeneCards and OMIM databases were used to obtain the targets associated with hepatitis B; the STRING online platform was used to construct a PPI network of potential targets, and R language was used to perform gene ontology (GO) functional enrichment analysis and KEGG pathway analysis; Cytoscape 3.7.2 was used to construct an "active component-core target" network and perform a topology analysis of this network; AutoDock vina and related software were used to perform molecular docking and visualized analysis of the active components with high value and the core targets in the network. Results A total of 193 main chemical components (including quercetin, kaempferol, wogonin, and naringenin) and 247 related targets were screened out, among which the key targets included RELA, MAPK1, TP53, ESR1, EGFR, and AKT1. A total of 2612 enrichment items were obtained by GO functional enrichment analysis, which were mainly involved in regulating the biological processes such as cell response to chemical stress, response to drugs, oxidative stress response, and lipopolysaccharide response. A total of 174 pathways were obtained by the KEGG pathway analysis, mainly involving hepatitis B, PI3K-AKT signaling pathway, and MAPK signaling pathway. Molecular docking results showed that the main active components had strong binding force to core targets, and the protein crystal complex had a stable conformation. Conclusion This study preliminarily shows that Xiaochaihu decoction exerts a therapeutic effect on hepatitis B through multiple components, targets, and pathways.
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Objective To investigate the mechanism of action of Xiaochaihu decoction in the treatment of hepatitis B based on network pharmacology. Methods The TCMSP database was used to obtain the main chemical components and action targets of the seven traditional Chinese medicines in Xiaochaihu decoction; the GeneCards and OMIM databases were used to obtain the targets associated with hepatitis B; the STRING online platform was used to construct a PPI network of potential targets, and R language was used to perform gene ontology (GO) functional enrichment analysis and KEGG pathway analysis; Cytoscape 3.7.2 was used to construct an "active component-core target" network and perform a topology analysis of this network; AutoDock vina and related software were used to perform molecular docking and visualized analysis of the active components with high value and the core targets in the network. Results A total of 193 main chemical components (including quercetin, kaempferol, wogonin, and naringenin) and 247 related targets were screened out, among which the key targets included RELA, MAPK1, TP53, ESR1, EGFR, and AKT1. A total of 2612 enrichment items were obtained by GO functional enrichment analysis, which were mainly involved in regulating the biological processes such as cell response to chemical stress, response to drugs, oxidative stress response, and lipopolysaccharide response. A total of 174 pathways were obtained by the KEGG pathway analysis, mainly involving hepatitis B, PI3K-AKT signaling pathway, and MAPK signaling pathway. Molecular docking results showed that the main active components had strong binding force to core targets, and the protein crystal complex had a stable conformation. Conclusion This study preliminarily shows that Xiaochaihu decoction exerts a therapeutic effect on hepatitis B through multiple components, targets, and pathways.
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Adult-onset Still's disease (AOSD) is a rare but clinically well-known, polygenic, and systemic autoinflammatory disease, which is characterized by spiking fever, evanescent skin rash, arthralgia, and sore throat. The application of non-steroidal anti-inflammatory drugs and glucocorticoids, which are first-line therapies of AOSD, is limited due to their side effects such as liver injury or disorder of blood glucose. Therefore, patients who suffer from systemic diseases in China prefer to seek help from Chinese herbal medicine (CHM), which is an important part of complementary and alternative medicine. In this case, we report a 28-year-old male badminton coach presenting with a 15-day history of fever and skin rash, accompanied by sore throat, fatigue, myalgia and chills. Additionally, hepatosplenomegaly, multiple lymphadenopathies, aminotransferase abnormality, and elevated inflammatory factor levels were observed during hospitalization. Infectious diseases, solid tumors, hematological diseases, and common autoimmune diseases were excluded. Not benefitting from antibiotic therapy, the patient was finally diagnosed with AOSD, after a careful examination, then showed rapid remission after a six-week treatment with CHM granules based on Xiaochaihu Decoction and Yinqiao Powder. After stopping the treatment, there was no relapse within a 15-month follow-up period. To the best of our knowledge, this is the first well-documented case of this successful treatment. The present case report suggests that CHM is a reliable choice for complementary and alternative therapy for AOSD, but confirming the utility of CHM for AOSD requires further support from prospective studies.
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OBJECTIVE@#To investigate the effect of Modified Xiaochaihu Decoction (MXD, ) on collagen degradation in rats with chronic pancreatitis (CP).@*METHODS@#Rats were injected dibutyltin dichloride (DBTC, 7 mg/kg of body weight) into the right caudal vein to induce CP model. Thirty heallhy male Wistar rats were randomly divided into three groups by a random number table: the control, the model and the treatment groups. Rats of treatment group were administered MXD (10 g/kg of body weight) orally once daily starting from the day post-model establishment. Pancreatic tissues were harvested after 28-day feeding and fibrosis was evaluated by picro-sirius red staining. The contents of collagen type I and III were detected using enzymelinked immunosorbent assay (ELISA), the expression of matrix metalloproteinase 13 (MMP13) and tissue inhibitor of metalloproteinase 1 (TIMP1) was analyzed by Western blot and real-time polymerase chain reaction (PCR).@*RESULTS@#The fibrosis scoring of pancreatic tissues, the concentrations of collagen type I and III, the expression levels of MMP13 and TIMP1 proteins and mRNA in the model group were all increased compared with the control group (P0.05).@*CONCLUSIONS@#MXD could promote collagen degradation and reverse pancreatic fibrosis in CP rats via a mechanism involve up-regulation of MMP13 expression.
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Objective: The aim of this article was to study the potential antivirus and fever reducing mechanisms of Xiaochaihu Decoction (XCHD) on novel coronavirus pneumonia based on network pharmacology and molecular docking method. Methods: Firstly, the potential targets and pathways of XCHD on fever were analyzed using network pharmacology. Compounds and potential targets in XCHD were screened using TCMSP and PharmMapper databases. The targets in fever reducing were identified from OMMI and Genecards databases. The protein-protein interaction network was established by String database to analyze key targets. The gene oncology (GO) analysis and Kyoto encyclopedia of genes and genomes (KEGG) analysis of key targets were also conducted to generate the relative pathways based on DAVID and KOBAS 3.0 databases, respectively. The compound-target-pathway network was established using Cytoscape 3.2.7. In addition, we used molecular docking method to identify the crucial compounds with higher connectivity on SARS-CoV-2 and the angiotensin-converting enzyme 2 (ACE2). ACE2 has been identified as the key target of SARS-CoV-2 entering cells. The possible binding sites of compounds on SARS-CoV-2 and ACE2 were predicted. Results: Network pharmacology analysis indicated that 165 active compounds and 168 relative targets were selected. A total of 7006 targets related to fever were identified. In addition, 141 potential targets of XCH on fever were identified. Totally, 292 GO terms of XCHD on fever and 30 pathways were identified using GO and KEGG analysis. Furthermore, molecular docking indicated that main active compounds in XCHD exhibited higher affinity with both SARS-CoV-2 and ACE2. Beta-sitosterol, stigmasterol, 3’-hydroxy-4’-O-methylglabridin were top three candidates with highest affinity. Conclusion: In summary, our study identified the potential mechanisms of XCHD on fever. Besides, Beta-sitosterol, stigmasterol, 3’-hydroxy-4’-O-methylglabridin could be the key compounds to exert anti-viral effects against SARS-CoV-2. Our prediction also provided the research fields to further study the mechanisms of XCH on SARS-CoV-2 infection in future.
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Objective: To study the efficacy network and potential mechanism of Xiaochaihu Decoction (XCHD) in the treatment of coronavirus disease 2019 (COVID-19) with syndrome of pathogenic heat lingering in the lung and obstructive cardinalat, and analyze the active ingredients of XCHD with anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) efficacy. Methods: The correspondence between COVID-19 and XCHD was analyzed by literature consulting. Based on network pharmacology, Cytoscape 3.6.0 and other software were then used to construct XCHD efficacy network of “Chinese medicine prescription-active ingredient-key target” for pneumonia and immune regulation, in order to confirm anti-SARS-CoV-2 active ingredients in the prescription. Some softwares were used to analyze XCHD for COVID-19 treatment in multiple aspects. Results: A total of 48 active ingredients with potential anti-SARS-CoV-2 effect in herbs were collected; 140 active ingredients in XCHD for pneumonia treatment and immune regulation were analyzed, of which 12 ingredients had direct anti-SARS-CoV-2 activity including baicalein, formononetin, quercetin, etc. The active ingredients in XCHD exerted efficacy for pneumonia treatment and immunoregulation through 95 key targets such as IL-6, NOS2, and ESR1, involving multiple pathways such as the TNF signaling pathway, IL-17 signaling pathway, and influenza A. Analysis of gene co-expression and PPI interaction analysis found that ACE2 only co-expressed with NOS2 in the above targets, and also interacted with only five targets in the PPI interaction network. It is speculated that the ACE2 target only plays an important role when SARS-CoV-2 invaded the human body, and had little effect in the treatment of pneumonia after viral infection. Conclusion: The active ingredients in XCHD play a role in treating COVID-19 by inhibiting SARS-CoV-2 activity, blocking the SARS-CoV-2 invasion pathway, inhibiting cytokine storm, and regulating immunity. It is worth noting that drugs designed for the ACE2 target can block virus invasion, but may not be effective for diseases such as alveolar inflammation, Therefore, this study also provides a multi-target and multi-directional space for XCHD for early COVID-19 treatment. In addition, when XCHD is used in the early treatment of COVID-19, we should pay attention to the precise use of drugs based on syndrome accurate identification, one is to avoid adverse reactions, the other is to avoid cytokine damage caused by re-crown disease.
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Objective: The protective effect of Xiaochaihu Decoction on non-alcoholic steatohepatitis (NASH) model mice was studied by constructing a methionine-choline deficiency (MCD) diet-induced NASH model in mice. Methods: C57BL/6 mice, as the research objects, were randomly divided into normal control group, model group, Xiaochaihu Decoction (high, medium and low doses) group, Yishanfu group and Qianggan Capsule group. The NASH model was established by feeding MCD feeds, and model intervention was carried out at the same time by giving different drugs in groups; Changes in body weight, daily food intake, and daily water volume of the mice were recorded during the experiment. HE staining of liver tissue was performed at the end of the experiment to observe pathological changes. and the levels of biochemical indicator of alanine aminotransferase (ALT), Aspartate aminotransferase (AST), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), interleukin 6 (IL-6), and tumor necrosis factor-α (TNF-α) in serum, and the changes of TC and TG levels in liver tissue were detected, RT-PCR was used to detect the expression levels of fatty acid synthase (FAS) and sterol regulatory element binding protein 1c (SREBP-1c) in liver tissues. Results: Data such as mouse weight, daily food intake, daily water intake, and organ coefficients indicated that MCD diet-induced model mice showed weight loss, decreased intake, and decreased liver wet weight. The weight, intake and liver coefficient of mice in Xiaochaihu Decoction group were significantly higher than those in the model group; The results of HE staining showed that Xiaochaihu Decoction could significantly reduce the degree of steatosis and inflammation of liver tissue, and improve the morphology and structure of liver cells; The results of serum biochemical indicators showed that Xiaochaihu Decoction significantly reduced the levels of TG, TC, AST, ALT, IL-6, TNF-α and increased the level of HDL-C in NASH model mice; RT-PCR results showed that the gene expression levels of FAS and SREBP-1c in the liver tissue of the model group mice were significantly increased, and the administration of Xiaochaihu Decoction could significantly reduce the gene expression levels of FAS and SREBP-1c. Conclusion: Xiaochaihu Decoction has obvious protective effect on NASH mouse model induced by MCD diet. It may play a lipid-lowering role by regulating the expression of inhibitors of fatty acid synthetase genes (FAS, SREBP-1c), reducing fat accumulation, and inhibiting the expression of inflammatory factors to improve liver tissue damage.
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AIM: To observe the protective effects of Xiaochaihu Decoction (XCHD) on carbon tetrachloride (CCl4)-induced hepatic fibrosis (HF) in mice. METHODS: HF was induced in male mice by 20% CCl4 twice a week for 12 weeks. XCHD (3.90, 7.80, 15.60 g/kg) and Silybin (0.1 g/kg) were administrated via gavage once a day starting from the CCl4 treatment for subsequent 12 weeks. Then, the levels ALT and AST in serum were assayed, liver samples were taken to examine the degree of HF by HE, Masson, Sirius Red staining and Electron microscope. Moreover, the protein and mRNA expression levels of α-smooth muscle actin (α-SMA) and Collagen Ι were determined by RT-qPCR, immunofluorescence and Western blot. RESULTS: The data demonstrated that XCHD (7.80, 15.60 g/kg) effectively reduced histopathological changes, such as steatosis, collagen deposition; meanwhile the histopathological analysis suggested that XCHD obviously alleviated the degree of HF. Furthermore, XCHD significantly reduced the levels of ALT, AST (P<0.05), and attenuated the expressions of α-SMA, Collagen Ι both of protein and mRNA levels (P<0.05). CONCLUSION: XCHD has protective effect on chemical HF in mice.
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OBJECTIVE： To investigate the substance basis and mechanism of Xiaochaihu decoction in treatment of sepsis， and to provide reference for clinical application and R&D of the decoction. METHODS： Based on TCM integrative pharmacology platform （TCMIP）， chemical component analysis of Xiaochaihu decoction， disease target prediction， gene function and pathway enrichment analysis were all performed. The multi-dimensional network relationship of “TCM-chemical components-core targets-key pathways” was established， and the mechanism of Xiaochaihu decoction in treatment of sepsis was investigated. RESULTS： A total of 224 predicted chemical ingredients of Xiaochaihu decoction （including saikoside， ginsenoside， glycyrrhizin， etc.） interacted with 118 key targets about sepsis， including PF4， MYD88， TLR4， CD14， NOS3， etc. Its anti-sepsis mechanism involved nervous system， endocrine system， immune response and energy metabolism， etc. CONCLUSIONS： Based on “neuronal- endocrine-immune-metabolism”， Xiaochaihu decoction achieved its role in regulating sepsis by multi-level， multi-channel and multi-channel. This research may reveal the potential mechanism of Xiaochaihu decoction for sepsis， and the prescription provide theoretical basis for further experimental research of pharmacodynamic substance basis and mechanism of action．
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Objective: To explore the “efficacy-toxicity” targets, pathways, and mechanism of Xiaochaihu Decoction in the treatment of hepatitis based on the ADR information excavating of drug-induced liver injury in the treatment of hepatitis with Xiaochaihu Decoction. Methods: Taking Xiaochaihu Decoction as the research object, the integrated pharmacology platform was used to analyze and predict key targets and pathways. Cytoscape software was used to collate and analyze key targets and pathways to obtain co-participation pathways and mechanisms of “efficacy-toxicity”. Results: The analysis of the effect of Xiaochaihu Decoction for liver injury in the treatment of hepatitis showed that there were 40 common targets such as HADHA, HADH, NSDHL, ADH1A, ALDH 3A2, and GCK among the top 100 candidate targets with degree value. The chemical components jointly participated in the network of “effect-toxicity” which belonged to Xiaochaihu Decoction including 27 components in Bupleuri Radix, 74 components in Ginseng Radix, 13 components in Pinelliae Rhizoma, 8 components in Zingiberis Rhizoma, 32 components in Glycyrrhizae Radix et Rhizoma, 39 components in Jujubae Fructus, and 33 components in Scutellaria baicalensis. A total of 226 components were involved in the “effect-toxicity” process through endocrine and metabolic diseases, non-alcoholic fatty liver disease (NAFLD), estrogen signaling pathway, neurodegenerative diseases, nervous system, chemokine signaling pathway, and endocrine system. Conclusion: The “efficacy-toxicity” effect of Xiaochaihu Decoction on liver injury in the treatment of hepatitis may be closely related to Ras/Raf/MEK/ERK, NF-B, and PI3K/AKT signal transduction pathway. It plays a role by regulating cell proliferation, cell apoptosis and the expression of inflammatory factors, which provides a theoretical basis for further pharmacological and toxicological verification and chemical separation research. It plays a role by regulating cell proliferation, cell apoptosis and the expression of inflammatory factors.
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To discuss the effects of total glucosides from white paeony on preventing and treating radioactive liver damage, and explore its possible mechanisms. Thirty-six patients with primary hepatic carcinoma from 105th Hospital of Chinese PLA were treated with 3-dimensional conformal radiotherapy and randomly divided into simple irradiation group, total glucosides from white paeony group, and control group. The levels of AST, ALT, HA, LN, PCⅢ, CIV and TGF-β1 in serum of various groups were determined by using ELISA method. As compared with the simple irradiation group and control group, total glucosides from white paeony could obviously decrease the levels of AST, ALT, HA, LN, PCⅢ, CIV and TGF-β1(P<0.05, P<0.01). The results showed that the total glucosides from white paeony could effectively prevent and treat radioactive liver damage, and its mechanism might be associated with decreasing the levels of TGF-β1, and inhibiting the synthesis of collagen synthesis.
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Xiaochaihu Decoction comes from Shang Han Lun, which is a main formula for Shaoyang diseases. According to the principle of prescriptions corresponding to syndromes, the clinical application of modified Xiaochaihu Decoction for the treatment of swelling, pain, nausea, vomiting, bloating, and constipation after artificial total knee arthroplasty can achieve good efficacy.
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OBJECTIVE:To investigate the prevention and treatment effect of Xiaochaihu decoction on irinotecan(CPT-11)-in-duced bloodystool in model mice with delayed diarrhea. METHODS:40 mice were randomly divided into normal control group (equal volume of normal saline),model control group(equal volume of normal saline),Xiaochaihu decoction group(1500 mg/kg, calculated by crude drug)and loperamide group(positive control,0.5333 mg/kg),ig,once a day,for 17 days. Except for normal control group,other groups were intraperitoneally injected CPT-11 to induce delayed diarrhea in 4th-10th day. Body mass changes, bloodystool rate of mice were determined,and pathological changes in large intestine and small intestine were observed. RE-SULTS:After 17 days of administration,compared with normal control group,the body mass in modeling groups was obviously declined (P<0.05),while body mass in Xiaochaihu decoction group was higher than model control group (P<0.05). In the 11th-17th day,bloodystool rate in Xiaochaihu decoction group and loperamide group were significantly lower than model control group(P<0.01),and bloodystool rate in Xiaochaihu decoction group was lower than loperamide group(P<0.05). Pathological re-sults showed,obvious diffuse necrosis and inflammatory cell infiltration were observed in mucosal epithelial cells of large intestine and small intestine in model control group,and the intestinal mucosal tissue in administration groups tended to be normal. CON-CLUSIONS:Xiaochaihu decoction can effectively reduce bloodystool rate,improve intestinal mucosa injury,and has prevention and treatment effect on CPT-11-induced bloodystool in mice,with superior effect to loperamide.
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Objective: To establish a method for determination of saikosaponin a, baicalin and glycyrrhizic acid in Xiaochaihu Decoction. Methods: A combined method of HPLC-DAD and time of flight mass spectrometry (TOF/MS) was used; the chromatography condition was as following: Agilent Zorbax XDB C18 column (25°C, 2.1 mm × 50 mm, 1.8 μm); mobile phase: methanol (0.025%, V/V, formic acid)-water 0.025%, V/ V, formic acid) with gradient elution at a flow rate of 0.15 ml · min-1. The injection volume was 0.25 μl. Atomospheric pressure electronic spray ionization was used to quantify saikosaponin a at the capillary voltage of 4 000 V, the flow and temperature of drying gas were 10.0 L · min-1 and 350°C, respectively; nebulizer pressure was 40 psi (275 792 Pa), and the fragment voltage was 200 V; the m/z of saikosaponin a was 803.420 0-803.490 0 for quantitative analysis. The wavelengths for detection of baicalin and glycyrrhizic acid were 275 nm and 250 nm, respectively. Results: The calibration curves were Y=461 182X + 2 000 000(r=0.999 0),Y=0.949 9X-1.046 4(r=0.999 5) and Y=5.978 9X-27.418(r=0.999 5) for saikosaponin a (0.211 6-127.3 μg · ml-1), baicalin (0.758-455 μg · ml-1) and ammonium glycyrrhizinate (2.268-136.8 μg · ml-1), respectively. The recovery rates of the low, medium and high concentrations were (95.54 ± 1.60)%, (99.39 ± 3.97)% and (103.8 ± 1.97)% for saikosaponin a, (102.3 ± 0.47)%, (100.9 ± 1.32)% and (97.15 ± 2.10)% for baicalin, and (102.6 ± 1.96)%, (100.3 ± 3.12)% and (97.75 ± 1.25)% for ammonium glycyrrhizinate, respectively. The intra-day and inter-day RSD was both less than 5% and the RSD was less than 5% for 21 days. Conclusion: The method in the present study is simple, sensitive, rapid, and accurate for quality control of Xiaochaihu Decoction.
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Objective: To rapidly identify the chemical components in a traditional Chinese herb Xiaochaihu decoction by high performance liquid chromatography-time of flight mass spectrometry (HPLC-TOF/MS). Methods: An Agilent ZORBAX SB-C 18 column (100 mmX3.0 mm,3.5 μm) was used for rapid separation and identification of chemical components in Xiaochaihu decoction, with a mobile phase of methanol and 0.1% formic acid aqueous solvent in gradient elution. The flow rate was 0.6 ml/min and the injection volume was 4 μl. The detector was time-of-flight mass spectrometer with an ESI ion source. Scanning mass range was m/z 200-1 500. Results: Thirty-eight chemical compounds were identified from Xiaochaihu decoction in one run. Conclusion: Thirty-eight chemical compounds have been identified in Xiaochaihu decoction by HPLC-TOF/MS in one run, which paves a way for further understanding the metabolism and mechanism of the chemical compounds in Xiaochaihu decoction.
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Objective: To establish an HPLC method for determination of baicalin and wogonoside contents in Xiaochaihu decoction. Methods: Decoction pieces were mixed and decocted with water. The chromatographic column was Agilent Zorbax XDB-C18 (150 mmX4.6 mm, 5 μm); the mobile phase was composed of 0.2% phosphate acid-water(A) and acetonitrile (B) with gradient elution at a flow rate of 1 ml/min. The detection wavelength was set at 275 nm, the temperature of column was 25°C, and the injection volume was 15 μL. Results: Baicalin and wogonoside were separated at baseline within 30 min with good linearity; the standard curves for baicalin and wogonoside were Y=44.16X-36.22 (r=0.999,9) and Y=52.08X-28.69(r= 0.999,9), respectively. The intra-day and inter-day precisions were both less than 1%, and the limits of qualification were 0.615,6 μg/ml for baicalin and 0.220,8 μg/ml for wogonoside. The recovery rates (n = 6) were 95.73% (RSD = 0.8%) for baicalin and 97.02% (RSD= 1.56%) for wogonoside. Conclusion: The method is simple, accurate, stable, and reliable in determining the contents of baicalin and wogonoside in Xiaochaihu decoction, and it can be used for the quality control of this preparation.
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Objective To study the effect of modified Xiaochaihu Decoction on NF-kB and HSP70 of BRL cell induced by cisplatin. Methods BRL Cells were divided into control group, cisplatin group, high and low dose of modified Xiaochaihu decoction. Complete cell protein dot blot technique and immunohistochemisth analysis were appllied to detect the change of NF-kB and HSP70. Results There was a significant increase in NF-kB and decrease in HSP70 of BRL cell induced by cisplatin compared with control group. There was a significant decrease of NF-kB in modified Xiaochaihu decoction group compared with cisplatin group. There were increases of the expression of HSP70 in both high and low dose group, but only the high dose group demonstrated significant difference. Conclution The expression of NF-kB of BRL cell induced by cisplatin can be inhibited while the expression of HSP70 can be enhenced by modified Xiaochaihu decoction. It may be one of important mechanisms of relieving cell oxidize lesion and inhibiting apoptosis by modified Xiaochaihu decoction.
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Objective To observe the effect of Xiaochaihu decoction(XCD) on experimental endometriosis in rats.Methods Rat models of endometriosis were established and the effect of XCD were evaluated by measuring the volume of ectopic endometrium (EE) and its ultrastructure with transmission electron microscopy.Results After treatment,moderate and high-dosage of XCD(10g/kg and 15g/kg respectively) could markedly inhibit endometrial explant growth and decrease the volume of EE(P 0.05).Meanwhile,the glandular cells in the endometrium after treatment in the moderate and high-dosage groups showed characteristic features of apoptosis:cellular atrophy,condensation of cytoplasm and nuclear chromatin and increase of their density,occurrence of the intercellular apoptotic bodies as well as degeneration and necrosis of stromal cell.Conclusion XCD has obvious effects in inhibiting ectopic endometrium and its mechanism may be related to the reduction of cell death (including apoptosis and necrosis) by regulating the immune function.