The protective mechanism of Bu-Zhong-Yi-Qi in pelvic organ prolapse is revealed through network pharmacology and molecular docking.

By employing network pharmacology and molecular docking techniques, this study seeks to elucidate the targets and molecular mechanisms of Bu-Zhong-Yi-Qi decoction (BZYQD) in the management of pelvic organ prolapse (POP). Active components of BZYQD were identified via liquid chromatography-tandem mass spectrometry analysis and matched with potential targets in POP utilizing databases like Swiss Target Prediction, Gene Expression Omnibus, and "Disease" + "Gene" + "NETwork" (DisGeNET). The overlapping genes underwent Gene Ontology and pathway analyses, followed by visualization of protein-protein interactions using Search Tool for the Retrieval of Interacting Genes/Proteins and Cytoscape. Binding affinities between the active compounds and target proteins were assessed through molecular docking simulations employing AutoDock (The Scripps Research Institute [TSRI]) software. A total of 504 compounds were detected, with 13 identified as active ingredients, including benzenepropanoic acid and narirutin. Analysis revealed 96 shared targets with POP-related genes, of which 28 key targets displayed significant interactions impacting biological processes associated with mechanistic pathways like oxidative stress, inflammatory responses, and extracellular matrix remodeling. Network analysis identified benzenepropanoic acid, narirutin, pinostrobin 5-glucoside, and scopoletin as significant regulators. Key genes with high network degrees included PTGS2, ESR2, ESR1, MMP3, CASP3, MAPK1, MMP2, MMP9, PPARG, and CTNNB1. Molecular docking simulations demonstrated favorable binding properties of these compounds to core targets, with benzenepropanoic acid showing the lowest binding free energy with MMP2. The research emphasizes the complex and multi-target characteristics of BZYQD, indicating its potential efficacy in the management of POP. It offers insights into the pharmacological mechanisms of the decoction, advocating for the investigation of traditional Chinese medicine in the treatment of pelvic disorders. Further clinical research is needed to confirm.