Exploring the mechanisms of Chaige Kangyi Recipe in treating recurrent pregnancy loss with insulin resistance

Chinese herbal medicine effectively treats recurrent pregnancy loss, though its mechanism is unclear. This study used RStudio 4.3.0 to collect successful cases for cluster analysis, identifying medication patterns and core formulas, and further researching key prescriptions. The prescription is frequently used for recurrent abortion patients with insulin resistance. UPLC-QTOF-MS identified components, and network pharmacology explored key prescription targets in recurrent abortion with insulin resistance, validated by molecular docking and in vitro experiments. Traditional Chinese medicine treatment for 177 recurrent abortion cases and 640 prescriptions was analysed using RStudio 4.3.0 to identify medication patterns. Chaige Kangyi Recipe (CGKYR) active components and targets were obtained from TCMNPAS, and a herb-ingredient-target gene network was constructed using Cytoscape 3.7.2. GeneCards provided RSA target genes, and Cytoscape visualised a drug-disease target PPI network. Metascape software performed GO and KEGG enrichment analyses. UHPLC-MS/MS identified active compounds in core prescriptions, and molecular docking evaluated the therapeutic effects and mechanisms of major chemical components on key targets. Key prescriptions were derived from RStudio 4.3.0 cluster analysis of the Chaige Kangyi Recipe (CGKYR), commonly used for recurrent miscarriages with insulin resistance. Sixty-seven active ingredients were identified via UPLC-QTOF-MS. Network pharmacology revealed 179 target genes related to CGKYR's effects on recurrent miscarriage with insulin resistance. PPI analysis indicated IL-6, AKT1, STAT3, and INS as potential targets. Molecular docking demonstrated strong binding activity of four compounds with IL-6.CCK-8 assays showed CGKYR promoted HDSC proliferation dose-dependently. In vitro experiments indicated CGKYR increased IL-6 mRNA expression in human decidual stromal cells. CGKYR employs a multifaceted therapy for RPL complicated by insulin resistance, enhancing endometrial receptivity and stimulating HDSC proliferation by upregulating IL-6 mRNA expression in human decidual stromal cells.