Clinical and Systems Pharmacological Evaluation of Kunning Oral Liquid in Promoting Hemostasis and Endometrial Regeneration After Hysteroscopic Surgery: A Multi-target Natural Product Study

Background and Purpose Kunning Oral Liquid is a traditional Chinese medicinal formula composed of multiple medicinal plants, including Leonurus japonicus , Angelica sinensis , Salvia miltiorrhiza , and other herbs known for their blood-activating, stasis-resolving, and tissue-repairing properties. However, its clinical efficacy and multi-target mechanisms in postoperative hemostasis and endometrial regeneration remain insufficiently characterized. This study aimed to evaluate the hemostatic efficacy and endometrial regenerative effects of Kunning Oral Liquid after hysteroscopic surgery and explore its potential multi-component, multi-target pharmacological mechanisms. Materials and Methods A total of 320 patients undergoing hysteroscopic surgery were randomly assigned in a 5:3 ratio to receive either Kunning Oral Liquid plus conventional postoperative management or conventional postoperative management alone. Postoperative bleeding volume, hemostasis time, and endometrial thickness recovery were continuously monitored for 30 days. In addition, coagulation parameters, inflammatory mediators, and uterine blood flow indices were assessed to explore potential pharmacodynamic mechanisms associated with the herbal formulation. Results Kunning Oral Liquid significantly reduced 48-h postoperative bleeding volume compared with controls (78.3 ± 24.6 vs. 136.5 ± 38.7 mL, p < .001) and shortened hemostasis time (18.4 ± 5.2 vs. 26.7 ± 6.8 h). It also significantly improved endometrial thickness recovery at 30 days (68.2% ± 12.4% vs. 45.6% ± 10.3%, p < .001). The proportion of patients achieving effective endometrial repair was markedly higher in the treatment group (76.5% vs. 40.8%). Mechanistically, improvements in uterine artery blood flow parameters and coagulation–fibrinolysis balance suggested that the formula may enhance local microcirculation and regulate tissue repair pathways. Safety outcomes showed no significant difference in adverse events between groups. Conclusion Kunning Oral Liquid, a multi-herb natural product formulation, demonstrates significant hemostatic and endometrial regenerative effects after hysteroscopic surgery. Its therapeutic efficacy may be attributed to synergistic interactions among its bioactive constituents, acting on coagulation regulation, angiogenesis, and inflammatory modulation. These findings support its potential as a pharmacognosy-relevant natural product for postoperative uterine recovery.