{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:03:49Z","timestamp":1777637029422,"version":"3.51.4"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Subinvolution of the postpartum uterus is a common puerperal complication. While Chinese herbal hot compress (CHHC) therapy has been widely applied to promote postpartum uterine involution, its underlying mechanisms remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study employed a longitudinal metabolomics approach based on UPLC-Q-TOF-MS to analyze serum samples collected from 168 patients with postpartum uterine subinvolution (CHHC group, n = 86; routine care group, n = 82) at baseline (T0), day 3 (T1), and day 7 (T2) of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>OPLS-DA analysis revealed that the metabolic profiles of the two groups were highly overlapping at T0 and gradually diverged as treatment progressed, with the most significant separation observed at T2. A total of 83 differential metabolites were identified based on the criteria of VIP &amp;gt; 1.0, p &amp;lt; 0.05, and |log\u2082(Fold Change)| &amp;gt; 0.58, among which 21 core metabolites exhibited four distinct dynamic patterns: sustained increase, sustained decrease, rise-then-fall, and fall-then-rise. KEGG pathway enrichment analysis indicated that the differential metabolites were primarily associated with arachidonic acid metabolism, glycerophospholipid metabolism, amino acid metabolism, and the tricarboxylic acid cycle. Spearman correlation analysis identified four candidate biomarkers\u2014LysoPC(18:1), arachidonic acid, L-tryptophan, and citric acid\u2014and the combined model achieved an AUC of 0.913. Notably, both pathway enrichment and biomarker diagnostic performance showed progressive enhancement from T1 to T2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This study is the first to characterize the dynamic metabolic changes associated with the \u201cwarming meridians and activating blood\u201d effects of CHHC therapy from a dynamic metabolomics perspective, providing preliminary molecular evidence for evaluating the efficacy of traditional Chinese medicine external therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1791959","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T06:00:34Z","timestamp":1777442434000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dynamic serum metabolomic changes during Chinese herbal hot compress therapy for postpartum uterine involution: pathway analysis and candidate biomarker identification"],"prefix":"10.3389","volume":"13","author":[{"given":"Xinxin","family":"Yin","sequence":"first","affiliation":[{"name":"Shijiazhuang Maternity and Child Healthcare Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyan","family":"Liu","sequence":"additional","affiliation":[{"name":"Shijiazhuang Maternity and Child Healthcare Hospital","place":["Shijiazhuang, Hebei, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"436","DOI":"10.3238\/arztebl.m2021.0168","article-title":"Diseases and complications of the puerperium","volume":"118","author":"Schrey-Petersen","year":"2021","journal-title":"Dtsch Arztebl Int"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e0301825","DOI":"10.1371\/journal.pone.0301825","article-title":"Effect of low-intensity focused ultrasound therapy on postpartum uterine involution in puerperal women: a randomized controlled trial","volume":"19","author":"Wei","year":"2024","journal-title":"PLoS One"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"100724","DOI":"10.1016\/j.imr.2021.100724","article-title":"Auricular acupressure promotes uterine involution after cesarean section: a randomized controlled trial","volume":"10","author":"Wang","year":"2021","journal-title":"Integr Med Res"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1016\/j.wjam.2023.03.003","article-title":"Penetration moxibustion for postpartum subinvolution of uterus: two case reports and mechanism analysis","volume":"33","author":"Chen","year":"2023","journal-title":"World J Acupunct Moxibustion"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e25154","DOI":"10.1016\/j.heliyon.2024.e27154","article-title":"Effects of traditional Chinese medicine-assisted intervention on improving postpartum lactation: a systematic review and meta-analysis","volume":"10","author":"Fang","year":"2024","journal-title":"Heliyon"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1186\/s13020-025-01112-2","article-title":"Mass spectrometry-based metabolomic as a powerful tool to unravel the component and mechanism in TCM","volume":"20","author":"Liao","year":"2025","journal-title":"Chin Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1431862","DOI":"10.3389\/fphar.2024.1431862","article-title":"Application of multi-omics in the study of traditional Chinese medicine","volume":"15","author":"Zhao","year":"2024","journal-title":"Front Pharmacol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e40719","DOI":"10.1097\/MD.0000000000040719","article-title":"Metabolomics as a promising technology for investigating external therapy of traditional Chinese medicine: a review","volume":"103","author":"Yang","year":"2024","journal-title":"Medicine (Baltimore)"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"294","DOI":"10.3390\/jpm10040294","article-title":"Metabolomics for diagnosis and prognosis of uterine diseases? 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