自身免疫性卵巢早衰的中西医治疗

Treatment of autoimmune premature ovarian failure with TCM and Western medicine

众多研究表明,自身免疫是导致POF(primary ovarian failure)的重要因素。自身免疫性POF的免疫紊乱机制主要表现为ACA、SCA、AOA等抗体的异常以及淋巴细胞亚群的失衡。目前临床除激素替代治疗,促排卵治疗及赠卵胚胎移植等常规卵巢早衰疗法外,还包括糖皮质激素的免疫抑制疗法,此外调节性T细胞及干细胞的治疗也有较多的动物实验研究成果,而临床疗效尚需进一步的证实。中医治疗该病通过辨证论治予以活血调经、理血调肝、补肾健脾、清热活血、温补肾阳等疗法,在早期防治和改善症状方面效果显著。目前,该病在诊断和治疗上都有一定难度,明确诊断和深入了解其发病机制是早期干预治疗该病的关键。

Numerous studies have shown that autoimmunity is an important factor leading to POF（primary ovarian failure）.The immune disorder mechanism in autoimmune POF mainly manifest as the abnormity of ACA antibody,SCA antibody and AOA antibody,and also the imbalance of lymphocyte subpopulation.The current methods in clinical application except hormone replacement therapy,induced ovulation and in vitro fertilization with donor oocytes and embryo transfer normal ovarian,also including immunosuppressive therapy with glucocorticoids.In addition,regulatory T cell and stem cell therapy have obtained some achievements in animal experiments,but clinical efficacy remains to be confirmed further.Traditional Chinese medicine treatments by syndrome differentiation including promoting blood circulation to restore menstrual flow,regulating liver blood,tonifying kidney and spleen,heat-clearing and blood-activating,warming and invigorating kidney yang and so on,they can improve symptoms and prevent POF in the early phase of this disease.At present,this disease has certain difficulty in the diagnosis and treatment,definitive diagnosis and in-depth understanding of the pathogenesis is the key to treatment the disease in early stage.