针灸治疗卵巢储备功能减退机制研究进展

Research Progress on Mechanism of Acupuncture and Moxibustion in Treating Diminished Ovarian Reserve

卵巢储备功能减退(diminished ovarian reserve,DOR)是妇科常见病,以卵巢内卵母细胞数量减少和质量下降为主要特征,造成生殖内分泌紊乱及生育能力下降。西医临床治疗以激素为主,存在一定局限性,若长期使用远期风险较高。中医采用针灸疗法,通过经络穴位推动机体阴阳转化,使胞宫定期藏泻,以改善卵巢功能,且针灸治疗该病疗效确切、简便经济、不良反应少。针灸治疗DOR的作用机制可能与生殖内分泌激素水平、卵巢组织形态、免疫系统、颗粒细胞凋亡、相关信号转导通路、卵巢局部微循环、卵巢排卵及妊娠等方面有关,从多系统、多层次、多靶点调节卵巢分泌与合成功能,改善卵巢局部微环境,促进卵泡发育、成熟及排出。该文总结了近年来针灸治疗DOR的作用机制进展,并分析目前研究的优势与不足,为临床运用提供理论依据和思路。

Diminished ovarian reserve(DOR)is a common gynecological disease,which is characterized by the decrease of oocytes'quantity and quality in the ovary,resulting in the disorder of reproductive endocrine and decline of fertility.Western medicine is mainly treated with hormone,which has some limitations,and the long-term risk is higher if it is used for a long time.Acupuncture and moxibustion can be used in traditional Chinese medicine to promote the transformation of Yin and Yang through meridians and acupoints,so as to make the uterus hide and diarrhea regularly and improve the function of ovary.Meanwhile,acupuncture is effective,simple and economical in the treatment of this disease with few adverse reactions.The mechanism of acupuncture in treating DOR may be related to the level of reproductive endocrine hormone,ovarian tissue morphology,immune system,granulosa cell apoptosis,correlative signal transduction pathway,local ovarian microcirculation,ovarian ovulation and pregnancy.Acupuncture regulates the function of ovarian secretion and synthesis,improves the local microenvironment of ovary,and promotes follicular development and excretion from multi-system,multi-level and multi-target.This review summarized the progress about mechanism of acupuncture in the treatment of DOR in recent years,and analyzed the advantages and disadvantages of the current research in order to provide theoretical basis and ideas for clinical application.