针刺在治疗卵巢低反应的临床应用进展

卵巢低反应(poor ovarian response,POR)是卵巢对促性腺激素(Gn)刺激反应不良的病理状态,患者在控制性超促排卵(COH)中效果不理想,体外受精-胚胎移植(IVF-ET)妊娠率低下。如今对于POR的常规治疗仍存在局限。针刺疗法作为祖国传统医学的重要组成部分,操作简便,经济安全。目前临床针刺治疗POR包括毫针刺法、经皮穴位电刺激(TEAS)和针药结合等方法。研究表明POR患者经针刺治疗后基础内分泌、肾虚症状和卵巢功能等有所改善,接受IVF-ET患者获卵数与妊娠率有所提高。其治疗机制可能是通过调节中枢相关神经元活性和下丘脑-垂体-卵巢轴的分泌功能,改善血清性激素水平和卵巢血液供应,提高IVFET妊娠率。现将针刺治疗POR的临床研究进展从治疗的机制、方法、疗效、安全性等方面进行综述。

Clinical Application of Acupuncture in Treatment of Poor Ovarian Response

Poor ovarian response(POR) is a pathological state of ovarian stimulation to the gonadotropin (Gn), which leads to the poor outcome of controlled ovarian hyperstimulation (COH) and the low pregnancy rate in in-vitro fertilization and embryo transfer (IVF-ET). Nowadays there are also limitations of conventional therapy. As a vital part of traditional Chinese medicine, acupuncture is economical, secure and easy to do. At present, the methods of clinical acupuncture for POR include the filiform needle acupuncture, the transcutanclus electrical acupoint stimulation (TEAS) and the acupuncture combined with medicine,etc. The basal hormone levels, symptoms of "kidney deficiency" and ovarian function were improved in those POR patients underwent acupuncture treatment, and the pregnancy rate and the quantity of oocytes were raised in their IVF-ET cycles. The underlying mechanisms of acupuncture treatment could include the positive regulation of central neuron, the improvement of hypothalamic-pituitary-ovarian axis, and the improved ovarian blood supply. In this review, the clinical research progress of acupuncture treatment of POR is summarized.