针灸治疗排卵障碍性不孕症临床研究进展  

Clinical Research Progress in Acupuncture and Moxibustion in the Treatment of Ovulatory Disorder Infertility

作　　者：张驰 闫颖[1] 张晗[1] ZHANG Chi;YAN Ying;ZHANG Han(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin,China,300193)

机构地区：[1]天津中医药大学第一附属医院,国家中医针灸临床医学研究中心,天津300193

出　　处：《河南中医》2025年第3期479-486,共8页Henan Traditional Chinese Medicine

基　　金：国家自然科学青年基金项目(82104912)。

摘　　要：排卵障碍性不孕症的主要病机是肾精亏虚、痰湿阻滞、肝气郁结、气滞血瘀、心肾不交、阴阳失衡,这些因素既可单独致病,也可相互作用而致病。肾虚是导致卵泡排出障碍的关键,肾为先天之本,肾气充盛才能有正常的月经和排卵,治疗应以补肾为根本,辨证论治同时需配合疏肝健脾、交通心肾、理气活血、阴阳平衡等方法。针灸治疗排卵障碍性不孕症是通过调节内分泌、改善卵巢功能、影响卵泡发育质量、影响支配卵泡周围血管的神经等途径,提高患者的妊娠率。针灸治疗排卵障碍性不孕症的相关中医疗法包括针刺治疗(飞针、腹针、电针等)、灸法治疗、穴位埋线、穴位注射、耳穴压豆、火龙罐等。但临床科研缺乏大样本量的研究,试验设计不严密,缺乏合理性,医生对选穴、针刺操作手法及治疗持续时间皆必不可少带有个人经验及偏好。根据患者情况辨证论治进行个体化的选择穴位,不断优化腧穴配伍、针刺手法、时间、频率、深度、留针时间、针具来降低医生之间个体经验差异对结果造成的影响是今后研究的方向。The etiology and pathogenesis of ovulatory disorder infertility(ODI)mainly revolve around kidney essence deficiency,phlegm-dampness obstruction,liver qi stagnation,qi stagnation and blood stasis,heart-kidney disharmony,and imbalance of yin and yang,which can cause disease independently or interact with each other.Kidney deficiency is the key factor causing ovulatory dysfunction.The kidney is the foundation of the body′s innate constitution.Only when the kidney qi is abundant can there be normal menstruation and ovulation.The treatment should focus on tonifying the kidney as the fundamental approach.While applying syndrome differentiation and treatment,it is also necessary to take into account methods such as soothing the liver,strengthening the spleen,harmonizing the heart and kidney,regulating qi and promoting blood circulation,and balancing yin and yang.Acupuncture and moxibustion for ODI improve the pregnancy rate by regulating endocrine,bettering ovarian function,influencing the quality of follicular development,and affecting the nerves that control the blood vessels around the follicles,etc.The relevant TCM therapies include acupuncture(such as flying needling,abdominal acupuncture,electroacupuncture,etc.),moxibustion,acupoint embedding,acupoint injection,auricular point pressing with seeds,and fire dragon cupping,and so on.However,clinical research lacks large-scale studies,and the experimental design is not rigorous and lacks rationality.Doctors′selection of acupoints,acupuncture manipulation techniques,and treatment duration all inevitably involve personal experience and preferences.Therefore,according to the patient′s condition,individualized selection of acupoints through syndrome differentiation and treatment,and continuous optimization of acupoint combinations,acupuncture manipulation techniques,time duration,frequency,depth,retention time,and acupuncture tools to reduce the impact of individual experience differences among doctors on the therapies is the research direction in the future.

关 键 词：排卵障碍性不孕症 针灸 肾虚 卵泡排出障碍 

分 类 号：R271.14[医药卫生—中医妇科学]