中医药干预卵巢功能减退类疾病围体外受精期的生育力保护策略  

Fertility Protection Strategy of Traditional Chinese Medicine Intervention in Peri-IVF Stage of Ovarian Insufficiency

作　　者：李茂雅 钟函芝 文怡[1] 魏绍斌[1] LI Maoya;ZHONG Hanzhi;WEN Yi;WEI Shaobin(Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China)

机构地区：[1]成都中医药大学附属医院,成都610075

出　　处：《世界中医药》2025年第4期659-664,共6页World Chinese Medicine

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号);中华中医药学会团体标准项目(20211220-BZ-CACM);成都中医药大学2023年度“杏林学者”学科人才科研提升计划(MPRC2023009)。

摘　　要：卵巢功能减退类疾病包括卵巢储备功能减退(DOR)、早发性卵巢功能不全(POI)、卵巢早衰(POF)。体外受精-胚胎移植(IVF-ET)已成为卵巢功能减退类疾病伴不孕患者主要选择的治疗方式。针对此类患者的生育力保护已成为当下研究热点。中医药在IVF-ET的各阶段切入,可单用中医药综合治疗,或IVF-ET联合中医药干预,分期论治,从各阶段辅助IVF-ET(进周前审证求因,治病求本——提高卵巢储备功能;降调期疏肝健脾,调和阴阳——改善低雌激素症状;促排卵期补肾益精,活血通络——提高卵泡数量及质量,减少不良反应;移植后期补肾健脾,温肾养血——改善子宫内膜容受性),采用中医特色疗法(针刺疗法、耳穴贴压、穴位贴敷、中药灌肠、食疗等),从而提高成熟卵子数量及质量,改善子宫内膜容受率及辅助生殖结局,同时可减轻辅助生殖技术的不良反应,提高IVF-ET成功率。Ovarian dysfunction-related diseases include diminished ovarian reserve(DOR),premature ovarian insufficiency(POI),and premature ovarian failure(POF).In vitro fertilization-embryo transfer(IVF-ET)has emerged as the primary treatment option for patients with ovarian dysfunction and infertility.Fertility preservation in these patients has become a current research hotspot.Traditional Chinese medicine(TCM)offers potential interventions throughout the IVF-ET process,either as a standalone treatment or in conjunction with IVF-ET,tailored for each stage of treatment.TCM can assist IVF-ET by evaluating and addressing underlying causes prior to stimulation to enhance ovarian reserve;soothing liver and regulating spleen during suppression phase to regulate yin and yang,thereby alleviating low estrogen symptoms;tonifying kidney,benefiting essence,activating blood,and dredging collaterals to improve ovarian follicle number and quality,while reducing side effects during ovarian stimulation;tonifying kidney,invigorating spleen,warming kidney,and nourishing blood to enhance endometrial receptivity after embryo transfer.TCM therapies,such as acupuncture,auricular acupressure,acupoint application,TCM enema therapy,and dietary treatment,can improve oocyte quantity and quality,endometrial receptivity,and overall IVF-ET outcomes,while reducing side effects and enhancing the success rate of assisted reproductive technologies.

关 键 词：卵巢功能减退类疾病 卵巢储备功能减退 早发性卵巢功能不全 卵巢早衰 生育力保护 中医药 围体外受精期 

分 类 号：R711.75[医药卫生—妇产科学]