This article studies the impact of treatment frequency of the Tiaojing Cuyun acupuncture (acupuncture for regulating menstruation and promoting pregnancy) in the treatment of premature ovarian insufficiency (POI) based on real-world evidence.Using a prospective cohort study design, 100 POI patients were categorized into strong exposure and weak exposure groups based on different levels of acupuncture stimulation, with a primary outcome event of a 10 IU/L decrease in follicle stimulating hormone (FSH).Demographic and clinical characteristics of the cases were analyzed, and serum hormone levels before and after treatment, Kupperman scale scores, peak systolic velocity (PSV), and resistance index (RI） were compared with a logistic regression model to determine the optimal threshold of acupuncture stimulation exposure.The results indicated that the total acupuncture treatment duration of 6 weeks was the most sensitive dividing point, with 6 weeks or longer being considered as the high-exposure group.There were 73 cases in the high-exposure group and 27 cases in the low-exposure group.Before and after treatment, the FSH levels decreased in both groups, while the levels of estradiol (E2) and anti-Müllerian hormone (AMH) significantly increased (P<0.05).The Kupperman scores and RI decreased while PSV increased in both groups.Furthermore, the strong exposure group showed superior efficacy compared to the weak exposure group.Logistic regression analysis indicated that age, age at menarche, and the number of acupuncture treatments were correlated with efficacy (P<0.05).The "Tiaojing Cuyun" acupuncture technique can effectively improve premature ovarian insufficiency, and the efficacy is even better with a total acupuncture treatment duration of 6 weeks or longer.
[1] Webber L, Davies M, Anderso P. ESHRE guideline: Management of women with premature ovarian insufficiency[J]. Reproductive Endocrinology, 2017(37): 41-48.
[2] Ayesha, Jha V, Goswami D. Premature ovarian failure: An association with autoimmune diseases[J]. Journal of Clinical and Diagnostic Research, 2016, 10(10): QC10-QC12.
[3] Wu X Y, Cai H, Kallianpur A, et al. Impact of premature ovarian failure on mortality and morbidity among Chinese women[J]. PLoS One, 2014, 9(3): e89597.
[4] Roeters van Lennep J E, Heida K Y, Bots M L, et al. Cardiovascular disease risk in women with premature ovarian insufficiency: A systematic review and meta-analysis[J]. European Journal of Preventive Cardiology, 2016, 23(2): 178-186.
[5] Allshouse A A, Semple A L, Santoro N F. Evidence for prolonged and unique amenorrhea-related symptoms in women with premature ovarian failure/primary ovarian insufficiency[J]. Menopause, 2015, 22(2): 166-174.
[6] Gallagher J C. Effect of early menopause on bone mineral density and fractures[J]. Menopause, 2007, 14(3): 567- 571.
[7] Okamura Y. Clinical management of primary ovarian insufficiency[M]//Cell Biology of the Ovary. Singapore: Springer, 2018: 89-99.
[8] Faubion S S, Kingsberg S A, Clark A L, et al. The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society[J]. Menopause,2020, 27(9): 976-992.
[9] 徐娅琼, 赵淑云, 周桦, 等. 早发性卵巢功能不全中西医治疗研究现状[J]. 生殖医学杂志, 2024, 33(2): 271-276.
[10] Gatta L A, Jiang X Z, Schnatz P F. Hormone therapy in women with primary ovarian insufficiency or early menopause[J]. Menopause, 2015, 22(9): 923-925.
[11] 谢依璇, 闫世艳, 陈波, 等. 新时代针灸的发展[J]. 科技导报, 2023, 41(14): 42-50.
[12] 杨莉, 许焕芳, 勾明会, 等. 调经促孕针法治疗卵巢功能衰退性疾病的应用探析[J]. 中国针灸, 2022, 42(10): 1200-1204.
[13] 黄奕珊, 卓缘圆, 黄杏贤, 等. 调经促孕针法联合灸法治疗早发性卵巢功能不全的临床观察[J]. 中国民间疗法, 2021, 29(7): 41-44.
[14] 徐呈超, 李虎, 房繄恭, 等. 调经促孕针法对早发性卵巢功能不全患者负性情绪的影响[J]. 中国针灸, 2021, 41(3): 279-282.
[15] 徐健钦, 于海波, 王超, 等. 调任通督针法治疗轻中度产后抑郁障碍的疗效评价[J]. 科技导报, 2023, 41(14): 75-81.
[16] Yi W M, Pan A Z, Li J J, et al. Clinical observation on the acupuncture treatment in patients with urinary retention after radical hysterectomy[J]. Chinese Journal of Integrative Medicine, 2011, 17(11): 860-863.
[17] 麦吉么吾甲, 赵雨, 文谦, 等. 不同疗程电针治疗对颈型颈椎病患者疗效及依从性的影响: 一项小样本随机对照研究[J]. 针刺研究, 2019, 44(11): 835-839.
[18] 王伟明, 许焕芳, 刘志顺. 针灸治疗原发性卵巢功能不全的文献回顾[J]. 环球中医药, 2013, 6(3): 213-217.
[19] 周雪忠, 王世华, 张迪, 等. 构建中医药特色真实世界临床研究新模式的实践与思考[J]. 科技导报, 2023, 41(14): 22-31.
[20] Jo J, Lee Y J, Lee H. Effectiveness of acupuncture for primary ovarian insufficiency: A systematic review and meta-analysis[J]. Evidence-Based Complementary and Alternative Medicine, 2015, 2015: 842180.
[21] 王占利, 李坤寅, 冯尧伟, 等.《傅青主女科》益经汤对治疗卵巢早衰的启示[J]. 中国中医基础医学杂志, 2012, 18(5): 492-493.
[22] 杨福霞, 杨卓欣, 罗文舒, 等. 调经促孕针法治疗早发性卵巢功能不全临床观察[J]. 光明中医, 2020, 35(24): 3935-3938.
[23] 吴家满, 宁艳, 陈瑜, 等. 调经促孕针法治疗卵巢早衰的临床疗效观察[J]. 时珍国医国药, 2019, 30(6): 1422- 1423.
[24] 尚洁. 针刺治疗早发性卵巢功能不全的前瞻性病例序列研究[D]. 北京: 中国中医科学院, 2018.
[25] 李晓彤. 调经促孕针刺法对卵巢储备功能下降影响的临床探索性研究[D]. 北京: 中国中医科学院, 2017.
[26] 尹雅倩, 郑晨思, 郝鸣昭, 等. 调经促孕针刺法治疗早发性卵巢功能不全的前瞻性病例序列研究[C]// 2019中国针灸学会年会暨40周年回顾论文集. 武汉: 中国针灸学会, 2019: 968-972.
[27] 杨会生, 房繫, 恭尚洁, 等. 调经促孕针刺治疗早发性卵巢功能不全的临床观察[C]//2017世界针灸学术大会暨 2017中国针灸学会年会论文集. 北京: 中国针灸学会, 2017: 457-458.
[28] 杨会生. 针刺对早发性卵巢功能不全患者卵巢功能影响的病例注册登记研究[D]. 北京: 中国中医科学院, 2019.
[29] Yi A L, Qin X B, Du Z Y, et al. Clinical observation on the improvement of serum sex hormone and ovarian function in premature ovarian failure patients with deficiency-cold syndrome by combining Wenjing Decoction with tiaobu Chongren acupuncture and moxibustion[J]. Evidence-Based Complementary and Alternative Medicine, 2021, 2021: 3926822.
[30] Wang F, Fang Y G, Chen Y R, et al. Acupuncture for premature ovarian failure: A prospective cohort study[J]. Chinese Acupuncture & Moxibustion, 2014, 34(7): 653- 656.
[31] Esperança-Pina J A, Reis A M. Arterial component of the angioarchitecture of the canine ovary[J]. Acta Anatomica, 1984, 120(3): 112-116.
[32] Zbornikova V, Johansson I. Duplex criteria for grading internal carotid artery stenosis >50% based on multiregression analysis[J]. Journal of Neuroimaging, 1998, 8(3): 132-135.
[33] Zong X Y, Yu Y, Chen W H, et al. Ovarian reserve in premenopausal women with breast cancer[J]. Breast, 2022, 64: 143-150.
[34] Schwehr N A, Shippee N D, Johnson P J. Acupuncture 'dose' (number of treatments) and insurance benefits in the USA[J]. Acupuncture in Medicine, 2018, 36(2): 88- 95.
[35] 杨会生, 房繄恭, 刘保延, 等. 基于病例注册登记研究探讨针刺对早发性卵巢功能不全患者窦卵泡计数的影响[J]. 中华中医药杂志, 2020, 35(5): 2276-2281.
