| Objective:This study excavated and analyzed the relevant literature on acupuncture and moxibustion treatment of early-onset ovarian insufficiency,observed the TCM name,acupuncture method,acupoint regularity,meridian tropism and curative effect of POI,emphatically studied the relevant data with early-onset ovarian insufficiency as an important clinical feature,summarized the rules of acupoint selection for acupuncture treatment of early-onset ovarian insufficiency,and analyzed the clinical features of acupuncture and moxibustion.The characteristics of syndrome differentiation and treatment provide scientific basis for the effective treatment of POI,in order to better play the efficacy of acupoint stimulation in the disease,and better serve the clinical.Based on this research method.In the work of returning to China,we will carry out a correlation study between our traditional medicine and Chinese traditional medicine in order to serve the health of all mankind.Methods:1.Document mining and analysis:This study uses database retrieval and manual retrieval methods to analyze ancient and modern literature data in CNKI,CMB,VIP,WF and other Chinese databases,as well as in foreign databases such as Chorane Library,PubMed,EMBASE,Thai Journal（Thai Jo）TCI.To identify the Chinese keywords"premature ovarian insufficiency,premature ovarian failure,acupuncture,acupuncture,electro-acupuncture,clinical research","premature ovarian failure,acupuncture,needling,electro-acupuncture,random,clinical research",and the Thai keywords"premature ovarian insufficiency,premature ovarian failure,acupuncture,needling,electro-acupuncture,random,clinical research".Taking the period from January 1998 to June 2018 as the retrieval period,we formulate the retrieval strategy and determine the inclusion of data screening.Standards and exclusion criteria,using Microsoft Excel 2012 software for data entry of clinical literature on acupuncture treatment of early-onset ovarian insufficiency,including publication date,author’s name,number of cases,syndrome differentiation,treatment principles,meridians,acupoints,sites,treatment methods,treatment courses,and other contents,using Microsoft Excel 2012 to establish the original database.SPSS 23.0 software was used to analyze the data of acupoints,frequency acupoints,meridians,locations,specific acupoints and syndromes,and Apriori algorithm was introduced to use SPSS Clementine 12.0 software to formulate Association rules,find out the relationship between acupoints and acupoints,meridians and collaterals,and summarize the commonly used clinical treatment acupoints and related compatibility recorded in the literature.2.Clinical randomized validation:The cases in this study were all from the gynecological,acupuncture and moxibustion and sub-health clinics of Sichuan Integrated Hospital between August 2017 and April 2018.They were clinically diagnosed as early-onset ovarian insufficiency（POI）.The patients with Kidney-Deficiency and liver-depression syndrome differentiation in traditional Chinese medicine were collected.A total of 165 cases met the inclusion and exclusion criteria were randomly scored.Acupuncture group（control group）,catgut embedding group（treatment group 1）and acupuncture combined catgut embedding group（treatment group 2）,55 cases in each group.Acupuncture acupoints were selected from previous literature data mining research results.Acupuncture acupoints were identified as five abdominal acupoints（Guanyuan,uterus,returning,Zhongji,Zhongwan）,five lower limb acupoints（Sanyinjiao,Taixi,Zusanli,Xuehai,Taichong）,and five back acupoints（Ganshu,Pishu,Shenshu,Guanyuanshu,Secondary Liao）.The patients were treated for 3 months and followed up for 1 month.Using the Guiding Principles for Clinical Research of New Chinese Medicine and the relevant criteria in Gynecology of Traditional Chinese Medicine,the evaluation indexes were established.The menstrual volume score,Kupperman scale,serum hormone levels before treatment,2 months after treatment,1 month after treatment and follow-up were recorded respectively:follicle stimulating hormone（FSH）,luteinizing hormone.Levels of（LH）,estradiol（E2）and anti-Mullerian hormone（AMH）.SPSS23.0 statistical software was used for statistical analysis to observe the difference of clinical efficacy among the three groups.Results:1.Literature mining and analysis:（1）A total of 60 literatures on acupuncture and moxibustion for primary ovarian insufficiency were included through database retrieval,and 65 therapeutic acupoints were retrieved.A total of 595 acupoints were used.The top 10 acupoints were Guanyuan 54times,Sanyinjiao 48 times,Shenshu 36 times,Taixi 32 times,Taichong 31 times,uterus28 times,Xuehai 25 times,intermediate 25 times,Pishu 25 times,Zusanli 22 times.The frequency of acupoint compatibility is Guanyuan with Sanyinjiao,Shenshu,Taixi;Shenshu,Guanyuan,Taixi,Taichong,uterus;Shenshu with Sanyinjiao,Guanyuan,Taichong,Taichong,uterus;Taixi with Sanyinjiao,Guanyuan,Shenshu,intermediate,Pishu,Taichong,uterus.（2）In the analysis of meridian relationship,the top three are the foot-sun Bladder Meridian 129 times,Ren meridian 115 times and Foot-Taiyin spleen meridian 86 times;in acupoints,the top three are foot-sun Bladder Meridian 13 times,Ren meridian 9 times,Du meridian 9 times,foot-yang-ming stomach meridian 9 times,foot-shaoyin kidney meridian8 times;in the analysis of meridian compatibility,the top three are Ren meridian matching Foot-Taiyin spleen meridian,Ren-taiyin spleen meridian meridian,Ren meridian The bladder meridian of foot sun is matched with the spleen meridian of Taiyin.（3）In the analysis of the relationship between acupoints,it mainly concentrates on lower limbs,lower abdomen and back.The top three are 192 lower limbs,180 lower abdomen and 67 back.At acupoints,the top three are 15 lower limbs,23 lower abdomen and 11 back acupoints.The top three were lower abdomen with lower limbs;lower limbs with lower abdomen and lower waist;lower back with lower limbs,lower abdomen and back.（4）In the analysis of the relationship between specific acupoints,the top three are172 intersections,104 Wushu acupoints and 94 original acupoints,and the top three are 17intersections,8 Wushu acupoints,5 original acupoints,5 back acupoints and 5 recruiting acupoints.According to the analysis of specific acupoint compatibility,the top three acupoints are Muxue,Yuan,Wushu and Beishu,and Jiaohui,Mu,Yuan,Wushu and Beishu.（5）In TCM syndromes,according to the statistical analysis of literature frequency,the top three are kidney yin deficiency 22 times,kidney deficiency liver depression 11times,spleen and kidney yang deficiency 10 times,accounting for more than 70%of the total frequency.2.Clinical study analysis:（1）165 patients with early-onset ovarian insufficiency were enrolled in a single-center randomized controlled study.There were 55 cases in the control group,55 cases in the treatment group and 55 cases in the treatment group.Nine cases of exfoliation were excluded.A total of 156 cases were included in the statistical analysis.Among them,50cases in the control group,53 cases in the treatment group and 53 cases in the treatment group.The control group was treated with simple acupuncture,while the trea tment group was treated with simple catgut embedding.The two groups were treated with acupuncture combined with catgut embedding for 12 weeks and followed up for 4 weeks.（2）Baseline data comparison:the comparison of age,course of disease,menarche and history of pregnancy and childbirth among the control group,treatment group 1 and treatment group 2,patients,P>0.05,the difference was not statistically significant.The baseline of the three groups was consistent and comparable.（3）Menstruation comparison:Before treatment,there was no significant difference in the amount,color,quality and duration of menstruation among the three groups,P>0.05,which was comparable.After treatment,there were significant differences among the three groups before and after treatment,P<0.05.（4）Kupperman symptoms:Before treatment,there was no significant difference in hot flashes and sweating,sensory disturbance,insomnia,agitation,depression and suspicion,dizziness,fatigue,bone and joint muscle pain,headache,palpitation,skin ant migration,urinary tract infection and sexual life among the three groups P>0.05.After treatment,there were significant differences between the three groups before and after treatment,P<0.05;among the three groups,there were significant differences in hot flashes and sweating,sensory disturbance,insomnia,agitation,depression and suspicion,dizziness,fatigue,bone and joint muscle pain,and sexual life,P<0.05;headache,palpitation,skin ant walking,etc.There was no significant difference in urinary tract infection P>0.05.（5）Serum endocrine level comparison:Before treatment,there was no significant difference in serum FSH,LH,E2,AMH levels among the three groups,P>0.05,which was comparable.After 8 weeks of treatment,the serum FSH level of the two groups was significantly improved compared with the other two groups.There was significant difference between the two groups by statistical comparison,P<0.05.The serum FSH level of the control group and the treatment group was improved in comparison,with no statistical significance,P>0.05.After treatment,there was significant difference between the three groups before and after treatment,P<0.05;among the three groups,there was significant difference in serum FSH,LH,E2 and AMH levels,P<0.05.Conclusions:（1）Kidney deficiency and liver depression are the main pathogenesis of this disease.The principle of treatment is tonifying kidney and benefiting essence and soothing liver.Acupuncture and moxibustion therapy often uses acupoint compatibility,meridian compatibility,location compatibility,specific acupoint compatibility and other methods to treat this disease.（2）The commonly used acupoints for the treatment of early-onset ovarian dysfunction are Guanyuan,Sanyinjiao,Shenshu,Taixi,Taichong,uterus,blood sea,intermediate,Pishu and Zusanli.Compatible acupoints are Guanyuan with Sanyinjiao,Shenshu and Taixi;Sanyin with Shenshu,Guanyuan,Taixi,Taichong and uterus.（3）The common meridians are the foot-sun bladder meridian,the Ren meridian,the foot-yang-ming stomach meridian and the Du meridian.The common compatibility of meridians and collaterals is that Ren Meridian matches Taiyin Spleen Meridian,Foot Taiyin Spleen Meridian matches Ren Meridian and Foot Taiyin Spleen Meridian matches Taiyin Spleen Meridian,Foot Taiyang Bladder Meridian matches Taiyin Spleen Meridian.（4）The commonly used specific acupoints are Jiaohui acupoint,Mu acupoint and Wushu acupoint.The common compatibility of specific acupoints is mu acupoint mating meeting acupoint,original acupoint,Wushu acupoint,back acupoint;Jiao acupoint mating original acupoint,Wushu acupoint,back acupoint.（5）Acupuncture,catgut embedding and needling combined with catgut embedding can improve the clinical symptoms,menstrual volume and serum sex hormone levels of early-onset ovarian insufficiency,but the combination of acupuncture and catgut embedding may have an earlier effect and a more lasting effect.（6）In the treatment of early-onset ovarian insufficiency,because of its high frequency of treatment,the compliance of patients is relatively poor,requiring the active cooperation of patients and the positive explanation of doctors;catgut embedding therapy is easier for patients to accept because of its low frequency treatment in the treatment cycle,with better compliance,but its existence reduces the chances of face-to-face communication between doctors and patients,which is not conducive to doctors.Understanding the patient’s psychological dynamics and disease outcomes;and acupuncture combined with catgut embedding therapy,can avoid the shortcomings of single therapy,strengthen the advantages of two effective treatment methods,can be used as a new method in the treatment of the disease. |
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