中国针灸2026，Vol.46Issue(9)：1441-1448,8.DOI:10.13703/j.0255-2930.20250620-k0006
基于阴道菌群结构探讨"调经促孕针法"治疗卵巢早衰的疗效差异影响机制
Exploring the mechanism underlying the efficacy differences of"Tiaojing Cuyun Acupuncture"for premature ovarian failure based on vaginal microbiota structure
摘要
Abstract
Objective To observe the efficacy of"Tiaojing Cuyun Acupuncture"combined with hormone replacement therapy in the treatment of premature ovarian failure(POF),and to investigate differences in vaginal microbiota among patients with different therapeutic responses,thereby preliminarily exploring the mechanism underlying efficacy differences.Methods Ninety-eight patients with POF were randomly divided into an observation group(49 cases,1 case was eliminated)and a control group(49 cases,1 case dropped out).The control group was treated with hormone replacement therapy with Femoston,one tablet each time,once daily.On the basis of the control group,the observation group was additionally treated with"Tiaojing Cuyun Acupuncture".Acupoint group 1 included Baihui(GV20),Zhongwan(CV12),Guanyuan(CV4),and bilateral Tianshu(ST25),Zigong(EX-CA1),Dahe(KI12),Zusanli(ST36),Sanyinjiao(SP6),and Taichong(LR3).Acupoint group 2 included Baihui(GV20),bilateral Shenshu(BL23),Ciliao(BL32),and Taixi(KI3).The two acupoint groups were used alternately,beginning with acupoint group 1.Treatment was administered once every other day,three times per week.Both groups were treated for three menstrual cycles.Serum follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E2),and anti-Müllerian hormone(AMH)levels on days 3-5 of the menstrual cycle were measured before and after treatment in the two groups.Self-rating anxiety scale(SAS)scores were assessed before and after treatment,and clinical efficacy was evaluated in the two groups.Five effective patients(G0 subgroup)and five ineffective patients(G1 subgroup)were randomly selected from each group,and their vaginal microbiota structure was analyzed using 16S rRNA sequencing.Results After treatment,FSH levels in both groups were lower than those before treatment(P＜0.05);SAS scores in both groups were lower than those before treatment(P＜0.05),and the observation group had lower SAS score than the control group(P＜0.05).The total effective rate was 77.1%(37/48)in the observation group,which was higher than 56.3%(27/48)in the control group(P＜0.05).Vaginal microbiota analysis showed that at the phylum level,the relative abundance of Firmicutes in the G0 subgroup of the control group was higher than that in the G1 subgroup,while the relative abundances of Bacteroidetes,Actinobacteria and Proteobacteria were lowed in the G0 subgroup.In contrast,the observation group exhibited an opposite trend:the G0 subgroup had lower Firmicutes abundance but higher abundances of Actinobacteria,Bacteroidetes and Proteobacteria compared with the G1 subgroup.At the family and genus levels,Bifidobacterium was enriched in the G0 subgroups of both groups,whereas Lactobacillus predominated in the G1 subgroups.The G0 subgroup of the control group showed higher abundance of Gardnerella,while both Lactobacillus and Gardnerella were concurrently elevated in the G1 subgroup of the observation group.Additionally,in the observation group indicated that Clostridiales and Rikenellaceae were significantly more abundant in the G0 subgroup than in the G1 subgroup(P＜0.05).Conclusion The"Tiaojing Cuyun Acupuncture"combined with hormone replacement therapy is superior to hormone replacement therapy alone in improving anxiety.There are differences in vaginal microbiota structure among patients with different theraputic efficacy,suggesting that the vaginal microecological environment may be involved in the mechanism of treatment response in POF.关键词
卵巢早衰/调经促孕针法/激素水平/焦虑自评量表/疗效差异/阴道菌群Key words
premature ovarian failure(POF)/Tiaojing Cuyun Acupuncture/hormone levels/self-rating anxiety scale(SAS)/differences in efficacy/vaginal microbiota引用本文复制引用
卓缘圆,吴子乐,罗渝,黄杏贤,饶晓丹,吴家满..基于阴道菌群结构探讨"调经促孕针法"治疗卵巢早衰的疗效差异影响机制[J].中国针灸,2026,46(9):1441-1448,8.基金项目
2025年国家自然科学基金面上项目:82575197 （）
2024年广东省中医药局面上项目:20251312 （）
2024年深圳市自然科学基金面上项目:JCYJ20240813115126035 （）
2025年深圳市自然科学基金面上项目:JCYJ20250604145807011 （）
