从下丘脑–垂体–卵巢轴探讨“补肾、调经、促孕”针法对卵巢储备功能减退的诊疗思路

Acupuncture for Diminished Ovarian Reserve via the HPO Axis: A “Tonify the Kidney, Regulate Menstruation and Enhance Fertility” Approach

摘要: 卵巢储备功能减退(DOR)是影响女性生育能力及内分泌功能的重要妇科疾病，其发病率逐年上升且趋于年轻化。本文基于下丘脑–垂体–卵巢(HPO)轴的理论框架，系统探讨“补肾、调经、促孕”针法治疗DOR的诊疗思路。文章从中医“肾–天癸–冲任–胞宫”生殖轴与西医HPO轴在生理与病理上的同构性出发，提出肾精亏虚为DOR的根本病机，冲任失调为关键环节，情志失畅为重要影响因素。针法以调冲任、补肝肾、安神志为原则，选取太溪、肓俞、关元、三阴交、气海、中极、子宫穴、百会、神庭等腧穴，通过调节神经内分泌功能、改善卵巢血流、调控自噬及炎症反应等机制，恢复HPO轴功能，促进卵巢储备功能的恢复。本文为DOR的针灸治疗提供了系统的理论依据与临床指导。

Abstract: Ovarian reserve decline (DOR) is a significant gynecological disorder affecting female fertility and endocrine function, with an increasing incidence and a trend toward younger age of onset. Based on the theoretical framework of the hypothalamus-pituitary-ovary (HPO) axis, this article systematically explores the diagnostic and therapeutic rationale of the “Tonify the kidney, regulate menstruation and enhance fertility” acupuncture method for treating DOR. By comparing the physiological and pathological homology between the traditional Chinese medicine (TCM) reproductive axis of “Kidney-Tian Gui-Chong Ren-Uterus” and the modern medical HPO axis, the article proposes that kidney essence deficiency is the fundamental pathogenesis of DOR, Chong and Ren meridian disharmony is the key link, and emotional disturbance is an important contributing factor. The acupuncture method adheres to the principles of regulating the Chong and Ren meridians, tonifying the liver and kidney, and calming the spirit. Acupoints such as Taixi (KI3), Huangshu (KI16), Guanyuan (CV4), Sanyinjiao (SP6), Qihai (CV6), Zhongji (CV3), Zigong (EX-CA1), Baihui (GV20), and Shenting (GV24) are selected. The therapeutic effects are achieved by regulating neuroendocrine function, improving ovarian blood flow, and modulating autophagy and inflammatory responses, thereby restoring HPO axis function and promoting the recovery of ovarian reserve. This article provides a systematic theoretical basis and clinical guidance for acupuncture treatment of DOR.