Ancient Literature Research On Acupuncture And Moxibustion Treatment Of Premature Ovarian Insuficiency(POI)

Objective:By retrieving and collecting the relevant contents of acupuncture and moxibustion treatment of POI scattered in ancient literatures,clinical characteristics of acupuncture and moxibustion treatment like acupoint selection rules,acupoint distribution and meridian,treatment methods and treatment contraindances,were discussed to provide multi-dimensional thinking for the treatment of POI,and to better show therapeutic advantage of acupoint stimulation.Methods:Eight disease names corresponding to POI were used as search terms,including Irregular Menstruation,Low menstruation,Late menstruation,Late or Early Menstruation,Infertility,and Symptoms before and after menopause.Chinese Medical Classics(5th edition),a large electronic book series of traditional Chinese medicine,was used to search the full text of ancient books before 1949 to extract and sort out the provisions on the treatment of POI by acupuncture and moxibustion and establish the corresponding database.By using the method of bibliometrics,the acupoint frequency,meridian,distribution and site distribution and so on were systematically analyzed and summarized.Results:A total of 20587 matching articles were retrieved from 76 search terms,and 682 items related to acupoints selection were screened out.The literatures covered a total of 51 ancient books from Qin and Han Dynasties to Ming and Qing Dynasties and even modern times,involving 53 acupoints and a total of 801 acupoints frequency.(1)The most commonly used acupoints are:Zhongji(CV4),Guanyuan(CV3),Zigong(EX-CA1),Yinjiao(CV7),Siman(CV5),Rangu(KI2),Qichong(ST30),Sanyinjiao(SP6),Xuehai(SP10),Zhaohai(KI6).The articles are mainly described by single acupoint,and there are only 55 prescriptions for the combination of multiple acupoints after the Song Dynasty.Sanyinjiao(SP6)-Zhongji(CV4)and Sanyinjiao(SP6)-Shenshu(BL23)are the most frequently used acupoints compatibility.(2)The most frequently used meridians of acupoints are Conception Vessel(CV)and Shaoyin Kidney Meridian of Foot(there are 5 intersection points of thoroughfare vessel(TV)and Kidney-meridian,accounting for 36%of the total frequency of Kidney-meridian acupoints).Acupoints are mainly selected on the lower abdomen and lower extremities,among which CV acupoints are mainly used on the lower abdomen and Kidney-meridian acupoints are mostly used on the lower extremities.(3)Fifty percent of the extracted articles specified the selection of acupuncture and moxibustion,of which 30%were moxibustion,and the amount of moxibustion at the lower abdomen acupoints was relatively large,19%were combined with acupuncture and moxibustion,and only 1%were acupuncture.(4)Shimen(CV5)and Sanyinjiao(SP6)--Hegu(L14)are the most common forbidden points.(5)Among all kinds of disease names,Infertility,Irregular menstruation and Amenorrhea involved the most acupuncture treatment,accounting for 48%,26%and 22%,respectively.Conclusion:The pathogenesis of the meridian of POI should be the imbalance of CV and TV,deficiency of kidney qi.So the treatment of the selected points should be mainly based on the regulation of ChongRen and the liver and kidney.Points of CV in the lower abdomen are selected locally,and the Kidney Meridian and Liver Meridian points of the lower limbs are selected at the distal end.Taboo points should be paid attention to but should not be restricted by them.The treatment plan can be selected according to the patient’s physical condition and pregnancy.The rule of selecting acupoints presented in the tedious ancient literature is different from that of modern clinical practice.There are many errors in the process of document collation.Therefore,it is not difficult to understand the deviation of the theory of acupoints from clinical practice and the influence of western medicine and anatomy.The high-frequency acupoints are also different in different periods.Therefore,avoiding simply compiling directly from ancient and modern acupuncture literatures without screening.The source should be verified by clinical practice and seek answer from the changes in acupuncture theory.