多囊卵巢综合征胰岛素抵抗的针灸治疗机制研究进展

陈琳; 王宏羽; 李瑞雪; 王晓梅; 尹海燕; 郭岩

doi:10.16766/j.cnki.issn.1674-4152.003728

多囊卵巢综合征胰岛素抵抗的针灸治疗机制研究进展

doi: 10.16766/j.cnki.issn.1674-4152.003728

1.
济宁医学院临床医学院，山东济宁 272067
2.
济宁医学院基础医学院，山东济宁 272067

基金项目:

山东省自然科学基金青年项目 ZR2022QC188

济宁医学院2019年度学校教师科研扶持基金项目 JYFC2019KJ001

济宁医学院2022年大学生创新训练计划项目 cx2022070z

详细信息

通讯作者:
郭岩，E-mail：15166798126@163.com

中图分类号: R245 R714.256
计量
- 文章访问数: 20
- HTML全文浏览量: 12
- PDF下载量: 2
- 被引次数: 0
出版历程
- 收稿日期: 2023-05-11
- 网络出版日期: 2024-12-28

cupuncture treatment mechanism and research progress of insulin resistance in polycystic ovary syndrome

1.
Clinical Medical College, Jining Medical University, Jining, Shandong 272067, China

摘要

摘要: 多囊卵巢综合征(PCOS)是育龄期女性常见的生殖内分泌疾病，典型表现为糖脂代谢异常、激素分泌异常等。现代医学认为PCOS的发病机制与胰岛素抵抗(insulin resistance，IR)及高雄激素血症(hyperandrogenemia，HA)密切相关，其中IR为其核心病理特征之一，现代医学在治疗手段上通常采用药物治疗(如枸橼酸克罗米芬、胰岛素增敏剂等)及手术治疗，可在一定程度上缓解患者症状。从中医角度看，PCOS的发生发展与肾气亏虚、脾虚生湿及肝郁气滞密切相关，针对以上病因病机采取辨证治疗可部分缓解患者症状。针灸(acupuncture and moxibustion，AM)是中医独有的一种“内病外治”的治疗手段。在经络学说的理论指导下，AM可通过特定操作方法，达到缓解症状，治疗全身性疾病的作用。根据使用器材及操作手段的不同，AM可分为针法及灸法，随着医疗技术的不断进步，穴位埋线及电针等疗法也逐渐应用于临床工作中。近年来，针灸疗法被广泛应用于PCOS的治疗，文章详细介绍了针灸改善PCOS合并IR的机制及研究进展，旨在为临床实践和基础研究提供参考。
- 多囊卵巢综合征 /
- 胰岛素抵抗 /
- 针灸治疗 /
- 机制
Abstract: Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder in women of childbearing age, typically characterized by abnormalities in glucose and lipid metabolism and hormone secretion. Modern medicine believes that the pathogenesis of PCOS is closely related to insulin resistance (IR) and hyperandrogenemia (HA), of which IR is one of the core pathological features, and modern medicine usually adopts medication (e.g., clomiphene citrate, insulin sensitizers, etc.) and surgery, which can relieve patients ' symptoms to a certain extent. From the perspective of Chinese medicine, the development of PCOS is closely related to kidney qi deficiency, spleen deficiency and dampness, and liver depression and qi stagnation, and dialectic treatment can partially alleviate the patient ' s symptoms by targeting the above etiology. Acupuncture and moxibustion (AM) is a kind of "internal disease external treatment" unique to Chinese medicine. Under the guidance of the theory of meridians and collaterals, AM can relieve symptoms and treat systemic diseases through specific manipulation methods. According to the use of equipment and different means of operation, AM can be divided into acupuncture and moxibustion, with the continuous progress of medical technology, acupuncture point buried wire and electro-acupuncture and other therapies are also gradually applied in clinical work. In recent years, acupuncture and moxibustion have been widely used in the treatment of PCOS. This article details the mechanism and methods of acupuncture in improving insulin resistance in PCOS, aiming to provide reference for clinical practice and basic research.
- Polycystic ovary syndrome /
- Insulin resistance /
- Acupuncture and moxibustion therapy /
- Mechanism

HTML全文

参考文献(52)

[1]	ORTIZ-FLORES A E, LUQUE-RAMÍREZ M, ESCOBAR-MORREALE H F. Polycystic ovary syndrome in adult women[J]. Medicina Clínica (English Edition), 2019, 152(11): 450-457. doi: 10.1016/j.medcle.2019.02.019
[2]	WOODWARD A, BROOM D, DALTON C, et al. Supervised exercise training and increased physical activity to reduce cardiovascular disease risk in women with polycystic ovary syndrome: study protocol for a randomized controlled feasibility trial[J]. Trials, 2020, 21(1): 101-108. doi: 10.1186/s13063-019-3962-7
[3]	YIN X, JI Y, CHAN C L W, et al. The mental health of women with polycystic ovary syndrome: a systematic review and meta-analysis[J]. Arch Womens Ment Health, 2021, 24(1): 11-27. doi: 10.1007/s00737-020-01043-x
[4]	DONG X C, LIU C, ZHUO G C, et al. Potential roles of mtDNA mutations in PCOS-IR: a review[J]. Diabetes Metab Syndr Obes, 2023, 16: 139-149. doi: 10.2147/DMSO.S393960
[5]	宁春妹, 赵颖, 安佳秀, 等. 动物胰岛素抵抗的发生机制及治疗[J]. 黑龙江畜牧兽医, 2022, 65(21): 23-29. NING CM, ZHAO Y, AN J X, et al. Mechanism and treatment of insulin resistance in animals[J]. Heilongjiang Animal Science And veterinary Medicine, 2022, 65(21): 23-29.
[6]	丁芳, 易晓芳. 血清抗苗勒管激素和胰岛素样生长因子-1与多囊卵巢综合征的相关研究[J]. 中国临床研究, 2022, 35(12): 1658-1661. DING F, YI X F. Associations of serum anti-Müllerian hormone and insulin-like growth factor-1 with polycystic ovary syndrome[J]. Chinese Journal of Clinical Research, 2022, 35(12): 1658-1661.
[7]	HECTOR F E, JOSE L S M. Abdominal adiposity and the polycystic ovary syndrome[J]. Trends Endocrinol Metab, 2007, 18(7): 266-272. doi: 10.1016/j.tem.2007.07.003
[8]	贾凡, 刘新敏, 陈如枫, 等. 中医药治疗多囊卵巢综合征胰岛素抵抗的研究进展[J]. 时珍国医国药, 2022, 33(8): 1971-1974. JIA F, LIU X M, CHEN R F, et al. Research progress of Chinese medicine in the treatment of insulin resistance in polycystic ovary syndrome[J]. Lishizhen Medicine and Materia Medica Research, 2022, 33(8): 1971-1974.
[9]	SADIQ I Z. Free radicals and oxidative stress: signaling mechanisms, redoxbasis for human diseases, and cell cycle regulation[J]. Curr Mol Med, 2023, 23(1): 13-35. doi: 10.2174/1566524022666211222161637
[10]	GENG Z, NIE X, LING L, et al. Electroacupuncture may inhibit oxidative stress of premature ovarian failure mice by regulating intestinal microbiota[J]. Oxidative Med Cell Longev, 2022, 2022: 4362317. DOI: 10.1155/2022/4362317.
[11]	ROSENZWEIG R, NILLEGODA N B, MAYER M P, et al. The Hsp70 chaperone network[J]. Front Mol Biosci, 2019, 20(11): 665-680.
[12]	黄玉梅, 罗静思, 曹晓兰, 等. PCOS患者血清HSP70、炎症-氧化应激指标表达及与胰岛素抵抗的关系[J]. 中国妇产科临床杂志, 2020, 21(3): 295-296. HUANG Y M, LUO J S, CAO X L, et al. Expression of serum HSP70, indicators of inflammation-oxidative stress and relationship with insulin resistance in patients with PCOS[J]. Chinese Journal of Clinical Obstetrics and Gynecology, 2020, 21(3): 295-296.
[13]	MAHGABEEN W, KHAN D A, MIRZA S A. A Role of resveratrol supplementation in regulation of glucose hemostasis, inflammation and oxidative stress in patients with diabetes mellitus type 2: a randomized, placebo-controlled trial[J]. Complement Ther Med, 2022, 66: 102819. DOI: 10.1016/j.ctim.2022.102819.
[14]	张婧怡, 李瑞, 曹昺焱, 等. 电针对胰岛素抵抗大鼠氧化应激状态及线粒体形态结构的影响[J]. 针灸临床杂志, 2020, 36(11): 56-60. ZHANG J Y, LI R, CAO B Y, et al. Effect of Electro-Acupuncture on Oxidative Stress Status and Mitochondrial Morphology in Rats with Insulin Resistance[J]. Journal of Clinical Acupuncture and Moxibustion, 2020, 36(11): 56-60.
[15]	刘珍珍, 黄伟, 向丽莉, 等. 基于FXR/SHP通路探讨电针预处理对心肌缺血再灌注损伤大鼠心肌组织相关凋亡基因的影响[J]. 针刺研究, 2021, 46(5): 368-374. LIU Z Z, HUANG W, XIANG L L, et al. Effect of electroacupuncture preconditioning on myocyte apoptosis in myocardial ischemia-reperfusion injury rats based on FXR/SHP pathway[J]. Acupuncture Research, 2021, 46(5): 368-374.
[16]	TORRES PEDRO J, HO BRYAN S, ARROYO PABLO, et al. Exposure to a healthy gut microbiome protects against reproductive and metabolic dysregulation in a PCOS mouse model[J]. Endocrinology, 2019, 160(5): 1193-1204. doi: 10.1210/en.2019-00050
[17]	ZHOU L, NI Z X, YU J, et al. Correlation between fecal metabolomics and gut microbiota in obesity and polycystic ovary syndrome[J]. Front Endocrinol, 2020, 11: 628-641. doi: 10.3389/fendo.2020.00628
[18]	GIAMPAOLINO P, FORESTE V, DI FILIPPO C, et al. Microbiome and PCOS: state-of-art and future aspects[J]. Int J Mol Sci, 2021, 22(4): 2048-2062. doi: 10.3390/ijms22042048
[19]	赵珈宇, 王图南, 王旒靖, 等. 针刺对应激性胃溃疡模型大鼠肠道菌群及脑和肠组织内TLR4含量的影响[J]. 中国针灸, 2021, 41(4): 413-419. ZHAO J Y, WANG T N, WANG L J, et al. Effect of acupuncture on intestinal flora and TLR4 in brain and intestinal tissues in rats with stress gastric ulcer[J]. Chinese Acupuncture & Moxibustion, 2021, 41(4): 413-419.
[20]	王阳, 刘艳霞, 佟庆, 等. 基于TLR-4/NF-κB信号通路探讨归术益坤方联合粪菌移植对多囊卵巢综合征大鼠的治疗作用[J]. 世界中西医结合杂志, 2023, 18(5): 855-861. WANG Y, LIU Y X, TONG Q, et al. Guizhu Yikun Formula Combined with Fecal Microbiota Transplantation Treats Polycystic Ovary Syndrome in Rats via TLR-4/NF-κB Signaling Pathway[J]. World Journal of Integrated Traditional and Western Medicine, 2023, 18(5): 855-861.
[21]	姜晓琳, 刘静, 张阳, 等. 苍附导痰汤加二甲双胍联合穴位埋线对肥胖型多囊卵巢综合征不孕症患者免疫功能及肠道菌群的影响[J]. 临床误诊误治, 2020, 33(8): 51-56. JIANG X L, LIU J, ZHANG Y, et al. Effect of Cangfu Daotan Decoction Combined with Point Thread-embedding on Immunity and Intestinal Flora in Obese Polycystic Ovary Syndrome[J]. Clinical Misdiagnosis & Mistherapy, 2020, 33(8): 51-56.
[22]	MIKHAEL S, PUNJALA-PATEL A, GAVRILOVA-JORDAN L. Hypothalamic-pituitary-ovarian axis disorders impacting female fertility[J]. Biomedicines, 2019, 7(1): 5-13. doi: 10.3390/biomedicines7010005
[23]	ZHU H M, NAN S, SUO C G, et al. Electro-Acupuncture affects the activity of the hypothalamic-pituitary-ovary axis in female rats[J]. Front Physiol, 2019, 10: 466-474. doi: 10.3389/fphys.2019.00466
[24]	XU G, ZHANG A, LIU J, et al. Effects of electroacupuncture on ovarian expression of the androgen receptor and connexin 43 in rats with letrozole-induced polycystic ovaries[J]. Evid Based Complement Alternat Med, 2020, 2020: 3608062. DOI: 10.1155/2020/3608062.
[25]	EAGLESON C A, GINGRICH M B, PASTOR C L, et al. Polycystic ovarian syndrome: evidence that flutamide restores sensitivity of the gonadotropin-releasing hormone pulse generator to inhibition by estradiol and progesterone[J]. J Clin Endocrinol Metab, 2020, 85(11): 4047-4052.
[26]	TONG X Y, LIU Y J, XU X Q, et al. Ovarian innervation coupling with vascularity: the role of electro-acupuncture in follicular maturation in a rat model of polycystic ovary syndrome. [J]. Front Physiol, 2020, 11(474): 1-14.
[27]	ZUO M, LIAO G, ZHANG W, et al. Effects of exogenous adiponectin supplementation in early pregnant PCOS mice on the metabolic syndrome of adult female offspring[J]. J Ovarian Res, 2021, 14(1): 15-26. doi: 10.1186/s13048-020-00755-z
[28]	申学婷, 张双双, 陈小燕, 等. 基于AMPK探究电针"天枢"结合二甲双胍对2型糖尿病大鼠的降糖效应[J]. 中国针灸, 2023, 43(1): 53-59. SHEN X T, ZHANG S S, CHEN X Y, et al. Hypoglycemic effect of electroacupuncture at "Tianshu"(ST 25) combined with metformin on rats with type 2 diabetes mellitus based on AMPK[J]. Chinese Acupuncture & Moxibustion, 2023, 43(1): 53-59.
[29]	刘洋洋, 蔡雅迪, 高军. AMPK作为治疗多囊卵巢综合征新靶点的研究进展[J]. 现代妇产科进展, 2018, 27(10): 792-795. LIU Y Y, CAI Y D, GAO J. Advances in AMPK as a new target for the treatment of polycystic ovary syndrome[J]. Progress in Obstetrics and Gynecology, 2018, 27(10): 792-795.
[30]	武峻艳, 李星, 王杰, 等. 针刺对阿尔茨海默病大鼠海马区胰岛素PI3K/Akt信号通路及葡萄糖代谢的影响[J]. 中华中医药学刊, 2023, 41(8): 51-55, 270-271. WU J Y, LI X, WANG J, et al. Study on Effect of Acupuncture on Glucose Metabolism in Hippocampus of AD Rats Based on PI3K/Akt Signaling Pathway[J]. Chinese Archives of Traditional Chinese Medicine, 2023, 41(8): 51-55, 270-271.
[31]	武欢, 梁凤霞, 陈邦国, 等. 电针对胰岛素抵抗肥胖大鼠炎性反应和肠道屏障的影响[J]. 中国针灸, 2019, 39(11): 1199-1204. WU H, LIANG F X, CHEN B G, et al. Effects of electroacupuncture on inflammatory response and intestinal mucosal barrier in obese rats with insulin resistance[J]. Chinese Acupuncture & Moxibustion, 2019, 39(11): 1199-1204.
[32]	RAMASUBBU K, RAJESWARI D V. Impairment of insulin signaling pathway PI3K/Akt/mTOR and insulin resistance induced AGEs on diabetes mellitus and neurodegenerative diseases: a perspective review[J]. Mol Cell Biochem, 2023, 478(10): 1307-1324.
[33]	于萍, 宋轶. 有氧运动联合穴位埋线通过调控PI3K/AKT信号通路对糖尿病大鼠糖脂代谢的影响[J]. 中国疗养医学, 2023, 32(9): 934-939. YU P, SONG Y. Aerobic exercise combined with catgut implantation at acupoint regulates glucose and lipid metabolism in diabetic rats by mediating the PI3K/AKT signaling pathway[J]. Chinese Healing Medicine, 2023, 32(9): 934-939.
[34]	MENDONCA A, THANDAPANI P, NAGARAJAN P, et al. Role of microRNAs in regulation of insulin secretion and insulin signaling involved in type 2 diabetes mellitus[J]. J Biosci, 2022, 47(4): 58-79. doi: 10.1007/s12038-022-00295-2
[35]	林燕玲, 王瑛, 黄颀, 等. 多囊卵巢综合征患者血清miR-143-3p、miR-222-3p及抗苗勒管激素水平检测及其临床价值[J]. 中华全科医学, 2022, 20(11): 1881-1883, 1888. doi: 10.16766/j.cnki.issn.1674-4152.002726 LIN Y L, WANG Y, HUANG Q, et al. Detection and clinical value of serum levels of miR-143-3p, miR-222-3p and AMH in patients with polycystic ovary syndrome[J]. Chinese Journal of General Practice, 2022, 20(11): 1881-1883, 1888. doi: 10.16766/j.cnki.issn.1674-4152.002726
[36]	杨娟, 刘英, 黄健, 等. 针药人工周期疗法对痰湿型多囊卵巢综合征胰岛素抵抗患者临床疗效及部分作用机制观察[J]. 中国针灸, 2017, 37(11): 1163-1168. YANG J, LIU Y, HUANG J, et al. Acupuncture and Chinese medicine of artificial cycle therapy for insulin resistance of polycystic ovary syndrome with phlegm damp type and its mechanism[J]. Chinese Acupuncture & Moxibustion, 2017, 37(11): 1163-1168.
[37]	武祎, 刘梅梅, 刘双岭, 等. 补脾滋肾汤联合针灸治疗多囊卵巢综合征不孕症的临床疗效观察[J]. 现代生物医学进展, 2022, 22(6): 1107-1111. WU Y, LIU M M, LIU S L, et al. Clinical Observation of Bupi Zishen Decoction Combined with Acupuncture in Treating Infertility with Polycystic Ovary Syndrome[J]. Advances Modern Biomedi, 2022, 22(6): 1107-1111.
[38]	李玉嫦, 冯婷, 容春凤, 等. 耳穴揿针联合二甲双胍对痰湿型多囊卵巢综合征患者胰岛素抵抗的影响[J]. 中医外治杂志, 2021, 30(2): 59-61. LI Y C, FENG T, RONG C F, et al. Effect of auricular snap acupuncture combined with metformin on insulin resistance in patients with phlegmatic polycystic ovary syndrome[J]. Journal of External Therapy of Traditional Chinese Medicine, 2021, 30(2): 59-61.
[39]	张世科, 何慧, 高维滨, 等. 经皮电刺激耳迷走神经治疗多囊卵巢综合征的机制探讨[J]. 针刺研究, 2020, 45(2): 164-168. ZHANG S K, HE H, GAO W B, et al. Mechanism of transcutaneous auricular vagus nerve stimulation on polycystic ovary syndrome[J]. Acupuncture Research, 2020, 45(2): 164-168.
[40]	张晓林, 陈邵涛, 刘辉辉, 等. "合募配穴"针刺对肥胖胰岛素抵抗大鼠骨骼肌组织SIRT1及PGC-1α表达的影响[J]. 世界科学技术-中医药现代化, 2022, 24(8): 3234-3241. ZHANG X L, CHEN S T, LIU H H, et al. Effect of Acupuncture at "He-Mu combination" on Expression of SIRT1 and PGC-1 α in Skeletal Muscle of Obese Insulin Resistance Rats[J]. Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology, 2022, 24(8): 3234-3241.
[41]	王佳媛, 马瑶, 杜维娜, 等. 二甲双胍联合针刺对肥胖型PCOS糖脂代谢与脂肪因子影响的临床研究[J]. 中国当代医药, 2020, 27(27): 69-72. WANG J Y, MA Y, DU W N, et al. Clinical study of influence of Metformin combined with acupuncture on glucolipid metabolism and adipokines in obese polycystic ovarian syndrome[J]. China Modern Medicine, 2020, 27(27): 69-72.
[42]	赵晓君, 黄丽琳, 麦威, 等. 朱琏抑制Ⅱ型针法对多囊卵巢综合征伴胰岛素抵抗大鼠IRS-1、IRS-2蛋白的影响[J]. 南京中医药大学学报, 2021, 37(4): 542-547. ZHAO X J, HUANG L L, MAI W, et al. Effect of Zhu Lian ' s TypeⅡInhibition Needling Technique on IRS-1 and IRS-2 Protein Expression on Polycystic Ovary Syndrome Combined with Insulin Resistance Model[J]. Journal of Nanjing University of Traditional Chinese Medicine, 2021, 37(4): 542-547.
[43]	张小雪, 王翰林, 谢长才. 针灸联合西药治疗肥胖多囊卵巢综合征患者疗效观察[J]. 湖北中医药大学学报, 2022, 24(6): 86-88. ZHANG X X, WANG H L, XIE C C. Clinical observation on therapeutic effect of acupuncture combined with Western medicine on obese patients with polycystic ovary syndrome[J]. Journal of Hubei University of Traditional Chinese Medicine, 2022, 24(6): 86-88.
[44]	张连娣, 张兵, 姜晓琳, 等. 膈下逐瘀汤联合穴位埋线对肥胖型多囊卵巢综合征不孕症的临床疗效观察[J]. 海南医学院学报, 2019, 25(5): 375-379, 383. ZHANG L D, ZHANG B, JIANG X L, et al. The Clinical effect of Under the diaphragm by stasis soup combinated with Point thread-embedding on Infertility patients with Obesity-type polycystic ovary Syndrome[J]. Journal of Hainan Medical University, 2019, 25(5): 375-379, 383.
[45]	钟浩宇, 卢许恩, 许能贵, 等. 穴位埋线治疗肥胖型多囊卵巢综合征的临床应用及机制探讨[J]. 时珍国医国药, 2022, 33(3): 659-661. ZHONG H Y, LU X E, XU N G, et al. Clinical application and mechanism of acupuncture point embedding in the treatment of obese polycystic ovary syndrome[J]. Lishizhen Medicine and Materia Medica Research, 2022, 33(3): 659-661.
[46]	何丹娟, 梁少荣, 葛曼, 等. 穴位埋线联合二甲双胍对肥胖型多囊卵巢综合征患者糖脂代谢的影响[J]. 上海针灸杂志, 2020, 39(12): 1516-1520. HE D J, LIANG S R, GE M, et al. Effect of Acupoint Thread-embedding Combined with Metformin on Glucose and Lipid Metabolism in Patients with Obese Polycystic Ovary Syndrome[J]. Shanghai Journal of Acupuncture and Moxibustion, 2020, 39(12): 1516-1520.
[47]	叶利群, 杨脂, 蒋婴, 等. 健脾祛痰中药与穴位埋线联用治疗对肥胖型多囊卵巢综合征糖脂代谢的影响[J]. 中华中医药学刊, 2018, 36(7): 1634-1636. YE L Q, YANG Z, JIANG Y, et al. Traditional Chinese Drugs for Strengthening Spleen and Resolving Phlegm and Points Embedding Therapy for Glucolipid Metabolism of Patients with Polycystic Ovary Syndrome[J]. Chinese Archives of Traditional Chinese Medicine, 2018, 36(7): 1634-1636.
[48]	尹艳茹, 魏慧俊, 邢晶, 等. 针灸结合中药汤剂治疗多囊卵巢综合征临床疗效[J]. 中国计划生育学杂志, 2023, 31(8): 1844-1848. YIN Y R, WEI H J, XING J, et al. Clinical efficacy of the combination of acupuncture and traditional Chinese medicine decoction for treating patients with polycystic ovary syndrome[J]. Chinese Journal of Family Planning, 2023, 31(8): 1844-1848.
[49]	徐海霞, 朱春兰, 唐虹. 艾灸联合中药对多囊卵巢综合征不孕症患者卵巢储备功能的影响[J]. 上海针灸杂志, 2021, 40(5): 571-575. XU H X, ZHU C L, TANG H. Effect of Moxibustion Combined with Chinese Medication on Ovarian Reserve Function in Patients with Infertility Due to Polycystic Ovary Syndrome[J]. Shanghai Journal of Acupuncture and Moxibustion, 2021, 40(5): 571-575.
[50]	徐素君, 雷丽红, 陈敏, 等. 针灸联合抑亢汤治疗多囊卵巢综合征疗效及对卵巢储备功能的影响[J]. 中华中医药学刊, 2020, 38(7): 63-66. XU S J, LEI L H, CHEN M, et al. Effect of Acupuncture Combinedwith Anti-Hyperfunction Decoction on Ovarian Reserve in Patients with Polycystic Ovary Syndrome[J]. Chinese Archives of Traditional Chinese Medicine, 2020, 38(7): 63-66.
[51]	ZHANG Y, LIU Y M, NING B L, et al. Efficacy of the integrative acupuncture and moxibustion treatment in patients with major depressive disorder: the study protocol for a multicenter, single-blinded, randomized trial in China[J]. Front Med, 2022, 9(9): 761419. DOI: 10.3389/fmed.2022.761419
[52]	杨阳, 雷秀兵, 陈纯涛. 温针灸联合加味当归芍药散治疗多囊卵巢综合征效果及对卵巢功能、性激素水平的影响[J]. 中华中医药学刊, 2020, 38(3): 137-140. YANG Y, LEI X B, CHEN C T. Effects of Warming Needle Moxibustion Combined with Modified Danggui Shaoyao Powder on Ovary Function and Sex Hormone Level in Patients with Polycystic Ovary Syndrome[J]. Chinese Archives of Traditional Chinese Medicine, 2020, 38(3): 137-140.