基于"通、补、疏"三期序贯调经思维探析子宫内膜异位症性不孕的针灸辨治OA

[Objective]To explore the clinical approach of acupuncture therapy for endometriosis-related infertility guided by three-stage sequential strategy of regulating the menstrual cycle through"unblocking,tonifying and dredging".[Methods]This study summarizes the pathogenesis of endometriosis-related infertility,the connotation of the three-stage sequential strategy of regulating the menstrual cycle through"unblocking,tonifying and dredging",and the acupuncture treatment methods for endometriosis-related infertility,and cites a typical medical case for demonstration.[Results]Endometriosis-related infertility is an important type of reproductive disorders in women of childbearing age.Traditional Chinese medicine(TCM)believes that the key pathogenic factors of this disease are stasis,deficiency and stagnation,with stasis being the key,deficiency being the root and stagnation being an important link.The three factors interact with each other,leading to the disharmony of the Chong and Ren meridians and the malnutrition of the uterus.This study divides the menstrual cycle into the menstrual phase,the post-menstrual phase and the premenstrual phase,and proposes a three-stage sequential treatment strategy of regulating the menstrual cycle through"unblocking,tonifying,and dredging".The theoretical and practical pathways of acupuncture treatment for endometriosis-related infertility are systematically explored.It is believed that during the menstrual phase,the key is to eliminate stasis and unblock the meridians,with acupoints such as Geshu,Xuehai,and Zigong selected to activate blood circulation and regulate the Chong meridian,taking advantage of the downward flow of menstrual blood to clear stasis.In the post-menstrual phase,the emphasis is nourishing Yin and replenishing the source,with acupoints such as Sanyinjiao,Taixi and Guanyuan selected to nourish the kidneys and replenish essence,tonifying the Qi and blood of the uterus.In the premenstrual phase,emphasis is placed on soothing the liver and nurturing Yang,with acupoints such as Taichong,Hegu and Yaoyangguan selected to regulate the flow of Qi,promoting the"heavy Yang"state to facilitate menstruation.In addition,the sequential intervention mode combining acupuncture and herbal medicine is emphasized.By reconstructing the menstrual cycle rhythm,the receptivity of the endometrium and ovarian function are improved.The patient in the presented medical record was diagnosed as kidney Yang deficiency,liver depression and blood stasis.The treatment adhered to the"unblocking,tonifying and dredging"three-phase sequential menstrual regulation method,which involved unblocking stasis during the menstrual period,tonifying deficiency during the post-menstrual period,and dredging stagnation during the premenstrual period.With coordinated acupuncture and herbal treatment for over half a year,the patient successfully achieved pregnancy and subsequently delivered without complications.[Conclusion]The three-stage sequential treatment strategy of regulating the menstrual cycle through"unblocking,tonifying,and dredging"has a rich connotation and fits the physiological characteristics of the female menstrual cycle,which provides an integrated diagnostic and therapeutic strategy of"cycle-pathogenesis-treatment"for endometriosis-related infertility.