Diagnosis and treatment strategy of acupuncture-moxibustion for advanced-age infertility in vitro fertilization and embryo transfer based on the temporal rhythm theory of traditional Chinese medicine

自然受孕能力会随着年龄增长而降低, 现今许多高龄有生育意愿的女性开始尝试体外受精-胚胎移植 (in vitro fertilization and embryo transfer, IVF-ET) 技术.中医认为人体与自然界存在相应的周期性变化, 妇女在月经周期和IVF-ET周期会表现出不同的生理性冲任脉月节律和病理性节律.本文基于中医时间节律理论, 探讨高龄不孕女性在不同时期的病机特点.认为针刺干预应遵循的思路是:根据辨病确定主穴, 首选任脉及脾肾经腧穴,肝脾肾俞穴;根据辨证,兼症确定不同配穴;根据冲任脉月节律辨时确定配穴, 攻补兼施.在整个过程中要形神兼备, 调神贯穿始终. The ability of natural conception decreases with age, leading many advanced-age women with fertility desire begin to attempt in vitro fertilization and embryo transfer (IVF-ET) technique nowadays. Traditional Chinese medicine (TCM) believes that human body undergoes periodic changes corresponding to the natural rhythms. Women exhibit distinct physiological lunar rhythms of the thoroughfare vessel and the conception vessel, as well as pathological rhythms during the menstrual cycle and IVF-ET cycle. Based on the theory of TCM temporal rhythm, this paper discusses the pathogenesis characteristics of infertility in advanced-age women at different stages. It believes that acupuncture intervention should comply with the following ideas: determining main acupoints based on disease differentiation, with a preference for the acupoints on the thoroughfare vessel, the conception vessel, spleen meridian and kidney meridian, as well as the back- shu points of the liver, spleen and kidney; determining the supplementary acupoints based on syndrome differentiation and symptoms; determining the supplementary acupoints based on time differentiation of lunar rhythm of the thoroughfare vessel and the conception vessel, and integrating both reinforcing and reducing techniques. During the process of intervention, the physical and mental states were balanced simultaneously.