The correlation of acupuncture and moxibustion points for the treatment of diminished ovarian reserve and premature ovarian failure: A systematic review based on complex network

Background: Infertility rates have risen in recent years, with diminished ovarian reserve (DOR) affecting 10% of infertile women, accounting for approximately 20% of ovarian disorders. This highlights the importance of exploring effective treatments for DOR. This study investigates acupoint compatibility rules in acupuncture and moxibustion therapies for DOR and premature ovarian failure (POF) using complex network analysis. It also provides insights into acupuncture and moxibustion approaches for managing these conditions.

Methods: Clinical studies on acupuncture and moxibustion treatments for DOR and POF were retrieved from 5 databases, including China National Knowledge Infrastructure, SinoMed, Wanfang, CQVIP, and PubMed, covering the period from January 1, 2007, to September 15, 2024. Literature was screened based on inclusion and exclusion criteria to build a comprehensive database of acupuncture and moxibustion prescriptions for these conditions. Association rule analysis was performed using IBM SPSS Modeler 18.0, and complex network analysis was conducted with Gephi 0.9.2 software.

Results: A total of 70 articles and 67 acupoints from 70 prescriptions were analyzed, with 665 occurrences of these acupoints. The most frequently used acupoint was Guanyuan (RN4), followed by Sanyinjiao (SP6), Zusanli (ST36), Shenque (RN8), Bladder 23 (BL23), and Zigong (EX-CA1). These acupoints were primarily related to the Ren (RN) and Bladder (BL) meridians. Jiaohui points, dorsal Yu points, and 5 Shu points were the most commonly utilized specific points. The combination of Sanyinjiao (SP6) and Guanyuan (RN4) had the strongest association. Complex network analysis revealed a small-world network effect, with 24 core acupoints, including Guanyuan (RN4) and Zusanli (ST36), serving as key nodes.

Conclusion: Acupuncture treatments for DOR and POF primarily focus on the abdomen and lower back regions. Specific acupoints, such as rendezvous points, are frequently combined with distantly located points. These combinations are guided by therapeutic principles aimed at nourishing the kidney, strengthening the spleen, regulating liver qi, calming the heart, and promoting blood circulation.