Introduction:
To explore the mechanism and clinical effect of acupoint selection and acupuncture therapy on premature ovarian failure (POF).

Material and methods:
A total of 100 cases of POF patients were collected and divided into the POF group and POF + acupoint selection and acupuncture therapy (POF + ACU) group. Fifty healthy women were selected as a normal control (NC) group. Blood samples from patients in each group were collected and exosomes were isolated and purified. The expression level of exosome protein NELL2 was analyzed by western blot. The changes of sex hormone levels were detected by a TOSOH AIA 1800 automatic chemiluminescence analyzer. Follicular development and ovulation were monitored by B-ultrasound.

Results:
The expression of NELL2 protein in the POF + ACU group was higher than in the POF group. After 3 months of continuous acupoint selection and acupuncture therapy, it was found that the levels of testosterone (T) and estradiol (E2) in the POF + ACU group were significantly increased, while the follicular stimulating hormone (FSH) and luteinizing hormone (LH) levels were significantly decreased, showing a significant difference compared with the POF group. B-ultrasound found that ovulation occurred in 20% of the 50 patients in the POF group and 70% in the POF + ACU treatment group.

Conclusions:
Acupoint selection and acupuncture therapy can treat POF by promoting the secretion of exosome protein NELL2.