Effect of transcutaneous electrical acupoint stimulation on the quality of postoperative recovery: a meta-analysis.

BACKGROUND: The purpose of the present study was to systematically delve into the efficacy and safety of transcutaneous electrical acupoint stimulation (TEAS) on the quality of recovery after general anesthesia. METHODS: Randomized controlled trials related to TEAS improving postoperative recovery quality were searched in Cochrane Library, Web of Science, Embase, PubMed, CNKI, VIP, Wanfang and Chinese biomedical database from the inception of each database to June 2023. After literature screening and data extraction, Stata15 software was employed for meta-analysis, and the quality of the included literature was evaluated utilizing ROB2. RESULTS: The study included 10 articles involving 2,383 patients in total. The meta-analysis results unveiled that TEAS could improve 24-hour and 48-hour postoperative QoR-40 scores as well as 24-hour postoperative QoR-40 dimension scores [WMD = 8.52, 95%CI (5.12, 11.91), P < 0.001; WMD = 1.99, 95%CI (0.91, 3.07), P < 0.001], emotional state [WMD = 1.38, 95%CI (0.66, 2.09), P < 0.001], physical comfort [WMD = 2.99, 95%CI (1.59, 4.39), P < 0.001], psychological support [WMD = 0.63, 95%CI (0.36, 0.90), P < 0.001], and physical independence [WMD = 0.76, 95%CI (0.22, 1.30), P = 0.006]; pain [WMD = 1.81, 95%CI (0.87, 2.75), P < 0.001]; decrease 24-hour postoperative VAS pain scores [WMD = -0.84, 95%CI (-1.45, -0.23), P = 0.007] and the incidence of postoperative nausea and vomiting [RR = 0.88, 95%CI (0.81, 0.97), P = 0.006; RR = 0.62, 95%CI (0.52, 0.73), P < 0.001]. CONCLUSION: TEAS can improve postoperative QoR-40 scores and the quality of recovery, relieve pain, and decrease the incidence of nausea and vomiting after surgery in patients who underwent general anesthesia. TRIAL REGISTRATION: CRD42023433959.

Effect of Transcutaneous Electrical Acupoint Stimulation on Extubation-Related Stress Response in Noncardiac Surgery Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

PURPOSE: Stress response is a common complication during extubation, mainly manifested by dramatic hemodynamic fluctuations. Transcutaneous electrical acupoint stimulation (TEAS) is widely applied in the perioperative period. We performed this meta-analysis to evaluate whether the TEAS could relieve the stress response during extubation in noncardiac surgery patients. DESIGN: A systematic review and meta-analysis of randomized controlled trials. METHODS: We searched six databases (PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, CNKI, and Wan Fang) for relevant literature. A risk of bias assessment was executed based on the Cochrane Criteria. We applied RevMan5.4.1 software to analyze data. When the χ2 test did not show heterogeneity, we adopted the fixed-effect model. Otherwise, the random-effect model was used. FINDINGS: ln total, 12 randomized controlled trials with 1,347 participants were enrolled in this meta-analysis. Meta-analysis showed the heart rate and mean arterial pressure of the intervention group were significantly lower than the control group at immediately, 5 minutes, and 10 minutes after extubation. The occurrence rate of emergency agitation (RR 0.39, 95% CI [0.26,0.60]) and postoperative delirium (RR 0.40, 95% CI [0.22, 0.72] were also lower in the TEAS group. The consumption of propofol (standardized mean difference (SMD) 0.47, 95% CI [-0.77, -0.18]) and remifentanil (SMD 1.49, 95% CI [-2.01, -0.96]) of the intervention group were also significantly reduced compared with the control group. CONCLUSIONS: TEAS was beneficial for improving stress response during extubation, emergence agitation, postoperative delirium, and reduced the consumption of intraoperative propofol and remifentanil, but it was necessary to note the limitations of the current evidence.

Transcutaneous Electrical Acupoint Stimulation Pretreatment Alleviates Cerebral Ischemia-Reperfusion Injury in Rats by Modulating Microglia Polarization and Neuroinflammation Through Nrf2/HO-1 Signaling Pathway.

Cerebral ischemia-reperfusion injury (CIRI) may lead to severe disability even death, but the strategies for prevention and treatment are still limited. Transcutaneous electrical acupoint stimulation (TEAS) has been reported to have a significant neuroprotection against CIRI, but the underlying mechanisms remain obscure. In this study, we established a focal cerebral ischemia-reperfusion model in male Sprague-Dawley rats. TEAS pretreatment was applied to Baihui (GV20), Sanyinjiao (SP6) and Zusanli (ST36) acupoints for 5 consecutive days before CIRI. After 24 h reperfusion, the brain damage was assessed using Zea-Longa score, brain water content (BWC) and infarct volume. Meanwhile, the number of activated microglia and the TNF-α were detected by immunofluorescence and ELISA respectively. Moreover, Western Blot and RT-qPCR were conducted to detect the proteins and mRNA expressions of Nrf2, HO-1, iNOS and Arg-1. We found that TEAS pretreatment significantly reduced Longa score, BWC, infarct volume and the number of activated microglia. Besides, TEAS pretreatment increased Nrf2 and HO-1 levels, while lowered the expression of TNF-α. Subsequently, we also discovered that the microglia M1 phenotype maker iNOS decreased and the M2 maker Arg-1 increased after TEAS pretreatment. However, these effects of TEAS pretreatment were markedly eliminated by brusatol. These findings clearly suggested that TEAS pretreatment exerted neuroprotection against CIRI, which might be related to modulating microglia polarization and neuroinflammation via Nrf2/HO-1 pathway.

Transcutaneous electrical acupoint stimulation for cancer-related pain management in patients receiving chronic opioid therapy: a randomized clinical trial.

PURPOSE: The opioid crisis resulting from its use disorder and overdose poses additional challenges for cancer pain management. The American Society of Clinical Oncology Practice Guideline recommends acupuncture therapy for the management of adult cancer-related pain (CRP), but the effectiveness of transcutaneous electrical acupoint stimulation (TEAS) on CRP remains uncertain. METHODS: This 5-week prospective randomized clinical trial was conducted at 2 hospitals in China, and participants with CRP receiving chronic opioid therapy were randomized 1:1 into two groups between December 2014 and June 2018. The true TEAS group underwent 15 sessions of TEAS treatments over 3 consecutive weeks, while the control group received sham stimulation. The primary outcome was the numerical rating scale (NRS) score in the past 24h at week 3. The secondary outcomes included morphine equivalent daily dose, quality of life and adverse events. RESULTS: A total of 159 participants were included in the modified intention-to-treat population. The baseline characteristics were similar in both groups. The mean NRS scores were 0.98 points at week 3 in the true TEAS group and 1.41 points in the sham group, with the mean difference between groups of -0.43 points (P < 0.001; OR = 0.68, P < 0.05). The proportion of patients with NRS reduction more than thirty percentage at week 3 was 50.00% in the true TEAS group and 35.44% in the sham group (RD = 0.15, P > 0.05; RR = 1.41, P > 0.05). No significant difference in pain intensity between the two groups was observed during the follow-up period without TEAS intervention (week 4, OR = 0.83, P > 0.05; week 5, OR = 0.83, P > 0.05). The Karnofsky Performance Status value suggested that patients in the true TEAS group experienced an improved quality of life (Between-group differences: week 3, 3.5%, P < 0.05; week 4, 4.6%, P < 0.001; week 5, 5.6%, P < 0.001). CONCLUSIONS: The 3-week application of TEAS in patients with CRP receiving chronic opioid therapy resulted in a statistically significant reduction in pain scores, but the observed reduction was of uncertain clinical significance. The prolonged analgesic effect of TEAS was not confirmed in this trial. CLINICALTRIAL: GOV: ChiCTR-TRC-13003803.

Transcutaneous electrical acupoint stimulation for suspected laryngopharyngeal reflux disease.

PURPOSE: To determine the efficacy of transcutaneous electrical acupoint stimulation (TEAS) combined with proton pump inhibitor (PPI) therapy on symptoms and signs of patients with suspected laryngopharyngeal reflux disease (LPRD). METHODS: This was a prospective randomized controlled study. Seventy patients with reflux symptom index (RSI) > 13 and reflux finding score (RFS) > 7 were recruited and received PPI alone (control group) or TEAS combined with PPI (experimental group) for 12 weeks. Patients in the experimental group received TEAS at Tiantu (RN22), Renying (ST9), and Neiguan (PC6) once a day, five times a week. RSI, RFS, throat pain visual analog score (VAS), and LPR-health-related quality-of-life (LPR-HRQL) scores were evaluated at baseline and after 4 and 12 weeks. RESULTS: The decreases in total RSI and RFS, along with several subscores, were significantly higher in the experimental group than in the control group after 12 weeks (P < 0.05). The throat pain VAS and LPR-HRQL scores decreased significantly at 4 and 12 weeks after treatment in both groups, with significant differences between the groups (P < 0.001). No severe adverse events occurred, and the rates of adverse events were similar between the two groups. CONCLUSION: Compared with PPI alone, TEAS combined with PPI showed a significantly greater improvement in symptoms, signs, and quality of life in the treatment of LPRD without increasing the occurrence of adverse effects. Therefore, TEAS could serve as a useful and safe treatment method for LPRD. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2100046755.

Transcutaneous electrical acupoint stimulation combined with an integrated perioperative nursing program prevents subsyndromal delirium in older patients after joint replacement.

OBJECTIVES: This study aimed to develop transcutaneous electrical acupoint stimulation combined with an integrated perioperative nursing program and evaluate its effects on preventing subsyndromal delirium (SSD) and postoperative delirium (POD) in older patients after joint replacement surgery. METHODS: Participants were randomly divided into two groups, the experimental group (n = 48) was given transcutaneous electrical acupoint stimulation combined with an integrated perioperative nursing program based on the routine care of the control group (n = 49). The incidence of SSD and POD in a week after surgery was recorded. Assessments of delirium severity, cognition, anxiety, and depression were also conducted at baseline and on postoperative day 7. RESULTS: The findings indicate that the intervention program had significant advances in alleviating the severity of delirium, cognitive impairment, anxiety, and depression but failed to reduce the incidence of SSD and POD. CONCLUSIONS: Our study indicated that TEAS combined with an integrated perioperative nursing program has a beneficial effect on alleviating symptoms of delirium, cognitive dysfunction, anxiety, and depression in older adults after joint replacement surgery.

Perioperative transcutaneous electrical acupoint stimulation (pTEAS) in pain management in major spinal surgery patients.

BACKGROUND: Lumbar disc herniation is seen in 5-15% of patients with lumbar back pain and is the most common spine disorder demanding surgical correction. Spinal surgery is one of the most effective management for these patients. However, current surgical techniques still present complications such as chronic pain in 10-40% of all patients who underwent lumbar surgery, which has a significant impact on patients' quality of life. Research studies have shown that transcutaneous electrical acupoint stimulation (TEAS) may reduce the cumulative dosage of intraoperative anesthetics as well as postoperative pain medications in these patients. OBJECTIVE: To investigate the effect of pTEAS on pain management and clinical outcome in major spinal surgery patients. METHODS: We conducted a prospective, randomized, double-blind study to verify the effect of pTEAS in improving pain management and clinical outcome after major spinal surgery. Patients (n = 90) who underwent posterior lumbar fusion surgery were randomized into two groups: pTEAS, (n = 45) and Control (n = 45). The pTEAS group received stimulation on acupoints Zusanli (ST.36), Sanyinjiao (SP.6), Taichong (LR.3), and Neiguan (PC.6). The Control group received the same electrode placement but with no electrical output. Postoperative pain scores, intraoperative outcome, perioperative hemodynamics, postoperative nausea and vomiting (PONV), and dizziness were recorded. RESULTS: Intraoperative outcomes of pTEAS group compared with Control: consumption of remifentanil was significantly lower (P < 0.05); heart rate was significantly lower at the end of the operation and after tracheal extubation (P < 0.05); and there was lesser blood loss (P < 0.05). Postoperative outcomes: lower pain visual analogue scale (VAS) score during the first two days after surgery (P < 0.05); and a significantly lower rate of PONV (on postoperative Day-5) and dizziness (on postoperative Day-1 and Day-5) (P < 0.05). CONCLUSION: pTEAS could manage pain effectively and improve clinical outcomes. It could be used as a complementary technique for short-term pain management, especially in patients undergoing major surgeries. TRIAL REGISTRATION: ChiCTR1800014634, retrospectively registered on 25/01/2018. http://medresman.org/uc/projectsh/projectedit.aspx?proj=183.

Transcutaneous electrical acupoint stimulation affects older adults' cognition after general anesthesia: A meta-analysis.

Perioperative neurocognitive dysfunction comprises pre-existing neurocognitive dysfunction, postoperative delirium (POD), and postoperative cognitive dysfunction (POCD). This meta-analysis aims to study the effects of transcutaneous electrical acupoint stimulation (TEAS) on postoperative cognitive function after general anesthesia in older adults. Eight databases were searched, from the establishment of the databases to January 2022. Eighteen randomized controlled trials were included. TEAS reduced POCD incidence on the 1st and 3rd but not on the 5th and 7th postoperative days (p<0.00001; p<0.00001; p = 0.20; p = 0.30). Owing to the limited number of original studies, POD incidence could not be analyzed. TEAS improved the MMSE scores on the 1st and 3rd but not on the 5th and 7th postoperative days. TEAS reduced the values of S100ß at the end of the surgery and 1 day after surgery and IL-6 on the 1st postoperative day. TEAS can prevent early postoperative cognitive decline after general anesthesia in older adults.

[Transcutaneous electrical acupoint stimulation for the treatment of idiopathic oligoasthenospermia: A meta-analysis].

Objective: To evaluate the effects of transcutaneous electrical acupoint stimulation (TEAS) on the pregnancy outcome and sperm parameters in patients with idiopathic oligoasthenospermia. METHODS: We searched PubMed, EMBASE, Cochrane Library, CNKI, VIP and Wanfang from inception till January 2020 for randomized controlled trials (RCT) with the keywords male infertility, oligozoospermia, asthenozoospermia, acupuncture, transcutaneous electrical acupoint stimulation, etc. Using the Cochrane risk bias tool, we evaluated the quality of the identified RCTs, and analyzed the primary outcomes, including pregnancy and live birth, and secondary outcomes, such as sperm concentration, motility and morphology. RESULTS: Four RCTs with 321 subjects were included, of which none reported live birth and only one reported a pregnancy rate of 15% after treatment of 2 Hz TEAS. Neither 2 Hz (WMD: －3.01, 95% CI: －22.28 to 16.26) nor 100 Hz TEAS (WMD: －0.02, 95% CI: －5.29 to 5.56) had any significant effect on sperm concentration, while 100 Hz TEAS markedly improved the percentage of grade a sperm (WMD: 6.83, 95% CI: 2.10 to 11.57) compared with 2Hz TEAS (WMD: 2.31, 95% CI: 1.01 to 3.61). In comparison with the blank control, neither 2 Hz (WMD: 4.07, 95% CI: －5.15 to 13.29) nor 100 Hz TEAS (WMD: 6.59, 95% CI: －5.36 to 18.55) significantly affected the percentage of grade a + b sperm or total sperm motility. CONCLUSIONS: The effect of TEAS on the pregnancy outcome is not yet clear. 100 Hz TEAS significantly improved the percentage of grade a sperm in idiopathic oligoasthenospermia patients, which, however, is to be further verified with more high-quality clinical studies.

[Transcutaneous electrical acupoint stimulation improves pregnancy outcomes of in vitro fertilization- embryo transfer : A meta-analysis of randomized controlled trials].

OBJECTIVE: To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on the pregnancy outcomes of in vitro fertilization-embryo transfer (IVF-ET) based on the available clinical evidence. METHODS: We searched PubMed, MEDLINE, EMBASE, Cochrane Library, CNKI, VIP, CBM and Wanfang Database up to February 2021 for published randomized controlled trials (RCT) relevant to TEAS for the improvement of the pregnancy outcomes of IVF-ET. We performed literature screening, data extraction and quality evaluation according to the inclusion and exclusion criteria, followed by a meta-analysis with the RevMan 5.3 software. RESULTS: A total of 2 206 cases of IVF-ET from 9 RCTs were included, 1 018 in the TEAS group and 1 188 in the control. The clinical pregnancy rate was significantly higher in the TEAS than in the mock TEAS and non-TEAS control groups (RR = 1.85, 95% CI: 1.42－2.42, P < 0.001; RR = 1.23, 95% CI: 1.10－1.39, P = 0.0004), and so was it before and after oocyte retrieval (RR = 1.50, 95% CI: 1.03－2.17, P = 0.03; RR = 1.47, 95% CI: 1.12－1.92, P = 0.005). The TEAS group also showed dramatically improved embryo implantation rate (RR = 1.49, 95% CI: 1.24－1.79, P < 0.0001) and live birth rate (RR = 1.44, 95% CI: 1.04－1.98, P = 0.03) compared with the control. CONCLUSIONS: As a safe and non-invasive treatment, TEAS can significantly improve the pregnancy outcomes of IVF-ET, with definite effectiveness. /.

Meta-Analysis of Electroacupuncture in Cardiac Anesthesia and Intensive Care.

BACKGROUND: Acupuncture treatment has been employed in China for over 2500 years and it is used worldwide as analgesia in acute and chronic pain. Acupuncture is also used in general anesthesia (GA). The aim of this systematic review and meta-analysis was to assess the efficacy of electroacupuncture (EA) in addition to GA in patients undergoing cardiac surgery. METHODS: We searched 3 databases (Pubmed, Cochrane Library, and Web of Science-from 1965 until January 31, 2017) for randomized controlled trials (RCTs) including patients undergoing cardiac surgery and receiving GA alone or GA + EA. As primary outcomes, we investigated the association between GA + EA approach and the dosage of intraoperative anesthetic drugs administered, the duration of mechanical ventilation (MV), the postoperative dose of vasoactive drugs, the length of intensive care unit (ICU) and hospital stay, and the levels of troponin I and cytokines. RESULTS: The initial search yielded 477 citations, but only 7 prospective RCTs enrolling a total of 321 patients were included. The use of GA + EA reduced the dosage of intraoperative anesthetic drugs (P < .05), leading to shorter MV time (P < .01) and ICU stay (P < .05) as well as reduced postoperative dose of vasoactive drugs (P < .001). In addition, significantly lower levels of troponin I (P < .01) and tumor necrosis factor α (P < .01) were observed. CONCLUSION: The complementary use of EA for open-heart surgery reduces the duration of MV and ICU stay, blunts the inflammatory response, and might have protective effects on the heart. Our findings stimulate future RCT to provide definitive recommendations.

Transcutaneous electrical acupoint stimulation for post-traumatic stress disorder: Assessor-blinded, randomized controlled study.

AIM: Transcutaneous electrical acupoint stimulation (TEAS) has the potential to alleviate post-traumatic stress disorder (PTSD). The purpose of this study was to determine whether adding TEAS to sertraline or cognitive behavioral therapy (CBT) could improve the anti-PTSD efficacy. METHODS: In this randomized controlled trial, 240 PTSD patients (60 in each group) were assigned to receive simulated TEAS combined with sertraline (group A) or with CBT (group B), active TEAS combined with CBT (group C), or active TEAS combined with CBT plus sertraline (group D) for 12 weeks. The outcomes were measured using the Clinician-Administered PTSD Scale, PTSD Check List-Civilian Version, and 17-item Hamilton Rating Scale for Depression. RESULTS: While PTSD symptoms reduced over time in all patients, groups C and D had markedly greater improvement in both PTSD and depressive measures than groups A and B in all post-baseline measurement points, with moderate to very large effect sizes of 0.484-2.244. Groups C and D also had a significantly higher rate than groups A and B on clinical response (85.0% and 95.0% vs 63.3% and 60.0%, P < 0.001) and on remission (15.0% and 25.0% vs 3.3% and 1.7%, P < 0.001). The incidence of adverse events was similar between groups A and D and between groups B and C. CONCLUSIONS: Additional TEAS augments the anti-PTSD and antidepressant efficacy of antidepressants or CBT, without increasing the incidence of adverse effects. TEAS could serve as an effective intervention for PTSD and comorbid depression. This trial was registered with www.chictr.org (no.: ChiCTR1800017255).

Pain management of surgical abortion using transcutaneous acupoint electrical stimulation: An orthogonal prospective study.

AIM: This study aimed to evaluate the optimal combination of parameters for the management of pain during surgical abortion using transcutaneous acupoint electrical stimulation (TEAS). METHODS: This study recruited patients scheduled for surgical abortion between October 2014 and August 2015. The treatment protocol was created using three levels for each factor (stimulating time, acupoints, age, and parity). The primary outcomes were intraoperative visual analog scale (VAS), postoperative VAS, cervical relaxation degree and intraoperative blood loss. The secondary outcomes were the vital signs. RESULTS: Stimulation time was associated with intraoperative VAS scores (P < 0.001), acupoints were associated with postoperative VAS scores (P = 0.037), and age was associated with postoperative VAS scores (P < 0.043). Parity (P = 0.025) was associated with heart rate. A comprehensive analysis of the parameters revealed the best levels for each (stimulation time: from 15 min before operation to immediate postoperative; acupoints: SP 6 and LR 3; patient age 25.1-30.0 years; and parity: G≥2 P0 A≥1 ). Seven patients did not complete follow-up. The remaining 135 subjects did not show continuous vaginal bleeding, abdominal pain, fever or any other adverse effect. CONCLUSION: During surgical abortion, TEAS stimulation from 15 min before operation to immediate postoperative, SP 6 and LR 3, age 25.1-30.0 years and G≥2 P0 A≥1 were associated with the best analgesic effect.

Effects of transcutaneous electrical acupoint stimulation at different frequencies on perioperative anesthetic dosage, recovery, complications, and prognosis in video-assisted thoracic surgical lobectomy: a randomized, double-blinded, placebo-controlled trial.

BACKGROUND: Transcutaneous electrical acupoint stimulation (TEAS), a non-invasive and non-pharmacological adjunctive intervention for perioperative analgesia, may also reduce the incidence of postoperative pulmonary complications. The effect of TEAS on video-assisted thoracic surgical (VATS) patients is still unknown, however. The purpose of this study was to investigate the effects of TEAS of different frequency on perioperative anesthetic dosage, recovery, complications, and prognosis for patients undergoing VATS lobectomy. METHODS: Eighty VATS lobectomy patients with no previous experience of TEAS or acupuncture were randomly assigned to four groups: control (con), 2/100, 2, and 100 Hz. The last three experimental groups received TEAS at the indicated frequencies for 30 min before induction, during the operation, and for another 30 min 24 and 48 h after surgery. 2/100 Hz is a type of alternating frequency which goes between 2 and 100 Hz every 3 s. TEAS was administered over acupoints Neiguan, Hegu, Lieque, and Quchi on the sick lateral. Electrodes were applied to the patients in the control group, but no TEAS was used. Anesthetic dosage, blood gas analysis results, lung function indexes FEV1 and FVC, post-anesthesia care unit (PACU) status, postoperative complications, and quality of life scores were recorded and analyzed statistically. RESULTS: Intraoperative opioid consumption was lowest in the 2/100 Hz group, with statistical significance (con, P ≤ 0.001; 2 Hz, P ≤ 0.001; 100 Hz, P = 0.026). Compared with preoperative FEV1 and FVC, postoperative FEV1 and FVC were significantly lower in all groups; during one-lung ventilation, arterial oxygen partial pressure (PaO2) decreased more slowly in the 2/100 Hz group than in the con group (P = 0.042). Moreover, in the 2/100 Hz group extubation time was shorter (P = 0.038), visual analgesia scale score lower (P = 0.047), and duration of PACU stay shorter (P = 0.043) than in the con group. In the 100 Hz group incidence of postoperative nausea and vomiting (PONV) was lower than the con group (P = 0.044). In all groups mean postoperative physical component scores were significantly lower than mean preoperative scores. CONCLUSIONS: TEAS is a safe noninvasive adjunctive intervention for anesthesia management among patients undergoing VATS lobectomy. TEAS at 2/100 Hz can reduce intraoperative opioid dosage and slow the decrease of PaO2 during one-lung ventilation. It can also effectively reduce pain score, extubation time, and PACU stay immediately after surgery. Further, 100 Hz TEAS can reduce PONV morbidity.

[Mid-frequency transcutaneous electrical acupoint stimulation combined with tamoxifen for the treatment of oligoasthenozoospermia].

OBJECTIVE: To explore the feasibility, safety and clinical effect of mid-frequency transcutaneous electrical acupoint stimulation (TEAS) combined with oral tamoxifen (TAM) in the treatment of oligoasthenozoospermia. METHODS: We randomly and equally assigned 120 patients with idiopathic oligoasthenozoospermia to receive oral TAM, mid-frequency TEAS, or TAM+TEAS, all for 8 weeks. Before and after treatment, we recorded the semen volume, total sperm count, sperm concentration, sperm motility, percentage of progressively motile sperm (PMS), and the levels of follicle-stimulating hormone (FSH), luteotrophic hormone (LH) and testosterone (T) in the peripheral serum and compared these parameters among the three groups of patients. RESULTS: Compared with the baseline, none of the patients showed significant improvement in the semen volume (P >0.05) but all exhibited remarkably elevated levels of serum FSH, LH and T after treatment (P <0.05); TAM significantly improved the total sperm count (ï¼»25.16 ± 2.05ï¼½ vs ï¼»42.65 ± 5.78ï¼½ ×106, P <0.05) and sperm concentration (ï¼»12.15 ± 2.51ï¼½ vs ï¼»24.31 ± 2.59ï¼½ ×106/ml, P <0.05), but not total sperm motility (ï¼»21.78 ± 8.81ï¼½ vs ï¼»22.61 ± 5.75ï¼½ %, P >0.05) or PMS (ï¼»15.87 ± 7.81ï¼½ vs ï¼»16.76 ± 5.86ï¼½ %, P >0.05); TEAS markedly increased total sperm motility (ï¼»24.81 ± 8.27ï¼½ vs ï¼»32.43 ± 4.97ï¼½ %, P <0.05) and PMS (ï¼»19.71 ± 9.15ï¼½ vs ï¼»27.17 ± 5.09ï¼½%, P <0.05), but not the total sperm count (ï¼»23.23 ± 3.14ï¼½ vs ï¼»25.87 ± 4.96ï¼½ ×106, P >0.05) or sperm concentration (ï¼»11.27 ± 2.24ï¼½ vs ï¼»14.12 ± 2.47ï¼½ ×106/ml, P >0.05); TAM+TEAS, however, improved not only the total sperm count (ï¼»26.17 ± 5.05ï¼½ vs ï¼» 51.14 ± 3.69ï¼½×106, P <0.05) and sperm concentration (ï¼»12.78 ± 2.41ï¼½ vs ï¼»27.28 ± 1.98ï¼½ ×106/ml, P <0.05), but also total sperm motility (ï¼»23.89 ± 9.05ï¼½ vs ï¼»37.12 ± 5.33ï¼½%, P <0.05) and PMS (ï¼»17.14 ± 8.04ï¼½ vs ï¼»31.09 ± 7.12ï¼½%, P <0.05). The total effectiveness rate was significantly higher in the TAM+TEAS group than in the TAM and TEAS groups (97.5% vs 72.5% and 75.0%, P <0.05). CONCLUSIONS: Mid-frequency TEAS combined with tamoxifen can significantly improve semen quality and increase sex hormone levels in patients with idiopathic oligoasthenozoospermia.

[Transcutaneous electrical acupoint stimulation for asthenozoospermia].

OBJECTIVE: To study the effect of transcutaneous electrical acupoint stimulation (TEAS) in the treatment of asthenozoospermia. METHODS: We randomly divided 72 asthenozoospermia patients into a 2 Hz TEAS (n = 29), a 100 Hz TEAS (n = 20), and a blank control group (n = 23), those in the former two groups treated by 30 minutes of TEAS at 2 Hz and 100 Hz respectively, applied to the acupoints of bilateral Shenshu, left Zusanli, and Guanyuan, once a day for 60 days, while those in the blank control group left untreated. Using computer-assisted sperm analysis (CASA), we examined sperm concentration and motility as well as the percentages of grade a and grade a+b sperm in different groups of the patients. RESULTS: Compared with the baseline, 2 Hz TEAS significantly increased sperm motility (ï¼»12.76 ± 1.39ï¼½ vs ï¼»18.89 ± 2.46ï¼½%, P<0.05) and the percentage of grade a+b sperm ( ï¼»10.68 ± 1.22ï¼½ vs ï¼»16.32 ± 2.10ï¼½%, P<0.05) in the asthenozoospermic patients, while 100 Hz TEAS improved not only sperm motility (ï¼»12.32 ± 2.21ï¼½ vs ï¼»23.81 ± 3.42ï¼½%, P<0.01) and the percentage of grade a+b sperm (ï¼»10.45 ± 1.98ï¼½ vs ï¼»20.25 ± 2.82 ï¼½%, P<0.01), but also the percentage of grade a sperm (ï¼»6.44 ± 1.16ï¼½ vs ï¼»13.31 ± 2.30ï¼½%, P<0.05). Moreover, in comparison with the blank control group, 2 Hz TEAS also remarkably increased sperm motility (ï¼»9.57 ± 1.60ï¼½ vs ï¼»18.89 ± 2.46ï¼½%, P<0.05) and the percentage of grade a+b sperm (ï¼»7.81 ± 1.31ï¼½ vs ï¼»16.32 ± 2.10ï¼½%, P<0.05) in the asthenozoosperma patients, while 100 Hz TEAS improved not only sperm motility (ï¼»9.57 ± 1.60ï¼½ vs ï¼»23.81 ± 3.42ï¼½%, P<0.01) and the percentage of grade a+b sperm (ï¼»7.81 ± 1.31ï¼½ vs ï¼»20.25 ± 2.82ï¼½%, P<0.01) but also the percentage of grade a sperm (ï¼»4.87 ± 1.01ï¼½ vs ï¼»13.31 ± 2.30ï¼½%, P<0.01). Meanwhile, the rate of clinical effectiveness was significantly higher in the 100 Hz TEASthan in the blank control group either in intention-to-treat (ITT) analysis (100% vs 18.18%) orper-protocol (PP) analysis (90% vs 0%), and so was it than in the 2 Hz TEAS group based on the data of ITT (100% vs 33.33%). CONCLUSIONS: Both 2 Hz and 100 Hz TEAS are effective for the treatment of asthenozoospermia by improving sperm motility and vitality.

Transcutaneous electrical acupoint stimulation for the treatment of withdrawal syndrome in heroin addicts.

OBJECTIVE: To assess the therapeutic effect of transcutaneous electric acupoint stimulation (TEAS) for the treatment of withdrawal syndrome in heroin addicts. METHODS: A total of 63 male heroin addicts with withdrawal score higher than 20 were recruited in the Detoxification Center of Zhongshan city, Guangdong province, China. They were randomly distributed into two groups: TEAS group (n = 31) received TEAS by using a Han's acupoint nerve stimulator (HANS) model 200A with two output channels, 2-3 sessions per day, 30 minutes per session for 10 consecutive days. Electrical stimulation of alternating frequencies of 2- and 100-Hz with 3 second each, and with intensity of 10-15 mA was applied on Hegu (LI-4) and Laogong (PC-8) points on one hand, and Neiguan (PC-6) and Waiguan (SJ-5) points on the other forearm via electroconductive skin pads of 4 cm × 4 cm in size. The control group (n = 32) was treated with similar procedure except that the leads of the output of the stimulator was disconnected. Assessments of the severity of the withdrawal syndrome were conducted one day before and on each day during the whole treatment period of 10 days. Buprenorphin of 1 mg per day sublingually was provided to all subjects in the first two days, and then to those with withdrawal score over 20 in the following days. RESULTS: The TEAS treatment dramatically alleviated the withdrawal syndrome during heroin detoxification. No significant difference was found in withdrawal scores between the two groups at the beginning of the observation. Withdrawal scores showed a more marked drop in TEAS group than the control starting from the second day, and maintained at a lower level for the whole course of treatment. The area under the curve of withdrawal score in TEAS group was only 40% of that in the control (P < 0.001, two way repeated measures analysis of variance), and the requirement of buprenorphine was only 10% of that in the control. No adverse effects were observed in either group. CONCLUSION: TEAS of 2/100 Hz for 10 days in abrupt abstinence of the heroin addicts resulted in a marked reduction of the withdrawal syndrome as well as a reduced requirement for rescue opioids.

Effects of transcutaneous electrical acupoint stimulation on ovarian reserve of patients with diminished ovarian reserve in in vitro fertilization and embryo transfer cycles.

AIM: The aim of this study was to investigate the effect of transcutaneous electrical acupoint stimulation (TEAS) on ovarian reserve in patients with diminished ovarian reserve undergoing in vitro fertilization and embryo transfer. MATERIAL AND METHODS: A total of 240 patients were randomly divided into the Han's acupoint nerve stimulator TEAS treatment (TES), comforting false Han's placebo (FHP), artificial endometrial cycle treatment (AEC), and control (CON) groups. RESULTS: Fifty-six patients in TES, 56 in FHP, 54 in AEC, and 60 in CON fulfilled the study, respectively. Antral follicle count and anti-Müllerian hormone levels were increased, whereas the estradiol level, follicle-stimulating hormone level, and follicle-stimulating hormone/luteinizing hormone ratio were significantly decreased after treatment in the TES and AEC groups. After treatment, the number of oocytes retrieved and average number of embryos transferred were higher in the TES and AEC than in the CON and FHP groups. Clinical pregnancy rate in the TES group was markedly higher than values obtained for the other three groups. CONCLUSION: TEAS and AEC treatments could improve basal endocrine levels in patients, and increase the number of oocytes retrieved and high-quality embryos. TEAS treatment could improve the clinical pregnancy rate in patients with decreased ovarian reserve during in vitro fertilization and embryo transfer cycles.

Low- and high-frequency transcutaneous electrical acupoint stimulation induces different effects on cerebral µ-opioid receptor availability in rhesus monkeys.

Although systematic studies have demonstrated that acupuncture or electroacupuncture (EA) analgesia is based on their accelerating endogenous opioid release to activate opioid receptors and that EA of different frequencies is mediated by different opioid receptors in specific areas of the central nervous system, there is little direct, real-time evidence to confirm this in vivo. The present study was designed to investigate the effects of transcutaneous electrical acupoint stimulation (TEAS), an analogue of EA, at low and high frequencies on µ-opioid receptor (MOR) availability in the brain of rhesus monkeys. Monkeys underwent 95-min positron emission tomography (PET) with (11) C-carfentanil three times randomly while receiving 0, 2, or 100 Hz TEAS, respectively. Each TEAS was administered in the middle 30 min during the 95-min PET scan, and each session of PET and TEAS was separated by at least 2 weeks. The results revealed that 2 Hz but not 100 Hz TEAS evoked a significant increase in MOR binding potential in the anterior cingulate cortex, the caudate nucleus, the putamen, the temporal lobe, the somatosensory cortex, and the amygdala compared with 0 Hz TEAS. The effect remained after the end of TEAS in the anterior cingulate cortex and the temporal lobe. The selective increase in MOR availability in multiple brain regions related to pain and sensory processes may play a role in mediating low-frequency TEAS efficacy.

Effects of transcutaneous electrical acupoint stimulation on early postoperative pain and recovery: a comprehensive systematic review and meta-analysis of randomized controlled trials.

Background: Previous studies have indicated beneficial outcomes of transcutaneous electrical acupoint stimulation (TEAS), but high-quality and comprehensive meta-analyses are lacking. The aim was to quantitatively analyze the efficacy and safety of perioperative TEAS on postoperative pain and recovery. Methods: PubMed, Web of Science, EMBASE, and the Cochrane Library were searched through July 2022. Randomized controlled trials (RCTs) that examined the perioperative application of TEAS in adults compared with sham-TEAS and/or non-TEAS were eligible. Cumulative analgesic consumption within 24 h and rest pain scores at 2, 6, 12, and 24 h postoperatively were the two co-primary outcomes. Results: Seventy-six RCTs (n = 9,665 patients) were included. Patients treated with TEAS experienced a reduction in clinical importance in cumulative analgesic (morphine equivalent) consumption (WMD: -14.60 mg, 97.5% CI: -23.60 to -5.60; p < 0.001) and a reduction in statistical importance in rest pain scores at multiple time points within the first 24 postoperative hours. The secondary outcome analysis also identified clinically significant recovery benefits to TEAS during the first 24 h after surgery. Furthermore, TEAS could effectively reduce opioid-related side effects and did not increase serious side effects. Conclusion: This article describes current evidence about TEAS intervention on early postoperative pain and recovery. The results support the effectiveness of TEAS, but more high-quality evidence of clinical applicability is also needed. Systematic review registration: PROSPERO (CRD42021249814).