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Li S, Jiang H, Liu W, Yin Y, Yin C, Chen H, Du Y, Zhao Q, Zhang Y, Li C. Transcutaneous electrical acupoint stimulation for the prevention of perioperative neurocognitive disorders in geriatric patients: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2022; 101:e32329. [PMID: 36550918 PMCID: PMC9771360 DOI: 10.1097/md.0000000000032329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND To evaluate whether transcutaneous electrical acupoint stimulation (TEAS) decreases rates of perioperative neurocognitive disorders (PND) when used as an adjuvant method during perioperative period in geriatric patients since the new definition was released in 2018. METHODS Six databases [Chinese National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, WanFang Database, PubMed, EMBASE, and Cochrane Library] were systematically searched. Data analysis was performed using RevMan 5.4.1 software (Copenhagen: The Nordic Cochrane Centre, the Cochrane Collaboration, 2020). Risk ratios (RR) with 95% confidence interval were calculated using a random effects model. Quality of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS 13 randomized clinical trials (999 patients) in total were included. TEAS had positive effects on preventing the incidence of PND (RR: 0.43; 0.31, 0.61; P < .001; low certainty) [postoperative delirium within 7 days (RR: 0.39; 0.26, 0.59; P < .001), delayed neurocognitive recovery within 3 months (RR: 0.51; 0.33, 0.78; P = .002)]. TEAS could also improve the scores of the confusion assessment method (CAM) (Mean difference: -1.30; -2.14, -0.46; P = .003; low certainty). Limited evidence suggested that TEAS could reduce the serum levels of biochemical indicator (S100β) (SMD = -1.08, -1.67, -0.49, P < .001; I2 = 83%; very low certainty) as well as anesthetic requirements (remifentanil) (SMD: -1.58; -2.54, -0.63; P = .001; I2 = 87%; very low certainty). Subgroup analysis indicated that different protocols of TEAS had significant pooled benefits (TEAS used only in surgery and in combination with postoperative intervention) (RR: 0.45; 0.31, 0.63; P < .001). Acupoint combination (LI4 and PC6) in the TEAS group had more significantly advantages (RR: 0.34; 0.17, 0.67; P = .002). TEAS group had a lower incidence of PND in different surgery type (orthopedic surgery and abdominal surgery) (RR: 0.43; 0.30, 0.60; P < .001), as well as with different anesthetic modality (intravenous anesthesia and intravenous and inhalational combined anesthesia) (RR: 0.38; 0.23, 0.61; P < .001). CONCLUSION In terms of clinical effectiveness, TEAS appeared to be beneficial for prophylaxis of PND during a relatively recent period, noting the limitations of the current evidence.
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Affiliation(s)
- Shuying Li
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Hailun Jiang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Wei Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yu Yin
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Chunsheng Yin
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Hao Chen
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yuzheng Du
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- * Correspondence: Yuzheng Du, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China (e-mail: )
| | - Qi Zhao
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yi Zhang
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Chen Li
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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Feng X, Zhu N, Yang S, Wang L, Sun W, Li R, Gong F, Han S, Zhang R, Han J. Transcutaneous electrical acupoint stimulation improves endometrial receptivity resulting in improved IVF-ET pregnancy outcomes in older women: a multicenter, randomized, controlled clinical trial. Reprod Biol Endocrinol 2022; 20:127. [PMID: 35996188 PMCID: PMC9396882 DOI: 10.1186/s12958-022-00997-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/09/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To examine the effects and mechanisms of transcutaneous electrical acupoint stimulation (TEAS) on pregnancy outcomes in women undergoing in vitro fertilization (IVF)-embryo transfer (ET). DESIGN, SETTING, AND PARTICIPANTS This efficacy study was a multicenter, randomized, controlled clinical trial (RCT) in women receiving IVF-ET. The mechanistic study was a single-center RCT. INTERVENTIONS The participants received TEAS vs. no TEAS treatment. MAIN OUTCOME MEASURES In the efficacy study, the primary outcomes were the rates of clinical pregnancy, embryo implantation, and live birth. In the mechanistic study, sex hormones and endometrial protein expression were examined. RESULTS Ultimately, 739 participants were enrolled (367 and 372 in the TEAS and control groups, respectively). The clinical pregnancy rate was higher in the TEAS group than in the controls (55.1% vs. 46.7%, P = 0.03). There were no significant differences in embryo implantation, biochemical pregnancy, and live birth rates between the two groups (all P > 0.05) in the study population. In women > 35 years, the clinical pregnancy rates, embryo implantation rates and live birth rates in the TEAS and control groups were 48.9% vs. 23.7% (P = 0.004),30.8 vs. 13.9% (P = 0.001) and 34.0% vs. 19.7% (P = 0.06) respectively. In the mechanistic study with 120 participants, on the theoretical embryo implantation day, better developed endometrial pinopodes, elevated endometrial integrin α1β1/αVβ3, leukemia inhibitory factor, and elevated serum progesterone levels were found in the TEAS group compared with controls. CONCLUSION TEAS significantly improved the clinical pregnancy rate in women undergoing IVF-ET, especially in women of older age. It might be due to improved endometrial receptivity. TRIAL REGISTRATION ChiCTR-TRC-13003950.
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Affiliation(s)
- Xiaojun Feng
- Center of Reproductive Medicine, The Second Hospital Affiliated to Shandong University of Traditional Chinese Medicine, Jinan, 250001, China
| | - Na Zhu
- Reproductive & Genetic Hospital of CITIC-XIANGYA, Changsha, 410000, China
| | - Shuo Yang
- Center of Reproductive Medicine, Department of Obstetrics and GynecologyKey Laboratory of Assisted Reproduction, Ministry of EducationBeijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, 100191, China
| | - Li Wang
- Center of Reproductive Medicine, The Second Hospital Affiliated to Shandong University of Traditional Chinese Medicine, Jinan, 250001, China
| | - Wei Sun
- Center of Reproductive Medicine, The Second Hospital Affiliated to Shandong University of Traditional Chinese Medicine, Jinan, 250001, China
| | - Rong Li
- Center of Reproductive Medicine, Department of Obstetrics and GynecologyKey Laboratory of Assisted Reproduction, Ministry of EducationBeijing Key Laboratory of Reproductive Endocrinology and Assisted Reproductive Technology, Peking University Third Hospital, Beijing, 100191, China
| | - Fei Gong
- Reproductive & Genetic Hospital of CITIC-XIANGYA, Changsha, 410000, China
| | - Songping Han
- Wuxi Shengpingxintai Medical Technology Co., Ltd, Wuxi, 214091, China
| | - Rong Zhang
- Department of Neurobiology, School of Basic Medical Sciences, Key Lab for Neuroscience, Neuroscience Research Institute, Peking UniversityPeking University Health Science CenterThe Ministry of EducationThe Ministry of Health, Beijing, 100191, China.
- Department of Integration of Chinese and Western Medicine, School of Basic Medical Sciences, Peking University, Beijing, 100191, China.
| | - Jisheng Han
- Department of Neurobiology, School of Basic Medical Sciences, Key Lab for Neuroscience, Neuroscience Research Institute, Peking UniversityPeking University Health Science CenterThe Ministry of EducationThe Ministry of Health, Beijing, 100191, China.
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Wang Y, Yang J, Liu J, Qi Y, Tu J, Tian Z, Shi G, Yan S, Wang L, Liu C. Home‐based transcutaneous electrical acupoint stimulation for high‐normal blood pressure: A randomized controlled trial. J Clin Hypertens (Greenwich) 2022; 24:984-992. [PMID: 35789530 PMCID: PMC9380160 DOI: 10.1111/jch.14496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 04/06/2022] [Accepted: 04/18/2022] [Indexed: 11/27/2022]
Abstract
The authors investigated the effectiveness of home‐based transcutaneous electrical acupoint stimulation (TEAS) combined with lifestyle modification on blood pressure (BP) control and explored the feasibility of the trial design in this prospective, randomized controlled trial. The authors recruited individuals with high‐normal BP who had a systolic blood pressure (SBP) of 120–139 mm Hg and a diastolic blood pressure (DBP) of 80–89 mm Hg, or both. Participants were randomly assigned to receive either lifestyle modification combined with TEAS four times weekly for 12 weeks at home (intervention group) or solely lifestyle modification (control group). The primary outcome was the change in mean SBP at week 12 from the baseline measurement. A total of 60 participants were randomized in a 1:1 ratio, and an intention‐to‐treat analysis was performed on all of the outcomes. The mean difference in the change in SBP for the intervention group (compared to the control) at week 12 was −3.85 mm Hg (95% CI: −7.58 to −.12; p = .043); for the DBP, the change was −2.27 mm Hg (95% CI: −5.76 to 1.23; p = .199). There was no difference in the proportion of progression to hypertension, quality of life, body mass index (BMI) or waist circumference. In addition, two participants reported TEAS‐related adverse events. The authors found a reduction in SBP control in the pragmatic, home‐based intervention by using TEAS combined with lifestyle modification in adults with high‐normal BP. Trial Registration: The study was registered in the Chinese Clinical Trial Registry (ChiCTR 1900024982) on August 6, 2019.
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Affiliation(s)
- Yu Wang
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
| | - Jing‐Wen Yang
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
| | - Jun‐Hong Liu
- Heyi Community Health Service Center Fengtai District Beijing China
| | - You‐Sheng Qi
- Heyi Community Health Service Center Fengtai District Beijing China
| | - Jian‐Feng Tu
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
| | - Zhong‐Xue Tian
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
| | - Guang‐Xia Shi
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
| | - Shi‐Yan Yan
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
| | - Li‐Qiong Wang
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
| | - Cun‐Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute Beijing University of Chinese Medicine Chaoyang District Beijing China
- School of Acupuncture‐Moxibustion and Tuina Beijing University of Chinese Medicine Chaoyang District Beijing China
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Wang Y, Shi GX, Tian ZX, Liu JH, Qi YS, Tu JF, Yang JW, Wang LQ, Liu CZ. Transcutaneous electrical acupoint stimulation for high-normal blood pressure: study protocol for a randomized controlled pilot trial. Trials 2021; 22:140. [PMID: 33588904 PMCID: PMC7885337 DOI: 10.1186/s13063-021-05039-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 01/09/2021] [Indexed: 01/09/2023] Open
Abstract
Background High-normal blood pressure (BP) is associated with increased all-cause, cardiovascular mortality and frequently progresses to hypertension. Transcutaneous electrical acupoint stimulation (TEAS) might be a non-pharmaceutical therapy option to control BP. This trial aims to determine the effectiveness and safety of TEAS combined with lifestyle modification for high-normal BP. Methods/design This prospective, randomized, and parallel clinical trial will be conducted in a community service center in China. Sixty participants with high-normal BP will be randomly allocated to receive TEAS plus lifestyle modification (intervention group) or lifestyle modification alone (control group) in a 1:1 ratio. In addition to lifestyle modification, the intervention group will receive TEAS at four acupoints for 30 min, 4 times weekly for 12 weeks for a total of 48 sessions at home. The control group will receive same lifestyle modification but no TEAS. The primary outcome will be the change in mean systolic blood pressure at 12 weeks from the baseline measurement. Secondary outcomes include the change of mean diastolic blood pressure, proportion of subjects with progression to hypertension, quality of life, body mass index, and waist circumference. Adverse events during the trial will be monitored. Discussion This trial will explore the feasibility and provide potential evidence for the effectiveness and safety of TEAS plus lifestyle modification for high-normal BP. Furthermore, this pilot trial is being undertaken to determine the feasibility of a full scale definitive randomized controlled trial. The results of this study will be published in a peer-reviewed journal. Trial registration Chinese Clinical Trial Registry, ChiCTR 1900024982. Registered on August 6, 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05039-5.
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Affiliation(s)
- Yu Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Chaoyang District, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Guang-Xia Shi
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Chaoyang District, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Zhong-Xue Tian
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Chaoyang District, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Jun-Hong Liu
- Nanyuan Community Health Service Center, Fengtai District, Beijing, China
| | - You-Sheng Qi
- Nanyuan Community Health Service Center, Fengtai District, Beijing, China
| | - Jian-Feng Tu
- Department of Acupuncture and Moxibustion, Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Dongcheng District, Beijing, China
| | - Jing-Wen Yang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Chaoyang District, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
| | - Li-Qiong Wang
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Chaoyang District, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China.
| | - Cun-Zhi Liu
- International Acupuncture and Moxibustion Innovation Institute, School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Chaoyang District, No. 11, Bei San Huan Dong Lu, Chaoyang District, Beijing, 100029, China
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