The Immediate Analgesic Effect and Impact on Gait Function of Transcutaneous Electrical Nerve Stimulation in Late-Stage Elderly Individuals with Knee Pain: Examination of Gait Function Using an IoT-Based Gait Analysis Device

Purpose: This study verified the effects of transcutaneous electrical nerve stimulation (TENS), which can be worn during walking and exercise, in elderly individuals with late-stage knee pain who exercise regularly. Methods: Thirty-two late-stage elderly individuals were evaluated for knee pain during rest, walking, and program exercises, with and without TENS. Gait analysis was performed using an IoT-based gait analysis device to examine the effects of TENS-induced analgesia on gait. Results: TENS significantly reduced knee pain during rest, walking, and programmed exercises, with the greatest analgesic effect observed during walking. The greater the knee pain without TENS, the more significant the analgesic effect of TENS. A comparison of gait parameters revealed a significant difference only in the gait cycle time, with a trend towards faster walking with TENS;however, the effect was limited. Conclusion: TENS effectively relieves knee pain in late-stage elderly individuals and can be safely applied during exercise. Pain management using TENS provides important insights into the implementation of exercise therapy in this age group.

Research on the Different Frequencies of Transcutaneous Electrical Acupoint Stimulation for Postpartum Pelvic Girdle Pain

Objective:To observe the clinical effect of different frequencies of transcutaneous electrical acupoint stimulation in treating postpartum pelvic girdle pain and promoting postpartum rehabilitation.Methods:From January to September 2022,300 patients with pelvic girdle pain after spontaneous delivery in a hospital in Shaanxi Province were selected and randomly divided into three groups,low frequency,high frequency,and alternating frequency,with 100 cases in each group.In addition to routine postpartum care and psychological counseling,the three groups received transcutaneous electrical acupoint stimulation at low-frequency(2 Hz,)high-frequency(100 Hz),and alternating frequency(2/100 Hz),respectively.The differences in initial pain,pain scores before and after treatment,satisfaction with analgesic effect,and postpartum rehabilitation effect were evaluated among the three groups of patients.Results:There was a significant correlation between maternal age and postpartum pelvic girdle pain(P<0.001),but no correlation was observed between newborn birth weight and postpartum pelvic girdle pain(P>0.05).After 1d/2d of treatment,the pain scores and rehabilitation effect of patients in the alternating-frequency group and low-frequency group were significantly better than those in the high-frequency group,and the postpartum curative effect of patients in the alternating-frequency group was the best,followed by the low-frequency group,and the high-frequency group;the differences were statistically significant(P<0.001).Among the three groups,the alternating-frequency group had the highest satisfaction with the analgesic effect and the highest rate of selecting the same analgesic regimen the next time;the differences were statistically significant(P<0.001).Conclusion:Transcutaneous electrical acupoint stimulation at different frequencies is safe and effective in treating postpartum pelvic girdle pain and beneficial to postpartum rehabilitation.Sparse-dense wave stimulation is effective in treating postpartum pelvic girdle pain.It has the best effect in promoting postpartum rehabilitation and the highest patient satisfaction.Therefore,its application in clinical practice is highly recommended.

Transcutaneous electrical acupoint stimulation in adult patients receiving gastrectomy/colorectal resection:A randomized controlled trial

BACKGROUND Acupuncture promotes the recovery of gastrointestinal function and provides analgesia after major abdominal surgery.The effects of transcutaneous electrical acupoint stimulation(TEAS)remain unclear.AIM To explore the potential effects of TEAS on the recovery of gastrointestinal function after gastrectomy and colorectal resection.METHODS Patients scheduled for gastrectomy or colorectal resection were randomized at a 2:3:3:2 ratio to receive:(1)TEAS at maximum tolerable current for 30 min immediately prior to anesthesia induction and for the entire duration of surgery,plus two 30-min daily sessions for 3 consecutive days after surgery(perioperative TEAS group);(2)Preoperative and intraoperative TEAS only;(3)Preoperative and postoperative TEAS only;or(4)Sham stimulation.The primary outcome was the time from the end of surgery to the first bowel sound.RESULTS In total,441 patients were randomized;405 patients(58.4±10.2 years of age;247 males)received the planned surgery.The time to the first bowel sounds did not differ among the four groups(P=0.90;log-rank test).On postoperative day 1,the rest pain scores differed significantly among the four groups(P=0.04;Kruskal–Wallis test).Post hoc comparison using the Bonferroni test showed lower pain scores in the perioperative TEAS group(1.4±1.2)than in the sham sti-mulation group(1.7±1.1;P=0.04).Surgical complications did not differ among the four groups.CONCLUSION TEAS provided analgesic effects in adult patients undergoing major abdominal surgery,and it can be added to clinical practice as a means of accelerating postoperative rehabilitation of these patients.

Effect of transcutaneous electrical acupoint stimulation combined with palonosetron on chemotherapy-induced nausea and vomiting: a single.blind,randomized, controlled trial

Background: Chemotherapy?induced nausea and vomiting adversely affects the quality of life of patients who receive chemotherapy via intravenous infusion or transcatheter arterial chemoembolization(TACE). This study aimed to investigate the clinical effects of transcutaneous electrical acupoint stimulation(TEAS) on nausea and vomiting after TACE.Methods: A total of 142 patients who received TACE with cisplatin for primary or metastatic liver cancer were assigned to the active?acupuncture(n = 72) or placebo?acupuncture(n Hegu(LI4), Neiguan(P6), an= 70) groups using a covariate?adaptive randomization at a ratio of 1:1. The acupointsd Zusanli(ST36) were stimulated twice daily for 6 days. The effects of TEAS on nausea and vomiting were assessed by using occurrence rate and severity of these symptoms. Anorexia scale and M. D. Anderson Symptom Inventory(MDASI) scores were secondary endpoints and were used to assess the effect of TEAS on patient appetite and quality of life. The safety of the treatments was also monitored.Results: Between the two groups, the differences in occurrence rates and severities of nausea and vomiting after TACE were not significant(all P > 0.05). From the second day after TACE, anorexia scores were significantly lower in the active?acupuncture group than in the placebo?acupuncture group and continued to decrease over time with treat?ment(all P values less than 0.01). On days 0, 1, and 2, the mean MDASI scores for the active?acupuncture group were slightly lower than those for the placebo?acupuncture group, but the differences were not statistically significant(all P > 0.05). No significant differences were found between the two groups in the occurrence rate of any adverse event(P > 0.05).Conclusion: TEAS appears to be a safe and effective therapy to relieve patients' gastrointestinal discomfort after chemotherapy.

A randomized trial comparing the Tennant Biomodulator to transcutaneous electrical nerve stimulation and traditional Chinese acupuncture for the treatment of chronic pain in military service members

Background:The present investigation tested the efficacy of the Tennant Biomodulator,a novel pain management intervention that uses biofeedback-modulated electrical stimulation,to reduce chronic pain and its psychosocial sequelae in a sample of current and former military service members.The Tennant Biomodulator used on its most basic setting was compared to two commonly used,non-pharmacological pain treatments—traditional Chinese acupuncture and transcutaneous electrical nerve stimulation(TENS)—in a comparative efficacy,randomized,open-label trial.Methods:Participants included 100 active duty and retired service men and women with chronic pain undergoing treatment at the Brooke Army Medical Center in Texas,USA,randomly assigned to receive six,weekly sessions of either Tennant Biomodulator treatment,traditional Chinese acupuncture,or TENS,in addition to usual care.Recruitment was conducted between May 2010 to September 2013.Outcome measures were collected at intake,before and after each treatment session,and at a 1-month follow-up.Intent-to-treat analyses were used throughout,with mixed models used to investigate main effects of group,time,and group×time interactions with consideration given to quadratic effects.Outcomes measured included ratings of chronic pain,pain-related functional disability,and symptoms of post-traumatic stress disorder(PTSD)and depression.Results:On average,regardless of their treatment group,participants exhibited a 16%reduction in pain measured by the Brooke Army Medical Center’s Clinic Pain Log[F(1,335)=55.7,P<0.0001]and an 11%reduction in pain-related disability measured by the Million Visual Analog Scale[MVAS:F(1,84)=28.3,P<0.0001]from baseline to the end of treatment,but no one treatment performed better than the other,and the reductions in pain and pain-related disability were largely lost by 1-month follow-up.Symptoms of PTSD and depression did not change significantly as a function of time or group.Conclusions:Findings build on previous work suggesting that traditional Chinese acupuncture and TENS can reduce pain and its functional sequelae without risks associated with pharmacological pain management.The Tennant Biomodulator used on its most basic setting performs as well as these other interventions.Based on the present findings,large,randomized controlled trials on the Tennant Biomodulator are indicated.Future work should test this device using its full range of settings for pain-related psychological health.Trial registration:Clincialtrials.gov(NCT01752010);registered December 14,2012.

Non-invasive transcutaneous electrical stimulation in the treatment of overactive bladder

We reviewed the literature on transcutaneous electrical nerve stimulation(TENS)used as a therapy for overactive bladder(OAB)symptoms,with a particular focus on:stimulation site,stimuli parameters,neural structures thought to be targeted,and the clinical and urodynamic outcomes achieved.The majority of studies used sacral or tibial nerve stimulation.The literature suggests that,whilst TENS therapy may have neuromodulation effects,patient are unlikely to benefit to a significant extent from a single application of TENS and indeed clear benefits from acute studies have not been reported.In long-term studies there were differences in the descriptions of stimulation intensity,strategy of the therapy,and positioning of the electrodes,as well as in the various symptoms and pathology of the patients.Additionally,most studies were uncontrolled and hence did not evaluate the placebo effect.Little is known about the underlying mechanism by which these therapies work and therefore exactly which structures need to be stimulated,and with what parameters.There is promising evidence for the efficacy of a transcutaneous stimulation approach,but adequate standardisation of stimulation criteria and outcome measures will be necessary to define the best way to administer this therapy and document its efficacy.

Evaluation of the Efficacy of Transcutaneous Electrical Acupoint Stimulation during the Treatment of Painless Colonoscopy

Objective:To investigate the clinical efficacy of transcutaneous electrical acupoint stimulation combined with propofol infusion during the treatment of patients under colonoscopy.Methods:A total of 90 patients received painless colonoscopy were randomly divided into three groups:transcutaneous electrical acupoint stimulation combined with propofol group(group T),sufentanil combined with propofol group(group S)and propofol group(group P),with 30 cases in each group.The patients in group T were anesthetized with propofol after transcutaneous electrical acupoint stimulation of 30min at Hegu(LI4),Neiguan(PC6),Zusanli(ST36),Shangjuxu(ST37)and Sanyinjiao(SP6)on both sides,and the electrical stimulation lasted until the end of the operation.Group S and group P were pasted electrode slices at the same acupoint with group T,but no electrical stimulation was given.The other treatments were the same as those in group T.Group S was given sufentanil 0.1ug/kg at the beginning of anesthesia.The levels of blood pressure(MAP),heart rate(HR)and pulse oxygen saturation(SpO2)were continuously monitored at time points of entering operating room(T0),disappearance of eyelash reflex(T1),during operation(through the liver region T2)and immediately after operation(T3),and the total dosage of propofol,awakening time and incidence of adverse reactions in each group were recorded.Results:Compared with group P,the blood pressure and heart rate of the patients at T1 and T2 in group T were more stable(P<0.05),the awakening time after operation was significantly shorter(P<0.05),and the dosage of propofol was significantly lower than that in group P(P<0.05).The incidence of bradycardia,hypotension and respiratory depression decreased significantly(P<0.05).Compared with group S,the postoperative awakening time of group T was significantly shorter(P<0.05),and there was no significant difference in other indexes.Conclusion:Transcutaneous electrical acupoint stimulation is effective during the treatment of analgesia under colonoscopy.It can reduce the dosage of anesthetics,reduce the incidence of postoperative adverse reactions and shorten the awakening time of patients.

Acupuncture transcutaneous electrical nerve stimulation reduces discomfort associated with barostat-induced rectal distension:A randomized-controlled study

AIM:To explore the effectiveness of acupuncture transcutaneous electrical nerve stimulation(Acu-TENS), a non-invasive modality in reduction of rectal discomfort during barostat-induced rectal distension. METHODS:Forty healthy subjects were randomized to receive 45 min of either Acu-TENS or placebo-TENS(no electrical output)over acupuncture points Hegu(largeintestine 4),Neiguan(pericardium 6)and Zusanli(stomach 36).A balloon catheter attached to a dual-drive barostat machine was then inserted into the subjects'rectum.A step-wise(4 mmHg)increase in balloon pressure was induced until maximal tolerable or 48 mmHg.Visual analogue scale and a 5-point subjective discomfort scale(no perception,first per-ception of distension,urge to defecate,discomfort/ pain and extreme pain)were used to assess rectal discomfort at each distension pressure.Blood beta-endorphin levels were measured before,immediately after intervention,at 24 mmHg and at maximal toler- able distension pressure. RESULTS:There was no difference in the demographic data and baseline plasma beta-endorphin levels between the two groups.Perception threshold levels were higher in the Acu-TENS group when compared to the placebo group,but the difference reached statistical significance only at the sensations"urge to defecate"and"pain".The distension pressures recorded at the"urge to defecate"sensation for the Acu-TENS and placebo-TENS groups were 28.0±4.5 mmHg and 24.6±5.7 mmHg,respectively(P=0.043);and the pressures recorded for the"pain"sensation for these two groups were 36.0±4.2 mmHg and 30.5± 4.3 mmHg respectively(P=0.002).Compared to the placebo group,a higher number of participants in the Acu-TENS group tolerated higher distension pressures (>40 mmHg)(65%in Acu-TENS vs 25%in placebo, P=0.02).The plasma beta-endorphin levels of the Acu-TENS group were significantly higher than that of the placebo group at barostat inflation pressure of 24 mmHg(1.31±0.40 ng/mL vs 1.04±0.43 ng/mL,P= 0.044)and at maximal inflation pressure(1.46±0.53 ng/mL vs 0.95±0.38 ng/mL,P=0.003). CONCLUSION:Acu-TENS reduced rectal discomfort during barostat-induced rectal distension and concur-rently associated with a rise in beta-endorphin level.

Transcutaneous acupoint electrical stimulation(TAES)for pre-operative anxiety:a prospective observational pilot investigation

Objective:Transcutaneous acupoint electrical stimulation(TAES)treatment is effective for post-operative anxiety.The investigation was designed to study the feasibility and effectiveness of TAES treatment for pre-operative anxiety.Methods:62 volunteered surgical patients were included in the pilot investigation.They all received TAES treatment for 30 minutes in the evening of the day before operation.Hegu(LI4)and Neiguan(PC6)of both sides were selected as the treatment acupoints.The anxiety degrees were measured by State-Trait Anxiety Inventory.Heart rate and blood pressure were also recorded.Results:After TAES,pre-operative anxiety measured by State-Trait Anxiety Inventory dropped by almost 12%,and both heart rate and systolic blood pressure decreased significantly.Conclusion:The pilot investigation of TAES for pre-operative anxiety can successfully test the feasibility of outcome measurements and provide necessary data for calculating the sample size of a subsequent randomized controlled trial.

QUANTITATIVE ANALYSIS ON CHANGES OF HEPATIC HEMODYNAMICS AFTER TRANSCUTANEOUS ELECTRIC PULSE STIMULATION OF LOCAL POINTS BY USING COLOR DOPPLER ULTRASOUND DIAGNOSTIC APPARATUS

Objective: To evaluate the effect of transcutaneous electric pulse stimulation (TEPS) on hepatic blood flow and parenchymal microcirculation in patients with fatty liver. Methods: A total of 31 fatty liver volunteer patients were observed in this study. Changes of color Doppler energy (CDE) images before and after TEPS of local points nearby the liver were recorded by using color Doppler ultrasound diagnostic apparatus (ACUSON 128XP/10C). Sum of color pixel area (SCPA), average of color value (ACV) and SCPA×ACV (integral) of the hepatic flow images were analyzed by an image processing system, single blind method and paired t-test. Programmed TEPS (0.5- 150 Hz / 2 000 Hz , 10- 25 V ) was applied to the right Qimen (期门 LR 14)-Jingmen (京门 GB 25), Fuai (腹哀 SP 16)-Ganshu (肝俞 BL 18) respectively for 15 min. Results: Compared with basic values of pretreatment, SCPA, ACV and SCPA×ACV increased significantly (t=2.71, P<0.02; t=3.42, P<0.01; and t=8.15, P<0.001) after TEPS, meaning improvement of hepatic blood flow supply. Conclusion: TEPS of acupoints near the liver can improve hepatic blood flow and hepatic parenchymal microcirculation in patients with fatty liver.

Transcutaneous electrical acupoint stimulation benefits postoperative pain relief of oocyte retrieval:A randomized controlled trial

Background Transvaginal oocyte retrieval is frequently followed by adverse events related to anesthesia and the procedure.Some research showed that transcutaneous electrical acupoint stimulation(TEAS)can relieve intraoperative pain and postoperative nausea.Objective This study examined whether TEAS can alleviate pain and relieve adverse symptoms after oocyte retrieval.Design,setting,participants and interventions Altogether 128 patients were randomly divided into the TEAS group and the mock TEAS group.The two groups received a 30-minute-long TEAS or mock TEAS treatment that began 30 min after oocyte retrieval.Main outcome measures The primary outcome was the visual analog scale(VAS)pain score.Secondary outcomes were pressure pain threshold,McGill score,pain rating index(PRI),present pain intensity(PPI),VAS stress score,VAS anxiety score,and postoperative adverse symptoms.Results The baseline characteristics of the two groups were comparable(P>0.05).The VAS pain scores of the TEAS group were lower than those of the mock TEAS group at 60 and 90 min after oocyte retrieval(P<0.05).The McGill score,PRI and PPI in the TEAS group were significantly lower than those in the control group at 60 min after oocyte retrieval(P<0.05).However,the two groups had equivalent beneficial effects regarding the negative emotions,such as nervousness and anxiety(P>0.05).The TEAS group was superior to the mock TEAS group for relieving postoperative adverse symptoms(P<0.05).Conclusion TEAS treatment can relieve postoperative pain and postoperative adverse symptoms for patients undergoing oocyte retrieval.

Analysis of the Effect of Transcutaneous Electrical Stimulation of Acupoints Combined with Rehabilitation Training in The Treatment of Upper Limb Dysfunction After Stroke

Objective:To analyze the effect of combining transcutaneous electrical acupoint stimulation(TEAS)with rehabilitation training in patients with upper limb dysfunction after stroke(ULDAS).Methods:A total of 130 ULDAS patients who were hospitalized and rehabilitated in Wuxi Xinwu District Rehabilitation Hospital from May 2021 to May 2023 were selected and randomly divided into Group A(65 cases,rehabilitation training)and Group B(65 cases,rehabilitation training+TEAS).The effects of the two groups were compared.Results:After treatment,the upper limb functional indexes of Group B were better than those of Group A(P<0.05).The rate of muscle tone grades 0-4 in Group B was higher than those of Group A(P<0.05).Conclusion:The function of upper limbs and muscle strength of ULDAS patients improved by combining TEAS with rehabilitation training.

Transcutaneous Electrical Acupoint Stimulation Combined with Warm Acupuncture for Breast Cancer Related Upper Limb Lymphedema:A Retrospective Cohort Study

Objective To observe the clinical efficacy of transcutaneous electrical acupoint stimulation(TEAS)combined with warm acupuncture in treating breast cancer associated with upper limb lymphedema(BCRL).Methods This was a retrospective cohort study using a paired control design.Fifty-two BCRL patients were assigned to the control group(27 cases)and the treatment group(25 cases).The patients in the control group were treated with lymphedema comprehensive detumescence treatment(CDT)for 4 weeks,including systematic therapy composed of manual lymphatic drainage,compression bandage,skincare,and functional exercise.The patients in the treatment group were treated with TEAS combined with warm acupuncture based on the control group methods.Each treatment lasted for 30 min and was applied twice a week for 4 weeks.The arm circumference(AC)of different positions of the affected limb and the degree of swelling of the affected limb were evaluated before the first treatment and after the last treatment.The clinical efficacy was evaluated according to the degree of edema before and after treatment.All adverse events during treatment were recorded.Results The patients’AC and the swelling feeling of the affected limb in the treatment group and the control group were both reduced compared with those before treatment.Compared with the control group,AC of the wrist joint transverse stria,the midpoint between the wrist joint transverse stria and the elbow joint transverse stria in the treatment group were significantly reduced(P<0.05).The decrease in AC diameter at the midpoint between the elbow joint transverse stria and the axillary transverse stria was the most significant(P<0.01).The swelling degree of the affected limbs in the treatment group was significantly lower than before treatment,and was significantly lower compared with the control group after treatment(P<0.01).The total effective rate was 72%in the treatment group,significantly higher than that in the control group(55.56%,P<0.05).No serious adverse events occured in either group.Conclusions TEAS combined with warm acupuncture can effectively reduce AC and swelling feeling of the affected limb in patients with BCRL.The effect is better than that of CDT therapy alone.

Effect of percutaneous electrical stimulation at the Baliao point on preventing postpartum urinary retention after labor analgesia

BACKGROUND Anesthetic drugs used in labor analgesia also paralyze the bladder muscle by blocking the sacral plexus,thereby affecting maternal postpartum spontaneous urination and increasing the risk of postpartum urinary retention(PUR).AIM To analyze the effect of percutaneous electrical stimulation at the Baliao point combined with biofeedback therapy for PUR prevention.METHODS We selected 182 pregnant women who received labor analgesia in obstetrics between June 2022 and December 2023.They were divided into the combined therapy group(transcutaneous electrical stimulation of the Baliao point combined with biofeedback therapy)and the control group(biofeedback therapy alone).The first spontaneous urination time,first postpartum urine volume,bladder residual urine volume,postpartum hemorrhage volume,pre-urination waiting time,PUR incidence,adverse reactions,and the intervention’s clinical efficacy were compared between the two groups.RESULTS The first spontaneous urination time after delivery was more delayed(2.92±1.04 h vs 3.61±1.13 h,P<0.001),with fewer initial postpartum urine(163.54±24.67 mL vs 143.72±23.95 mL,P<0.001),more residual bladder urine(54.81±10.78 mL vs 65.25±13.52 mL,P<0.001),more postpartum bleeding(323.15±46.95 mL vs 348.12±45.03 mL,P=0.001),and longer waiting time for urination(0.94±0.31 min vs 1.29±0.42 min,P<0.001),in the control group than in the combined therapy group.The control group also had higher PUR incidence(4.65%vs 15.85%,P=0.016).Both groups had no adverse reactions,but the clinical total efficacy rate of the intervention was significantly higher in the combined therapy group than in the control group(95.35%vs 84.15%,P=0.016).CONCLUSION Percutaneous electrical stimulation of the Baliao point combined with biofeedback can significantly promote postpartum micturition of parturients with labor analgesia,thereby effectively preventing PUR occurrence.

Transcutaneous Electrical Nerve Stimulation on Acupoints Relieves Labor Pain:A Non-randomized Controlled Study

Objective：To investigate the efficacy of transcutaneous electrical nerve stimulation（TENS）on four specific acupuncture points Hegu（LI4）,Neiguan（PC6）,Danshu（BL19）and Weishu（BL21）for reducing pain in labor.Methods：A total of 160 voluntary nulliparous women who were willing to receive TENS for analgesia were assigned to the treatment group after cervical dilation of more than 2 cm.Another 145 matched nullipara were recruited as the control group.Visual analogue scale（VAS）was used to assess the pain before and 0.5 h after the application of TENS.Then,VAS was assessed every one hour until delivery.Percentage of VAS score decreased by〉25%was the primary outcome,the delivery mode and neonatal outcome were measured as secondary outcomes.Adverse reactions were also recorded during TENS.Results：The percentage of VAS score decreased by〉25%was 68.6%in the TENS treatment group.Maternal delivery mode and neonatal outcomes were not significantly different between the two groups.In addition,the incidence of postpartum hemorrhage in the TENS treatment group was less than the control group（P〈0.05）.There was no adverse reaction recorded with TENS on acupoints.Conclusion：As a novel and non-invasive approach,TENS on specific acupoints including Hegu（LI4）,Neiguan（PC6）,Danshu（BL19）and Weishu（BL21）was an effective method for analgesia in labor.

Perioperative transcutaneous electrical acupoint stimulation for improving postoperative gastrointestinal function:A randomized controlled trial

Background:Postoperative gastrointestinal dysfunction(PGD)is one of the most common complications in patients undergoing major abdominal surgery.Acupuncture has been used widely in gastrointestinal diseases due to its effectiveness and minimally invasive nature.Objective:This study evaluated the efficacy of using transcutaneous electrical acupoint stimulation(TEAS)during the surgery and postoperative recovery in patients with gastric and colorectal surgery for improving postoperative gastrointestinal function.Design,setting,participants and interventions:A total of 280 patients undergoing abdominal surgery were stratified by type of surgery(i.e.,gastric or colorectal surgery)and randomly allocated into the TEAS group(group T)or the sham group(group S).Patients in group T received TEAS at LI4,PC6,ST36 and ST37.Patients in group S received pseudo-TEAS at sham acupoints.The stimulation was given from 30 min before anesthesia until the end of surgery.The same treatment was performed at 9 am on the 1st,2nd and 3rd days after surgery,until the recovery of flatus in patients.Main outcome measures:The primary outcome was the time to the first bowel motion,as detected by auscultation.The secondary outcomes included the first flatus and ambulation time,changes of perioperative substance P(SP),incidence of PGD,postoperative pain,postoperative nausea and vomiting(PONV)and some economic indicators.Results:The time to first bowel motion,first flatus and first ambulation in group T was much shorter than that in group S(P<0.01).In patients undergoing colorectal surgery,the concentration of SP was lower in group T than in group S on the third day after the operation(P<0.05).The average incidence of PGD in all patients was 25%,and the frequency of PGD was significantly lower in group T than in group S(18.6%vs.31.4%,respectively;P<0.05).TEAS treatment(odds ratio=0.498;95%confidence interval:0.232–0.786)and type of surgery were relevant factors for the development of PGD.Postoperative pain score and PONV occurrence were significantly lower in group T(P<0.01).Postoperative hospitalization days and the resulting cost to patients were greatly reduced in the TEAS group(P<0.01).Conclusion:Perioperative TEAS was able to promote the recovery of postoperative gastrointestinal function,reduce the incidence of PGD and PONV.The concentration of SP was decreased by TEAS treatment,which indicates that the brain-gut axis may play a role in how TEAS regulates gastrointestinal function.Trial registration:Chinese Clinical Trial Registry,Chi CTR1900023263.

Effect of Transcutaneous Electrical Acupoint Stimulation on Nausea and Vomiting Induced by Patient Controlled Intravenous Analgesia with Tramadol

Objective： To observe the effect of transcutaneous electrical acupoint stimulation （TEAS） on nausea and vomiting （N＆V） induced by patient controlled intravenous analgesia （PCIA） with Tramadol. Methods： Sixty patients who were ready to receive scheduled operation for tumor in the head-neck region and post-operation PCIA, aged 39-65 years, with the physique grades Ⅰ -Ⅱ of ASA, were randomized into two groups, A and B, 30 in each group. The pre-operation medication, induction of analgesia and continuous anesthesia used in the two groups were the same. TEAS on bilateral Hegu （LI4） and Neiguan （PC6） points was intermittently applied to the patients in group A starting from 30 min before analgesia induction to 24 h after operation, and the incidence and score of nausea and vomiting, antiemetic used, visual analogue scores （VAS）, and PCIA pressing times in 4 time segments （0-4, 4-8, 8-12 and 12-24 h after the operation was finished） were determined. The same management was applied to patients in Group B, with sham TEAS for control. Results： The incidence and degree of N＆V, as well as the number of patients who needed remedial antiemetic in Group A were less than those in Group B. The VAS score and PCIA pressing time were lower in Group A than those in Group B in the corresponding time segments respectively. Conclusion： TEAS could prevent N＆V induced by PCIA with Tramadol.

Transcutaneous Electrical Acupoint Stimulation Improves Postoperative Cognitive Function in Senior Patients Undergoing Video-Assisted Thoracoscopic Surgery:A Randomized Controlled Trial

Objective:To evaluate the effectiveness and safety of transcutaneous electrical acupoint stimulation(TEAS)for improving postoperative cognitive function in senior patients undergoing video-assisted thoracoscopic surgical(VATS).Methods:From January to December 2020,97 participants were randomly assigned to the TEAS group(49 cases)and the control group(48 cases)by a random number table.The patients in the TEAS group received TEAS,at the bilateral Neiguan(PC 6)and Zusanli(ST 36)acupoints.The control group received sham TEAS.The stimulation was started from 30 min before surgery until the end of the operation.The primary outcome was the incidence of pstoperative cognitive dysfunction(POCD),diagnosed based on the changes in the Mini-Mental Status Examination(MMSE)and Montreal Cognitive Assessment(MoCA)scores.The secondary outcomes were plasma levels of S100β protein and neuron-specific enolase(NSE).Results:The incidence of POCD on day 1 and 3 after surgery in the TEAS group was significantly lower than that in the control group[day 1 after surgery:28.3%(13/46)vs.52.3%(23/44),P=0.028;day 3 after surgery:21.7%(10/46)vs.40.9%(18/44),P=0.043].Compared with baseline,the MMSE and MoCA scores decreased to various extents in both groups.The MMSE scores on day 1,3,and 5 after surgery and MoCA scores on day 1,3,5,and 7 after surgery in the TEAS group were higher than those in the control group(all P<0.05)in both groups.Compared with baseline,the plasma levels of S100β and NSE were significantly increased at 4,8,12,24 h after surgery(all P<0.05).Compared with the control group,the plasma levels of S100β and NSE were lower in the TEAS group at 4,8,12,and 24 h after surgery(all P<0.05).No obvious adverse events were found during the trial.Conclusion:Application of TEAS in senior patients after VATS could reduce incidence of POCD and improve postoperative cognitive function.

Effects of Transcutaneous Electrical Acupoint Stimulation on Ovarian Responses and Pregnancy Outcomes in Patients Undergoing IVF-ET:A Randomized Controlled Trial

Objective:To evaluate the influence of different transcutaneous electrical acupoint stimulation(TEAS)modes on ovarian responses and pregnancy outcomes in patients with infertility undergoing in vitro fertilization and embryo transfer(IVF-ET).Methods:Two hundred infertility patients undergoing IVF-ET were divided randomly into experimental groups(TEAS groups:E-Ⅰ,E-Ⅱ,E-Ⅲ,and E-Ⅳ,40 cases each group)and a control group(mock TEAS group,40 patients)using the random number method.The patients in the experimental groups received TEAS treatment of 20,30,40 and 50 m A for the E-Ⅰ,E-Ⅱ,E-Ⅲand E-Ⅳgroups,respectively.The control group received a treatment of 5 m A.TEAS was applied at acupoints of Guanyuan(RN 4),Zhongji(RN 3),Sanyinjiao(SP 6),Zigong(EX-CA 1),and Taixi(KI 13),once a day for 30 min each time for a treatment period of 10-13 d.Treatment effect was assessed using the following indicators:endometrial thickness on the 6 th day of gonadotropin treatment(GN6 day),endometrial thickness on the day on chorionic gonadotropin administration(HCG day),number of ovarian follicles on HCG day,number of ova captured,amount of estrogen required for each harvested ova,number of mature ova divided by the total number of ova,percentage of high-quality embryos,and clinical pregnancy.Results:Endometrial thickness in the experimental groups on the HCG day was significantly better than that of the control group after TEAS stimulation(P=0.01).TEAS exhibited a greater impact on the number of ova captured(P=0.003).However,the effect of TEAS stimulation on the high-quality embryo rate and clinical pregnancy in patients was not statistically significant(P>0.05).Conclusions:TEAS is an effective method in improving the ovarian state.When the stimulus intensity was at 40 m A and above,it could be helpful to improve the patient’s endometrial condition and endometrial receptivity and to retrieve more oocytes.(Trial registration No.Chi CTR-TRC-11001780)

Effect of transcutaneous electrical nerve stimulation at acupoints on patients with type 2 diabetes mellitus:a randomized controlled trial

OBJECTIVE:To examine whether transcutaneous electric nerve stimulation at acupoints(Acu-TENS)improved the biochemical and physical indices of patients with type 2 diabetes mellitus(T2DM).METHODS:Ninety subjects with T2DM were divided randomly into a control group(n = 30),aerobic exercise group(n- 30),or Acu-TENS group(n = 30).In addition to conventional diabetes drug treatment,patients in the Acu-TENS group received acupoint stimulation,the aerobic exercise group engaged in walking exercises,and the control group was given sham electrical stimulation.All groups were treated for 30 min for each session and five times a week for 2 months.The indices of glycosylated hemoglobin,2 h postprandial glucose,fasting serum insulin,triglyceride,total cholesterol,and body mass index were assessed at pre-treatment,post-treatment,and follow-up,which was 2 months after treatment.RESULTS:The indices of the control group were not changed(P > 0.05) at the three time points.At the pre-treatment measurement,there were significant differences(P > 0.05) in indices among the three groups.At post-treatment,each index of the two groups was lower than that of the control group(P < 0.05),and improved in comparison with the pre-treatment measurement(P < 0.05).In follow-up,each index of the aerobic exercise group and Acu-TENS group increased,but was still decreased compared with the pre-treatment value(P < 0.05),excluding body mass index.CONCLUSION:Acu-TENS could improve the state of patients with T2 DM and be used as a therapy in clinical application.