Gong Yi, Li Jian, Wu Xiao-Ke
Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, China.
Department of Obstetrics and Gynecology, the First Hospital Affiliated to Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, China.
Zhonghua Nan Ke Xue. 2021 Oct 20;27(10):917-926.
To evaluate the effects of transcutaneous electrical acupoint stimulation (TEAS) on the pregnancy outcome and sperm parameters in patients with idiopathic oligoasthenospermia.
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.
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.
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.
评估经皮穴位电刺激（TEAS）对特发性少弱精子症患者妊娠结局及精子参数的影响。
检索PubMed、EMBASE、Cochrane图书馆、中国知网、维普和万方数据库，检索时间从建库至2020年1月，检索词为男性不育、少精子症、弱精子症、针灸、经皮穴位电刺激等。使用Cochrane偏倚风险工具评估纳入的随机对照试验（RCT）的质量，并分析主要结局，包括妊娠和活产，以及次要结局，如精子浓度、活力和形态。
纳入4项RCT，共321例受试者，其中无一例报告活产，仅1项研究报告2 Hz TEAS治疗后妊娠率为15%。2 Hz（加权均数差：－3.01，95%可信区间：－22.28至16.26）和100 Hz TEAS（加权均数差：－0.02，95%可信区间：－5.29至5.56）对精子浓度均无显著影响，而与2 Hz TEAS（加权均数差：2.31，95%可信区间：1.01至3.61）相比，100 Hz TEAS显著提高了a级精子百分比（加权均数差：6.83，95%可信区间：2.10至11.57）。与空白对照相比，2 Hz（加权均数差：4.07，95%可信区间：－5.15至13.29）和100 Hz TEAS（加权均数差：6.59，95%可信区间：－5.36至18.55）对a + b级精子百分比或总精子活力均无显著影响。
TEAS对妊娠结局的影响尚不清楚。100 Hz TEAS可显著提高特发性少弱精子症患者的a级精子百分比，但仍需更多高质量临床研究进一步验证。
