1.昆明医科大学药学院暨云南省天然药物药理重点实验室 云南 昆明 650500
2.昆明医科大学云南省现代生物医药产业学院 云南 昆明 650500
3.昆明医科大学第二附属医院检验科 云南 昆明 650500
缪敏,女,1999—,医学硕士生,主要从事神经药理学研究,E⁃mail:1228594054@qq.com
沈志强,男,1965—,医学博士,教授,主要从事心血管及骨质疏松药理学研究,E⁃mail:shzhq21cn@qq.com
孙岩,男,1990—,医学博士,讲师,主要从事骨疾病研究,E⁃mail:553046530@qq.com
收稿:2023-01-10,
纸质出版:2025-04-25
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缪敏,陈冉,沈志强等.电刺激治疗不孕症的研究进展[J].武汉大学学报(医学版),2025,46(04):532-539.
MIAO Min,CHEN Ran,SHEN Zhiqiang,et al.Research progress of electrical stimulation in infertility treatment[J].Medical Journal of Wuhan University,2025,46(04):532-539.
缪敏,陈冉,沈志强等.电刺激治疗不孕症的研究进展[J].武汉大学学报(医学版),2025,46(04):532-539. DOI: 10.14188/j.1671-8852.2023.0021.
MIAO Min,CHEN Ran,SHEN Zhiqiang,et al.Research progress of electrical stimulation in infertility treatment[J].Medical Journal of Wuhan University,2025,46(04):532-539. DOI: 10.14188/j.1671-8852.2023.0021.
不孕症是指12个月以上常规无保护措施性交后未能受孕的病症,常见原因包括排卵障碍、输卵管疾病、子宫内膜容受性、男性因素等,其中女性排卵障碍是不孕症产生的主要原因。临床不孕症的治疗手段有药物治疗、手术治疗、补充和替代医疗(CAM)。CAM作为一种新的不孕症治疗方法正逐渐在多种不孕症治疗方法中崭露头角。常见的CAM针灸治疗方法包括:电针(EA)、神经肌肉电刺激(NMES)、盆底神经肌肉电刺激(PFNES)、经皮穴位电刺激(TEAS)等。本文讨论了不同类型电刺激治疗不孕症的相关研究进展、疗效和安全性,为不孕症的临床治疗提供更多的CAM选择方案。
Failure to conceive after 12 months of regular unprotected intercourse is termed infertility
which may result from ovulation disorders
fallopian tube disease
endometrial receptivity issues
or male factors. Current clinical treatments for infertility include pharmacological therapy
surgical intervention
and complementary and alternative medicine (CAM). As an emerging infertility treatment
CAM is gaining prominence among various therapeutic approaches. Acupuncture
a form of CAM
encompasses techniques such as electro⁃acupuncture (EA)
neuromuscular electrical stimulation (NMES)
pelvic floor neuromuscular electrical stimulation (PFNES)
and transcutaneous electrical acupoint stimulation (TEAS)
which have been utilized in China for infertility treatment. This paper reviews the research progress
efficacy
and safety of these methods to introduce more appropriate CAM protocols for clinical infertility management.
Practice Committee of the American Society for Reproductive Medicine . Definitions of infertility and recurrent pregnancy loss: A committee opinion [J ] . Fertil Steril , 2020 , 113 ( 3 ): 533 ⁃ 535 .
KNAPIK L O , PARESH S , NABI D , et al . The role of T cells in ovarian physiology and infertility [J ] . Front Cell Dev Biol , 2022 , 10 : 713650 .
BUI B N , LENSEN S F , GIBREEL A , et al . Endometrial injury for pregnancy following sexual intercourse or intrauterine insemination [J ] . Cochrane Database Syst Rev , 2022 , 10 ( 10 ): CD011424 .
MENDIETA M A , ARANDA A S , LÓPEZ J F M , et al . Comparative analysis of the pregnancy rate via in vitro fertilization vs . previous artificial insemination in patients with unexplained infertility [J ] . JBRA Assist Reprod , 2022 , 26 ( 1 ): 22 ⁃ 27 .
XU J Y , ZHAO A L , XIN P , et al . Acupuncture for female infertility: Discussion on action mechanism and application [J ] . Evid Based Complement Alternat Med , 2022 , 7 ( 4 ): 3854117 .
QU F , LI R , SUN W , et al . Application of electroacupuncture and transcutaneous electrical stimulation in reproductive medicine: An expert consensus [J ] . J Zhejiang Univ Sci B , 2017 , 18 ( 3 ): 186 ⁃ 193 .
CARSON S A , KALLEN A N . Diagnosis and management of infertility: A review [J ] . JAMA , 2021 , 326 ( 1 ): 65 ⁃ 76 .
FENG J X , WANG J , ZHANG Y H , et al . The efficacy of complementary and alternative medicine in the treatment of female infertility [J ] . Evid Based Complement Alternat Med , 2021 , 4 ( 23 ): 6634309 .
SHI YQ , WANG Y , ZHU XT , et al . The application of complementary and alternative medicine in polycystic ovary syndrome infertility [J ] . Evid Based Complement Alternat Med , 2022 , 10 ( 7 ): 5076306 .
SÖNMEZ S , ÖZTÜRK M , SÖNMEZ F , et al . Prevalence and predictors of the usage of complementary alternative medicine among infertile patients [J ] . J Gynecol Obstet Hum Reprod , 2021 , 50 ( 6 ): 102112 .
LI D , BAI P , WU J Y , et al . Effect of acupuncture on ovary morphology and function in DHEA⁃induced polycystic ovary syndrome model rats [J ] . Chin J Integr Med , 2021 , 27 ( 3 ): 220 ⁃ 224 .
MINER S A , ROBINS S , ZHU Y J , et al . Evidence for the use of complementary and alternative medicines during fertility treatment: A scoping review [J ] . BMC Complement Altern Med , 2018 , 18 ( 1 ): 158 .
JAZANI A M , AZGOMI H N D , AZGOMI A N D , et al . A comprehensive review of clinical studies with herbal medicine on polycystic ovary syndrome (PCOS) [J ] . Daru , 2019 , 27 ( 2 ): 863 ⁃ 877 .
ARMOUR M , BETTS D , ROBERTS K , et al . The role of research in guiding treatment for women's health: A qualitative study of Traditional Chinese Medicine acupuncturists [J ] . Int J Environ Res Public Health , 2021 , 18 ( 2 ): 834 .
CHEN H , LIM C E D . The efficacy of using acupuncture in managing polycystic ovarian syndrome [J ] . Curr Opin Obstet Gynecol , 2019 , 31 ( 6 ): 428 ⁃ 432 .
赵爽 , 史玉林 . 金凤丸联合生物电刺激治疗薄型子宫内膜临床观察 [J ] . 辽宁中医药大学学报 , 2017 , 19 ( 2 ): 191 ⁃ 193 .
ZHAO S , SHI Y L . Clinical observation of Jinfeng pill combined with biological stimulation on the treatment of thin endometrium [J ] . Journal of Liaoning University of TCM , 2017 , 19 ( 2 ): 191 ⁃ 193 .
车玲 , 李淑萍 . 补肾中药和克罗米芬治疗排卵障碍性不孕的Meta分析 [J ] . 西部中医药 , 2022 , 35 ( 2 ): 61 ⁃ 66 .
CHE L , LI S P . Meta analysis of kidney⁃tonifying herbs and clomiphene citrate in the treatment of anovulatory infertility [J ] . Western Journal of Traditional Chinese Medicine , 2022 , 35 ( 2 ): 61 ⁃ 66 .
伍洁洁 , 苏同生 , 万兆新 . 经皮穴位电刺激治疗卵巢低反应结局的系统评价 [J ] . 世界最新医学信息文摘 , 2018 , 18 ( 51 ): 108 ⁃ 109,111 .
WU J J , SU T S , WAN Z X . Systematic review of outcomes of transcutanclus electrical acupoint stimulation for poor ovarian response [J ] . World Latest Medicine Information (Electronic Version) , 2018 , 18 ( 51 ): 108 ⁃ 109,111 .
杨会生 , 房繄恭 , 李晓彤 , 等 . 针灸对体外受精⁃胚胎移植患者妊娠结局影响的随机对照试验系统评价 [J ] . 中华中医药杂志 , 2017 , 32 ( 12 ): 5591 ⁃ 5598 .
YANG H S , FANG F G , LI X T , et al . Effects of acupuncture on pregnancy in patients undergoing in vitro fertilization and embryo transfer: A systematic review of randomized controlled trials [J ] . CJTCMP , 2017 , 32 ( 12 ): 5591 ⁃ 5598 .
尹萍 , 李丽 , 路璐 , 等 . 针刺联合辅助生殖技术对多囊卵巢综合征患者临床妊娠结局影响的Meta分析及GRADE质量评价 [J ] . 中华中医药杂志 , 2020 , 35 ( 2 ): 854 ⁃ 858 .
YIN P , LI L , LU L , et al . Effects of acupuncture with assisted reproductive technology on clinical outcome in polycystic ovary syndrome patients: A meta⁃analysis and GRADE classification [J ] . CJTCMP , 2020 , 35 ( 2 ): 854 ⁃ 858 .
ZHAO J J , RONG P J , SHI L , et al . Somato stimulation and acupuncture therapy [J ] . Chin J Integr Med , 2016 , 22 ( 5 ): 394 ⁃ 400 .
XU K , WANG J , HU F , et al . Effects of moxibustion on reproduction and metabolism of polycystic ovary syndrome: A protocol for meta⁃analysis and systematic review [J ] . BMJ Open , 2021 , 11 ( 8 ): e049039 .
JO J , LEE Y J , LEE H . Acupuncture for polycystic ovarian syndrome: A systematic review and meta⁃analysis [J ] . Medicine (Baltimore) , 2017 , 96 ( 23 ): e7066 .
NIKBAKHT R , DORFESHAN P . Assisted reproductive techniques and submucous myoma [J ] . JBRA Assist Reprod , 2021 , 25 ( 4 ): 650 ⁃ 652 .
周建勇 , 张小月 , 于美玲 , 等 . 经皮穴位电刺激对多囊卵巢综合征大鼠激素及卵巢甾体激素代谢酶表达的影响 [J ] . 针刺研究 , 2016 , 41 ( 1 ): 11 ⁃ 17 .
ZHOU J Y , ZHANG X Y , YU M L , et al . Effect of transcutaneuos acupoint electrostimulation on serum sex hormone levels and expression of ovarian steroid hormone metabolic enzymes in polycystic ovary syndrome rat [J ] . Acupuncture Research , 2016 , 41 ( 1 ): 11 ⁃ 17 .
MALIQUEO M , BENRICK A , MARCONDES R R , et al . Acupuncture does not ameliorate metabolic disturbances in the P450 aromatase inhibitor⁃induced rat model of polycystic ovary syndrome [J ] . Exp Physiol , 2017 , 102 ( 1 ): 113 ⁃ 127 .
WANG J , CHENG K , QIN Z , et al . Effects of electroacupuncture at Guanyuan (CV 4) or Sanyinjiao (SP 6) on hypothalamus⁃pituitary⁃ovary axis and spatial learning and memory in female SAMP8 mice [J ] . J Tradit Chin Med , 2017 , 37 ( 1 ): 96 ⁃ 100 .
宋燕娟 , 梁凤霞 , 吴松 , 等 . 针灸相关疗法对多囊卵巢综合征患者排卵率及妊娠率影响的网状Meta分析 [J ] . 中国针灸 , 2019 , 39 ( 7 ): 792 ⁃ 798 .
SONG Y J , LIANG F X , WU S , et al . Network meta⁃analysis on the effects of the acupuncture⁃related therapy on ovulation rate and pregnancy rate in patients with polycystic ovary syndrome [J ] . Chinese Acupuncture & Moxibustion , 2019 , 39 ( 7 ): 792 ⁃ 798 .
许娟 , 左玉 . 针刺辅助治疗多囊卵巢综合征不孕患者疗效观察 [J ] . 中国针灸 , 2018 , 38 ( 4 ): 358 ⁃ 361,363 .
XU J , ZUO Y . Efficacy of acupuncture as adjunctive treatment on infertility patients with polycystic ovary syndrome [J ] . Chinese Acupuncture & Moxibustion , 2018 , 38 ( 4 ): 358 ⁃ 361,363 .
XU G , ZHANG A , LIU J , et al . Effects of electroacupuncture on ovarian expression of the androgen receptor and connexin 43 in rats with letrozole⁃induced polycystic ovaries [J ] . Evid Based Complement Alternat Med , 2020 , 7 ( 14 ): 3608062 .
LIM C E D , NG R W C , CHENG N C L , et al . Acupuncture for polycystic ovarian syndrome [J ] . Cochrane Database Syst Rev , 2019 , 7 ( 7 ): CD007689 .
YI Y J , KIM D H , CHANG S , et al . Neurogenic spots in referred pain areas attenuates hepatic damages in bile duct⁃ligated rats [J ] . Int J Mol Sci , 2021 , 22 ( 4 ): 1974 .
贾功伟 , 李娜 , 殷樱 , 等 . 神经肌肉电刺激在慢性阻塞性肺疾病康复中的应用 [J ] . 中华物理医学与康复杂志 , 2017 , 39 ( 1 ): 21 ⁃ 24 .
JIA G W , LI N , YIN Y , et al . Neuromuscular electrical stimulation promotes rehabilitation in obstructive pulmonary disease [J ] . Chin J Phys Med Rehabil , 2017 , 39 ( 1 ): 21 ⁃ 24 .
REIS B M , DA SILVA J B , ROCHA A P R , et al . Intravaginal electrical stimulation associated with pelvic floor muscle training for women with stress urinary incontinence: Study protocol for a randomized controlled trial with economic evaluation [J ] . Trials , 2021 , 22 ( 1 ): 823 .
ALOUINI S , MEMIC S , COUILLANDRE A . Pelvic floor muscle training for urinary incontinence with or without biofeedback or electrostimulation in women: A systematic review [J ] . Int J Environ Res Public Health , 2022 , 19 ( 5 ): 2789 .
周莉 , 夏有兵 , 马翔 , 等 . 针灸序贯疗法对卵巢储备功能下降患者IVF⁃ET的影响 [J ] . 中国针灸 , 2016 , 36 ( 1 ): 25 ⁃ 28 .
ZHOU L , XIA Y B , MA X , et al . Effects of "menstrual cycle⁃based acupuncture therapy" on IVF⁃ET in patients with decline in ovarian reserve [J ] . Chinese Acupuncture & Moxibustion , 2016 , 36 ( 1 ): 25 ⁃ 28 .
KO J H , KIM S N . A literature review of women's sex hormone changes by acupuncture treatment: Analysis of human and animal studies [J ] . Evid Based Complement Alternat Med , 2018 , 10 ( 15 ): 3752723 .
LIAO Z , LIU C , CAI L , et al . The effect of endometrial thickness on pregnancy, maternal, and perinatal outcomes of women in fresh cycles after IVF/ICSI: A systematic review and meta⁃analysis [J ] . Front Endocrinol (Lausanne) , 2022 , 2 ( 11 ): 814648 .
LIAN R , WANG X , LIN R , et al . Evaluation of granulocyte colony⁃stimulating factor on the treatment of thin endometrium during frozen⁃thawed embryo transfer cycles: A retrospective cohort study [J ] . Gynecol Endocrinol , 2020 , 36 ( 4 ): 370 ⁃ 374 .
ZHONG Y , ZENG F , LIU W , et al . Acupuncture in improving endometrial receptivity: A systematic review and meta⁃analysis [J ] . BMC Complement Altern Med , 2019 , 19 ( 1 ): 61 .
毛中英 , 冯虹 , 黄冬梅 , 等 . 盆底仿生物电刺激促进产后子宫复旧效果研究 [J ] . 中国实用妇科与产科杂志 , 2017 , 33 ( 10 ): 1074 ⁃ 1076 .
MAO Z Y , FENG H , HUANG D M , et al . Clinical effect of pelvic floor bionic electrical stimulation in promoting postpartum uterine involution [J ] . Chinese Journal of Practical Gynecology and Obstetrics , 2017 , 33 ( 10 ): 1074 ⁃ 1076 .
XI J , CHENG J , JIN C C , et al . Electroacupuncture improves pregnancy outcomes in rats with thin endometrium by promoting the expression of pinopode⁃related molecules [J ] . Biomed Res Int , 2021 , 4 ( 15 ): 6658321 .
DE VRIES A M , VAN BREDA H M K , FERNANDES J G , et al . Para⁃urethral injections with urolastic for treatment of female stress urinary incontinence: Subjective improvement and safety [J ] . Urol Int , 2017 , 99 ( 1 ): 91 ⁃ 97 .
ALLON E F . The role of neuromuscular electrical stimulation in the rehabilitation of the pelvic floor muscles [J ] . Br J Nurs , 2019 , 28 ( 15 ): 968 ⁃ 974 .
葛伟平 , 楚蔚昕 , 陈龙 , 等 . PHENIX 8仿生物电刺激治疗薄型子宫内膜的临床研究 [J ] . 中国计划生育和妇产科 , 2019 , 11 ( 4 ): 78 ⁃ 81 .
GE W P , CHU W X , CHEN L , et al . Clinical study of PHENIX 8 bioelectric stimulation in the treatment of thin endometrium [J ] . Chinese Jounal of Family Planning & Gynecotokology , 2019 , 11 ( 4 ): 78 ⁃ 81 .
范祎 , 黄柳 , 范瑾 , 等 . 盆底仿生物电刺激治疗薄型子宫内膜的临床研究 [J ] . 中国妇幼保健 , 2016 , 31 ( 10 ): 2215 ⁃ 2216 .
FAN Y , HUANG L , FAN J , et al . Clinical research of pelvic floor biomimetic electrical stimulation in treatment of thin endometrium [J ] . Maternal and Child Health Care of China , 2016 , 31 ( 10 ): 2215 ⁃ 2216 .
李济衡 , 吴翠云 , 冯雪影 , 等 . 仿生物电刺激治疗薄型子宫内膜不孕症的临床研究 [J ] . 中外医学研究 , 2020 , 18 ( 14 ): 114 ⁃ 116 .
LI J H , WU C Y , FENG X Y , et al . Clinical study on the treatment of thin endometrial infertility by biomimetic electrical stimulation [J ] . Chinese and Foreign Medical Research , 2020 , 18 ( 14 ): 114 ⁃ 116 .
刘惠彬 . 盆底神经肌肉电刺激改善薄型子宫内膜患者子宫内膜厚度及血流灌注的研究 [J ] . 中外医学研究 , 2021 , 19 ( 33 ): 146 ⁃ 148 .
LIU H B . Pelvic floor neuromuscular electrical stimulation improves endometrial thickness and blood flow perfusion in patients with thin endometrium [J ] . Chinese and Foreign Medical Research , 2021 , 19 ( 33 ): 146 ⁃ 148 .
赵瑾 , 汤国娟 , 徐琪 , 等 . 经皮穴位电刺激仪对不孕症子宫内膜容受性的影响 [J ] . 中国继续医学教育 , 2019 , 11 ( 13 ): 150 ⁃ 152 .
ZHAO J , TANG G J , XU Q , et al . The effect of tanscutaneous electrical point stimulator on the endometrial receptivity with infertility [J ] . China Continuing Medical Education , 2019 , 11 ( 13 ): 150 ⁃ 152 .
何莹 , 张庆 , 刘盼 , 等 . 仿生物电刺激联合超声"针灸"治疗薄型子宫内膜不孕患者的临床疗效研究 [J ] . 中国实用妇科与产科杂志 , 2021 , 37 ( 12 ): 1254 ⁃ 1258 .
HE Y , ZHANG Q , LIU P , et al . Clinical effect of bionic electrostimulation combined with ultrasonic acupuncture on infertility patients with thin endometrium [J ] . Chinese Journal of Practical Gynecology and Obstetrics , 2021 , 37 ( 12 ): 1254 ⁃ 1258 .
江秋 , 林忠 , 覃晓玲 , 等 . 盆腔炎治疗仪结合低频神经肌肉电刺激对薄型子宫内膜不孕症患者子宫内膜容受性及妊娠结局的影响 [J ] . 中国性科学 , 2024 , 33 ( 3 ): 78 ⁃ 82 .
JIANG Q , LIN Z , QIN X L , et al . Effect of pelvic inflammation therapeutic apparatus combined with low⁃frequency neuromuscular electrical stimulation on endometrial receptivity and pregnancy outcomes in patients with thin endometrium infertility [J ] . Chinese Journal of Human Sexuality , 2024 , 33 ( 3 ): 78 ⁃ 82 .
李婷 , 胡欣欣 , 诸小丽 , 等 . 葛根黑苏汤联合神经肌肉电刺激、戊酸雌二醇治疗薄型子宫内膜不孕症临床研究 [J ] . 新中医 , 2024 , 56 ( 11 ): 90 ⁃ 94 .
LI T , HU X X , ZHU X L , et al . Clinical study on Gegen Heisu decoction combined with neuromuscular electrical stimulation and estradiol valerate for thin endometrial infertility [J ] . New Chinese Medicine , 2024 , 56 ( 11 ): 90 ⁃ 94 .
刘晓丹 , 冯洁玲 , 王嘉敏 , 等 . 盆底神经肌肉电刺激治疗对中重度宫腔粘连术后子宫内膜修复的疗效评估 [J ] . 中山大学学报(医学科学版) , 2022 , 43 ( 1 ): 140 ⁃ 145 .
LIU X D , FENG J L , WANG J M , et al . Effect of pelvic floor neuromuscular electrical stimulation on endometrial repair after the surgery of moderate to severe intrauterine adhesion [J ] . Journal of Sun Yat⁃Sen University(Medical Sciences) , 2022 , 43 ( 1 ): 140 ⁃ 145 .
QU F , LI R , SUN W , et al . Use of electroacupuncture and transcutaneous electrical acupoint stimulation in reproductive medicine: A group consensus [J ] . J Zhejiang Univ Sci B , 2017 , 18 ( 3 ): 186 ⁃ 193 .
张祥 , 张雯碧 . 针刺在治疗卵巢低反应的临床应用进展 [J ] . 国际生殖健康/计划生育杂志 , 2019 , 38 ( 1 ): 59 ⁃ 62 .
ZHANG X , ZHANG W B . Clinical application of acupuncture in treatment of poor ovarian response [J ] . J Int Reprod Health/Fam Plan , 2019 , 38 ( 1 ): 59 ⁃ 62 .
ÇOKSÜER H , BARUT M U , BOZKURT M , et al . Acupuncture enhances chances of pregnancy in unexplained infertile patients who undergo a blastocyst transfer in a fresh⁃cycle [J ] . Chin J Integr Med , 2019 , 25 ( 4 ): 298 ⁃ 302 .
TAGUCHI R , SATO K , ADOMI S , et al . Acupuncture and laser acupuncture as treatments for emotional distress in infertile women in Japan [J ] . Med Acupunct , 2019 , 31 ( 6 ): 372 ⁃ 378 .
HSU Y C , LIANG I T , HUANG S Y , et al . Transcutaneous electrical acupoint stimulation (TEAS) treatment improves pregnancy rate and implantation rate in patients with implantation failure [J ] . Taiwan J Obstet Gynecol , 2017 , 56 ( 5 ): 672 ⁃ 676 .
MOHAMMED W E , ABBAS M M , ABDELAZIM I A , et al . Sildenafil citrate as an adjuvant to clomiphene citrate for ovulation induction in polycystic ovary syndrome: Crossover randomized controlled trial [J ] . Prz Menopauzalny , 2022 , 21 ( 1 ): 20 ⁃ 26 .
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