摘要
非侵入性电刺激神经调控技术是一种潜力巨大的非药物镇痛手段,具有经济、易操作、安全性高等优点,已被应用于各类临床疼痛的治疗。然而,目前仍缺乏对不同电刺激神经调控技术镇痛特性的深入理解。本文从镇痛效果和镇痛机制两个方面入手,评述非侵入性外周神经电刺激(经皮神经电刺激、经皮迷走神经电刺激)和中枢神经电刺激(经颅直流电刺激、经颅交流电刺激)在镇痛方面的研究结果,总结各技术在缓解急性疼痛和慢性疼痛中常用的刺激参数和其镇痛效果,探讨可能的镇痛机制。最后,本文对比和总结各技术的镇痛特点,讨论了现有研究的若干局限和未来的研究方向。克服这些局限将促进相关技术的临床应用,最终达到帮助患者缓解疼痛的目的,减轻疼痛对患者、其家庭和整个社会带来的健康和经济负担。
As non-pharmaceutical interventions, non-invasive electrical neuromodulation techniques are promising in pain management.With many advantages, such as low costs, high usability, and non-invasiveness, they have been exploited to treat multiple types of clinical pain.Proper use of these techniques requires a comprehensive understanding of how they work.In this article, we reviewed recent studies concerning non-invasive electrical peripheral nerve stimulation(transcutaneous electrical nerve stimulation and transcutaneous vagus/vagal nerve stimulation) as well as electrical central nerve stimulation(transcranial direct current stimulation and transcranial alternating current stimulation).Specifically, we discussed their analgesic effects on acute and chronic pain, and the neural mechanisms thereof.We then contrasted the four kinds of nerve stimulation techniques, pointing out limitations of existing studies and proposing directions for future research.With more extensive and in-depth research to overcome these limitations, we shall witness more clinical applications of non-invasive electrical nerve stimulations to alleviate patients’ pain and ease the crippling medical and economic burden imposed on patients, their families, and the entire society.
作者
陈钰昕
张立波
吕雪靖
胡理
CHEN Yu-Xin;ZHANG Li-Bo;LYU Xue-Jing;HU Li(CAS Key Laboratory of Mental Health,Institute of Psychology,Chinese Academy of Sciences,Beijing 100101,China;Department of Psychology,University of Chinese Academy of Sciences,Beijing 100049,China)
出处
《生理学报》
CAS
CSCD
北大核心
2021年第3期389-406,共18页
Acta Physiologica Sinica
基金
supported by grants from the National Natural Science Foundation of China (No.32071061, 31822025, 31701000, 31671141)。
关键词
神经调控
镇痛
经皮神经电刺激
经皮迷走神经电刺激
经颅直流电刺激
经颅交流电刺激
neuromodulation
analgesia
transcutaneous electrical nerve stimulation
transcutaneous vagus/vagal nerve stimulation
transcranial direct current stimulation
transcranial alternating current stimulation