口干燥症的神经电刺激治疗

Nerve electrical stimulation treatment of xerostomia

口干燥症相关生活质量受损的患者需要长期治疗,神经刺激器通过电刺激相关分泌神经促进唾液分泌,具备提供天然唾液和对口干燥症患者长期管理的优势。多项临床试验初步证明了神经电刺激治疗口干燥症的疗效,然而,电刺激治疗至今未成为口干燥症的主流治疗方式,仍需要进行大规模的前瞻性随机对照临床试验以证实其长期有效性及安全性。另外,神经刺激器的设计对于临床推广具有重要意义。口外神经刺激器及第一代口内神经刺激器由于体积庞大,治疗不便,阻碍了临床的应用推广;第二代及第三代口内神经刺激器装置小巧,使用便捷,具有巨大应用前景。治疗口干燥症的神经刺激器的研发主要集中在欧美国家,国内研究甚少,亟需掌握神经刺激器研发的核心技术。小型化、高效供电、数据回馈以及封装方面的创新将是唾液电刺激设备未来研发的关键问题。本文对口干燥症的神经电刺激治疗方式及其研究进展进行综述,以期为我国基于口干燥症患者治疗的神经刺激器研发、临床转化应用及相关基础研究提供参考。

Patients with impaired quality of life associated with xerostomia need long-term treatment,and a nerve stimulator has the advantage of providing natural saliva and long-term management for patients with xerostomia by electrically stimulating the relevant secretory nerves to promote saliva production.A number of clinical trials have preliminarily demonstrated the efficacy of nerve electrical stimulation in the treatment of xerostomia.However,electrical stimulation has not yet become the mainstream treatment for xerostomia.Large prospective randomized controlled clinical trials are still needed to confirm its long-term effectiveness and safety.In addition,the design of nerve stimulators is of great significance for clinical application.The large volume and inconvenient treatment associated with the extra oral nerve stimulator and the first generation intraoral nerve stimulator hinder their clinical application and popularization.The second-and third-generation intraoral nerve stimulator devices are small,convenient to use and have great application prospects.Research on electrical nerve stimulators for xerostomia treatment is mainly concentrated in European and American countries,while there is very little domestic research.It is urgent to master the core technology for the research and development of electrical nerve stimulators.The innovation of miniaturization,efficient power supply,data feedback and packaging will be the key issues of electrical nerve stimulators in the future.In this paper,the treatment and research of electrical nerve stimulation for xerostomia are reviewed to provide a reference for related basic research and the clinical application of electrical stimulators treating xerostomia in China.