da Silva Marco Antonio Helio, Dorsher Peter T
1 Fluminense Federal University , Rio de Janeiro, Brazil .
J Altern Complement Med. 2014 Apr;20(4):233-40. doi: 10.1089/acm.2012.1022. Epub 2013 Dec 20.
The use of surgically implanted electronic devices for vagus nerve stimulation (VNS) is expanding in contemporary allopathic medical practice as a treatment option for selected clinical conditions, such as epilepsy, depression, tremor, and pain conditions, that are unresponsive to standard pharmacologic interventions. Although VNS device surgeries are considered minimally invasive, they are costly and have surgical and device-related risks; they can also cause serious adverse effects from excessive vagus nerve stimulation.
For millennia, acupuncturists have treated those same clinical conditions by piquering acupoints that are located proximate to the sternocleidomastoid muscle site where the VNS device is implanted on the vagus nerve. The hypothesis of this study is that these acupuncture points produce clinical benefits through stimulation of the vagus nerve and/or its branches in the head and neck region.
By using reference anatomic and acupuncture texts, classical and extraordinary acupoints in the head and neck region were identified that are anatomically proximate to vagus nerve pathways there, where the VNS electrode is surgically implanted. The clinical indications of these acupuncture points, as described in the acupuncture reference texts, were examined for similarities to those of VNS.
This analysis demonstrated marked correspondences of the indications for those lateral head and neck acupoints to the clinical effects (beneficial and adverse) documented for the VNS device in the medical literature. This clinical correspondence, in conjunction with the anatomic proximity of the acupoints to the vagus nerve in the lateral neck, strongly suggests that vagus nerve (and hence the autonomic nervous system) stimulation is fundamental in producing the clinical effects of the acupoints.
By having anatomic access to the vagus nerve and parasympathetic chain that permits electrical stimulation of those nerves in clinical practice, acupuncture may offer a less costly and safer alternative to implanted VNS devices for treating medically refractory epilepsy, tremor, depression, and pain conditions.
在当代对抗疗法医学实践中，手术植入电子设备进行迷走神经刺激（VNS）作为一种治疗选择，正用于某些对标准药物干预无反应的临床病症，如癫痫、抑郁症、震颤和疼痛病症。尽管VNS设备手术被认为是微创的，但它们成本高昂，存在手术及与设备相关的风险；过度的迷走神经刺激还会导致严重的不良反应。
数千年来，针灸师通过针刺位于胸锁乳突肌部位附近的穴位来治疗相同的临床病症，而VNS设备正是植入迷走神经的该部位。本研究的假设是，这些穴位通过刺激迷走神经及其在头颈部区域的分支产生临床益处。
通过参考解剖学和针灸文献，确定头颈部区域在解剖位置上与迷走神经通路接近的经典穴位和经外奇穴，而VNS电极正是手术植入于此。对照针灸参考文献中描述的这些穴位的临床适应症，检查其与VNS适应症的相似性。
该分析表明，那些头颈部外侧穴位的适应症与医学文献中记录的VNS设备的临床效果（有益和有害）有显著对应关系。这种临床对应关系，再加上穴位在颈部外侧与迷走神经的解剖学接近性，强烈表明迷走神经（进而自主神经系统）刺激是产生穴位临床效果的根本原因。
通过在临床实践中能够在解剖学上接触到迷走神经和副交感神经链以实现对这些神经的电刺激，针灸可能为治疗药物难治性癫痫、震颤、抑郁症和疼痛病症提供一种成本更低且更安全的替代植入式VNS设备的方法。
