De Couck Marijke, Nijs Jo, Gidron Yori
*Center for Neuroscience, Faculty of Pharmacy and Medicine †Pain in Motion Research Group, Departments of Human Physiology and Rehabilitation Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussels, Brussels, Belgium.
Clin J Pain. 2014 Dec;30(12):1099-105. doi: 10.1097/AJP.0000000000000071.
Pain is a complex common health problem, with important implications for quality of life and with huge economic consequences. Pain can be elicited due to tissue damage, as well as other multiple factors such as inflammation and oxidative stress. Can there be 1 therapeutic pathway that may target multiple etiologic factors in pain?
In the present article, we review evidence for the relationships between vagal nerve activity and pain, and between vagal nerve activity and 5 factors that are etiologic to or protective in pain.
Vagal nerve activity inhibits inflammation, oxidative stress, and sympathetic activity, activates brain regions that can oppose the brain "pain matrix," and finally it might influence the analgesic effects of opioids. Together, these can explain the antinociceptive effects of vagal nerve activation or of acetylcholine, the principal vagal nerve neurotransmitter. These findings form an evidence-based neurobiological rationale for testing and possibly implementing different vagal nerve-activating treatments in pain conditions.
In this article, we show evidence for the relationships between vagal nerve activity and pain, and between vagal nerve activity and 5 factors that are etiologic to pain. Given the evidence and effects of the vagus nerve activation in pain, people involved in pain therapy may need to seriously consider activation of this nerve.
疼痛是一个复杂的常见健康问题，对生活质量有重要影响，并产生巨大的经济后果。疼痛可由组织损伤引发，也可由炎症和氧化应激等其他多种因素引起。是否存在一种治疗途径可以针对疼痛的多种病因？
在本文中，我们综述了迷走神经活动与疼痛之间以及迷走神经活动与疼痛的5种病因或保护性因素之间关系的证据。
迷走神经活动可抑制炎症、氧化应激和交感神经活动，激活能够对抗大脑“疼痛矩阵”的脑区，最终可能影响阿片类药物的镇痛效果。综合起来，这些可以解释迷走神经激活或迷走神经主要神经递质乙酰胆碱的抗伤害感受作用。这些发现为在疼痛状况下测试并可能实施不同的迷走神经激活治疗提供了基于证据的神经生物学理论依据。
在本文中，我们展示了迷走神经活动与疼痛之间以及迷走神经活动与疼痛的5种病因之间关系的证据。鉴于迷走神经激活在疼痛中的证据和效果，参与疼痛治疗的人员可能需要认真考虑激活这条神经。
