Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Science, 100700 Beijing, China.
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, 100700 Beijing, China.
J Affect Disord. 2023 Sep 15;337:37-49. doi: 10.1016/j.jad.2023.05.048. Epub 2023 May 23.
Transcutaneous auricular vagus nerve stimulation (taVNS) is used for treating depression but the efficacy and safety have not been well assessed. This study was conducted to evaluate the efficacy and safety of taVNS in depression.
The retrieval databases included English databases of PubMed, Web of Science, Embase, the Cochrane Library and PsycINFO, and Chinese databases of CNKI, Wanfang, VIP and Sino Med, and the retrieval period was from their inception to November 10, 2022. The clinical trial registers (ClinicalTrials.gov and Chinese Clinical Trial Registry) were also searched. Standardized mean difference and the risk ratio were used as the effect indicator and the effect size was represented by the 95 % confidence interval. Revised Cochrane risk-of-bias tool for randomized trials and the Grades of Recommendation, Assessment, Development and Evaluation system were used to assess the risk of bias and quality of evidence respectively.
Totally, 12 studies of 838 participants were included. taVNS could significantly improve depression and reduce Hamilton Depression Scale scores. Low to very low evidence showed that taVNS had higher response rates than sham-taVMS and comparable response rates compared to antidepressants (ATD) and that taVNS combined with ATD had comparable efficacy to ATD with fewer side effects.
The number of studies in subgroups was small and the evidence quality was low to very low.
taVNS is an effective and safe method for alleviating depression scores and had a comparable response rate to ATD.
经皮耳迷走神经刺激（taVNS）用于治疗抑郁症，但疗效和安全性尚未得到很好的评估。本研究旨在评估 taVNS 治疗抑郁症的疗效和安全性。
检索数据库包括 PubMed、Web of Science、Embase、Cochrane 图书馆和 PsycINFO 的英文数据库，以及中国知网、万方、维普和 Sino Med 的中文数据库，检索时间从建库至 2022 年 11 月 10 日。还检索了临床试验注册库（ClinicalTrials.gov 和中国临床试验注册中心）。标准化均数差和风险比被用作效应指标，效应大小由 95%置信区间表示。修订后的 Cochrane 随机试验偏倚风险工具和推荐、评估、制定和评价系统分别用于评估偏倚风险和证据质量。
共纳入 12 项研究，涉及 838 名参与者。taVNS 可显著改善抑郁症状，降低汉密尔顿抑郁量表评分。低到极低质量证据表明，taVNS 的应答率高于假刺激 taVMS，与抗抑郁药（ATD）相当，taVNS 联合 ATD 的疗效与 ATD 相当，不良反应更少。
亚组研究数量较少，证据质量低到极低。
taVNS 是一种有效且安全的缓解抑郁评分的方法，与 ATD 的应答率相当。
