Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences.
Founding Member of Vagus Nerve Society, Atlantic Beach, FL, USA.
Int J Surg. 2024 Aug 1;110(8):4993-5006. doi: 10.1097/JS9.0000000000001592.
Currently, clinical practice and scientific research mostly revolve around a single disease or system, but the single disease-oriented diagnostic and therapeutic paradigm needs to be revised. This review describes how transcutaneous auricular vagus nerve stimulation (taVNS), a novel non-invasive neuromodulation approach, connects the central and peripheral systems of the body. Through stimulation of the widely distributed vagus nerve from the head to the abdominal cavity, this therapy can improve and treat central system disorders, peripheral system disorders, and central-peripheral comorbidities caused by autonomic dysfunction. In the past, research on taVNS has focused on the treatment of central system disorders by modulating this brain nerve. As the vagus nerve innervates the heart, lungs, liver, pancreas, gastrointestinal tract, spleen and other peripheral organs, taVNS could have an overall modulatory effect on the region of the body where the vagus nerve is widespread. Based on this physiological basis, the authors summarize the existing evidence of the taVNS ability to regulate cardiac function, adiposity, glucose levels, gastrointestinal function, and immune function, among others, to treat peripheral system diseases, and complex diseases with central and peripheral comorbidities. This review shows the successful examples and research progress of taVNS using peripheral neuromodulation mechanisms from more perspectives, demonstrating the expanded scope and value of taVNS to provide new ideas and approaches for holistic therapy from both central and peripheral perspectives.
目前,临床实践和科学研究主要围绕单一疾病或系统展开,但单一疾病导向的诊断和治疗范式需要修正。本篇综述描述了经皮耳迷走神经刺激(taVNS)这一新型非侵入性神经调节方法如何连接身体的中枢和外周系统。通过刺激从头部到腹部广泛分布的迷走神经,这种疗法可以改善和治疗由自主功能障碍引起的中枢系统疾病、外周系统疾病以及中枢-外周共病。过去,taVNS 的研究主要集中在通过调节这条脑神经来治疗中枢系统疾病。由于迷走神经支配着心脏、肺、肝、胰腺、胃肠道、脾脏和其他外周器官,taVNS 可能对迷走神经广泛分布的身体区域产生全面的调节作用。基于这一生理基础,作者总结了现有的 taVNS 调节心脏功能、肥胖、血糖水平、胃肠道功能和免疫功能等方面的证据,以治疗外周系统疾病和具有中枢-外周共病的复杂疾病。本篇综述从更多角度展示了 taVNS 利用外周神经调节机制的成功案例和研究进展,表明 taVNS 的应用范围和价值得到了扩展,为从中枢和外周两个角度进行整体治疗提供了新的思路和方法。