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非侵入性电刺激神经调控技术：镇痛效果与镇痛机制

陈钰昕^1,2, 张立波^1,2, 吕雪靖^1,2, 胡理^1,2,*

¹中国科学院心理健康重点实验室(中国科学院心理研究所)，北京 100101；²中国科学院大学心理学系，北京 100049

摘要

非侵入性电刺激神经调控技术是一种潜力巨大的非药物镇痛手段，具有经济、易操作、安全性高等优点，已被应用于各类临床疼痛的治疗。然而，目前仍缺乏对不同电刺激神经调控技术镇痛特性的深入理解。本文从镇痛效果和镇痛机制两个方面入手，评述非侵入性外周神经电刺激(经皮神经电刺激、经皮迷走神经电刺激)和中枢神经电刺激(经颅直流电刺激、经颅交流电刺激)在镇痛方面的研究结果，总结各技术在缓解急性疼痛和慢性疼痛中常用的刺激参数和其镇痛效果，探讨可能的镇痛机制。最后，本文对比和总结各技术的镇痛特点，讨论了现有研究的若干局限和未来的研究方向。克服这些局限将促进相关技术的临床应用，最终达到帮助患者缓解疼痛的目的，减轻疼痛对患者、其家庭和整个社会带来的健康和经济负担。

关键词： 神经调控; 镇痛; 经皮神经电刺激; 经皮迷走神经电刺激; 经颅直流电刺激; 经颅交流电刺激

分类号：R338;R441.1;Q42

Non-invasive electrical neuromodulation techniques: analgesic effects and neural mechanism

CHEN Yu-Xin^1,2, ZHANG Li-Bo^1,2, LYU Xue-Jing^1,2, HU Li^1,2,*

¹CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China；²Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China

Abstract

As non-pharmaceutical interventions, non-invasive electrical neuromodulation techniques are promising in pain management. With many advantages, such as low costs, high usability, and non-invasiveness, they have been exploited to treat multiple types of clinical pain. Proper use of these techniques requires a comprehensive understanding of how they work. In this article, we reviewed recent studies concerning non-invasive electrical peripheral nerve stimulation (transcutaneous electrical nerve stimulation and transcutaneous vagus/vagal nerve stimulation) as well as electrical central nerve stimulation (transcranial direct current stimulation and transcranial alternating current stimulation). Specifically, we discussed their analgesic effects on acute and chronic pain, and the neural mechanisms thereof. We then contrasted the four kinds of nerve stimulation techniques, pointing out limitations of existing studies and proposing directions for future research. With more extensive and in-depth research to overcome these limitations, we shall witness more clinical applications of non-invasive electrical nerve stimulations to alleviate patients’ pain and ease the crippling medical and economic burden imposed on patients, their families, and the entire society. 

Key words: neuromodulation; analgesia; transcutaneous electrical nerve stimulation; transcutaneous vagus/vagal nerve stimulation; transcranial direct current stimulation; transcranial alternating current stimulation

收稿日期：2020-06-30　　录用日期：2020-09-21

通讯作者：胡理　　E-mail: huli@psych.ac.cn

DOI: 10.13294/j.aps.2020.0093

引用本文：

陈钰昕, 张立波, 吕雪靖, 胡理. 非侵入性电刺激神经调控技术：镇痛效果与镇痛机制[J]. 生理学报 2021; 73 (3): 389-406.

CHEN Yu-Xin, ZHANG Li-Bo, LYU Xue-Jing, HU Li. Non-invasive electrical neuromodulation techniques: analgesic effects and neural mechanism. Acta Physiol Sin 2021; 73 (3): 389-406 (in Chinese with English abstract).