염증성 장 질환에서 전침을 중심으로 한 미주신경자극에 대한 고찰

Minjeong Kim, Dongwon Kim, Chae-Hoon Park, Jae-Woo Park, Seokhyeon Ko
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Abstract

Inflammatory bowel disease (IBD) is defined as a chronic inflammatory-mediated disease that causes ulceration and inflammation in the gastrointestinal tract. Among most patients, the course of chronic inflammation repeatedly shows intermittent exacerbations and alternating remissions. However, despite the various therapeutic options to relieve symptoms, such as corticosteroids, TNF-α inhibitors, and antibiotic drugs, there is no known cure for IBD. Nonetheless, previous research has revealed that the autonomic nervous system is involved in the pathophysiology of IBD. In this study, we reviewed clinical trials confirming the therapeutic effect of vagus nerve stimulation (VNS) on IBD in vivo. We searched in vivo and human studies on Pubmed using keywords combined with “vagus nerve stimulation”, “VNS”, and “inflammatory bowel disease”. All studies included in this review reported that direct VNS is effective in relieving symptoms of IBD and has no severe adverse effects. The most frequently stimulated site was the unilateral cervical vagus nerve area, and parameters for stimulation were set as 5-20 Hz. Based on the results, we aim to summarize the evidence for the efficacy of VNS on IBD and suggest the possibility of auricular electroacupuncture treatment as a therapeutic option for IBD.
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对炎症性肠疾患中以电针为中心的迷走神经刺激的考察
炎症性肠病(IBD)被定义为一种慢性炎症介导的疾病,引起胃肠道溃疡和炎症。在大多数患者中,慢性炎症的病程反复表现为间歇性加重和交替缓解。然而,尽管有多种缓解症状的治疗选择,如皮质类固醇、TNF-α抑制剂和抗生素药物,但目前还没有已知的治愈IBD的方法。尽管如此,先前的研究表明自主神经系统参与了IBD的病理生理。在本研究中,我们回顾了证实迷走神经刺激(VNS)治疗IBD的体内临床试验。我们结合关键词“迷走神经刺激”、“VNS”和“炎症性肠病”,检索Pubmed的体内和人体研究。本综述纳入的所有研究均报道直接VNS可有效缓解IBD症状,且无严重不良反应。刺激频率最高的部位为单侧颈迷走神经区,刺激参数设置为5 ~ 20 Hz。基于这些结果,我们旨在总结VNS对IBD疗效的证据,并提出耳穴电针治疗IBD的可能性。
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