我们的目的是进行系统回顾和荟萃分析，评估各种 VNS 方法的抗炎作用，同时探索多种抗炎途径。我们纳入了截至 2022 年 10 月使用迷走神经电刺激并评估炎症标志物的临床试验。我们排除了缺乏相关研究的研究对照组、联合干预组或没有全文的摘要。我们遵守系统评价和荟萃分析指南的首选报告项目以及系统评价的 Cochrane 手册。对于每种炎症标志物，使用逆方差法进行随机效应荟萃分析。使用的方法包括经皮耳廓 VNS (taVNS)、经皮颈椎 VNS (tcVNS)、侵入性颈椎 VNS (iVNS) 和电针 VNS (eaVNS)。主要报告的结果包括肿瘤坏死因子 (TNF)-α、白细胞介素 (IL)-6、IL-1ß、C 反应蛋白 (CRP) 和 IL-10。使用 Cochrane 协作工具 (RoB 2.0) 评估偏倚风险。该综述包括 15 项研究，涉及 597 名患者。没有观察到对 TNF-α、IL-6 和 IL-1ß 具有统计学意义的一般 VNS 效应。然而，在所有方法中，CRP、IL-10 和干扰素 (IFN)-γ 均受到 VNS 的显着调节。亚组分析揭示了特定的刺激技术产生了显着的结果，例如 taVNS 对 IL-1ß 和 IL-10 的影响，以及 iVNS 对 IL-6 的影响，而 tcVNS 和 eAVNS 并没有单独传达显着的汇总结果。在我们的荟萃回归模型中，VNS 的累积暴露、较高的偏倚风险、研究设计和脉冲宽度被确定为效应大小预测因子。汇集所有 VNS 技术表明 VNS 能够调节炎症标志物，例如 CRP、IL-10、和干扰素-γ。单独而言，taVNS 等方法可有效调节 IL-1ß 和 IL-10，而 iVNS 则可调节 IL-6。然而，不同的 VNS 技术应在更大规模、同质且有力的研究中单独分析，以便更清楚、更一致地了解每种 VNS 方法对炎症系统的影响。版权所有 © 2024 国际神经调节协会。由爱思唯尔公司出版。保留所有权利。

We aimed to conduct a systematic review and meta-analysis assessing the antiinflammatory effects of various VNS methods while exploring multiple antiinflammatory pathways.We included clinical trials that used electrical stimulation of the vagus nerve and assessed inflammatory markers up to October 2022. We excluded studies lacking control groups, those with combined interventions, or abstracts without full text. We adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews. For each inflammatory marker, a random-effects meta-analysis using the inverse variance method was performed. Methods used include transcutaneous auricular VNS (taVNS), transcutaneous cervical VNS (tcVNS), invasive cervical VNS (iVNS), and electroacupuncture VNS (eaVNS). Main reported outcomes included tumor necrosis factor (TNF)-α, interleukin (IL)-6, IL-1ß, C-reactive protein (CRP), and IL-10. Risk of bias was evaluated using the Cochrane Collaboration Tool (RoB 2.0).This review included 15 studies, involving 597 patients. No statistically significant general VNS effect was observed on TNF-α, IL-6, and IL-1ß. However, CRP, IL-10, and interferon (IFN)-γ were significantly modulated by VNS across all methods. Subgroup analysis revealed specific stimulation techniques producing significant results, such as taVNS effects in IL-1ß and IL-10, and iVNS in IL-6, whereas tcVNS and eaVNS did not convey significant pooled results individually. Cumulative exposure to VNS, higher risk of bias, study design, and pulse width were identified as effect size predictors in our meta-regression models.Pooling all VNS techniques indicated the ability of VNS to modulate inflammatory markers such as CRP, IL-10, and IFN-γ. Individually, methods such as taVNS were effective in modulating IL-1ß and IL-10, whereas iVNS modulated IL-6. However, different VNS techniques should be separately analyzed in larger, homogeneous, and powerful studies to achieve a clearer and more consistent understanding of the effect of each VNS method on the inflammatory system.Copyright © 2024 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.