In the framework of physiotherapy, electrophoresis is offered for the treatment of numerous pathologies both in state clinics and in private medical centers. We decided to check if this method has proven scientific effectiveness.
Electrophoresis (aka ionophoresis) is a non -invasive method the introduction of medicines through the skin using electricity. Such a method of healthcare institutions propose to treat diseases of the nervous system (meningitis, meningoencephalitis, encephalitis, encephalopathy, consequences of traumatic brain injuries and cerebrovascular disorders), gastrointestinal tract (gastritis, peptic ulcer, colitis, irritable bowel syndrome), Cardiovascular systems (hypertension, atrial fibrillation, coronary disease), breathing systems (bronchial asthma, pneumonia, chronic obstructive disease of the lungs), Ophthalmological, dental, gynecological and ENT pain, injuries, arthritis, arthrosis and fractures.
Most medicinal drugs - These are weak organic acids or bases that exist in the aquatic environment in non -ionized or ionized forms. The former are usually fat -soluble and therefore easily penetrate through cell membranes, the latter, on the contrary, almost dissolve in fats, but soluble in water, and their charged ions cannot overcome the electric barrier at the boundaries of fabrics. To facilitate this process and offer procedure Electrophoresis - the tissue impregnated with the medicine is placed on the intact area of the skin, and two electrodes are applied on top. When an electric current pass through the electrodes, the voltage between them provides additional potential and ions in the medicine, as expected, gain the ability to penetrate through the skin into the blood and further to the desired organ. In fact, electrodes should work as a springboard that gives substances sufficient acceleration.
However, not any substance is suitable for electrophoresis. Firstly, this procedure is not applicable for “delivery” of non -onized drugs that do not carry ions. The second restriction is the size of the molecule. Than him more, the more difficult the molecule is to overcome the percutaneous barrier. The most difficult thing is to deliver peptides and macromolecules, as well as DNA -based preparations and small interface RNA. At the same time, drugs, the size of the molecule of which can be overcome by the percutaneous barrier without additional acceleration. For example, they work like that Transdermal Plasters - hormonal (with estradiol or testosterone), against motion sickness (with scopolamine), to overcome nicotine dependence and analgesia (with fentanil). Today 15 substances And five combinations drugs are available for transdermal administration. That is, so that the drugs are effective for electrophoresis, they must have a certain size of the molecule (about 1000 longtons).
There are not so many evidence of electrophoresis effectiveness in therapy of various diseases. According to the National Medical Library (USA), its application is precisely as a treatment method justified Only in the case of hyperhidrosis (severe sweating in the area of the palms, soles or armpits). Moreover, to treat this disease in the process of electrophoresis, not a medicine is used, but ordinary water. Presumably, electric current Change The signals of the nervous system that excessively stimulate the sweat glands. Usually, to achieve a pronounced effect, 10-12 sessions are required, then the patient makes procedures less often.
Although electrophoresis is proposed as a variant of therapy for diseases of many internal organs, charged ions of the drugs simply do not have a chance to get to the place of planned effects. This is confirmed Experiments on the development of delivery systems using electrophoresis of highly toxic drugs for the treatment of certain types of cancer. The volunteers conducted appropriate tests for the use of this method in therapy of malignant formations located on the surface of the skin. 25 of 26 patients with basal cell carcinoma and flat -cell cancer who took part in the experiment, went into a persistent remission. In experiments with animals, electrophoresis was used to treat retinoblastoma (neoplasms of the retina), bladder tumors and pancreas. These experiments also showed a significant decrease in the tumor process, but only if the electrodes were placed directly into the affected organ. Otherwise, the concentration of the active substance was not enough even to inhibit the process of dividing pathological cells, not to mention reducing the tumor.
In other words, electrophoresis used in oncology is significantly different from that which is usually offered in clinics and private centers. It is possible that the use of this method in therapy of malignant neoplasms is a new step in the treatment of cancer, but clinical trials are still ongoing.
Electrophoresis is also actively promoted as a means of treating diseases of the musculoskeletal system, in particular with the help of drugs from the class of chondroprotectors. However, they are, firstly, in principle Do not proven effectiveness, and secondly, their molecules are too Great (8000 - 16,000 Dalton) for delivery to the body using electrophoresis. According to Kokrainsky reviews, electrophoresis does not help with pain in neck, in a rotational cuff shoulder Or with adhesive Capsulite (formation of excess scar tissue in the shoulder -bearing joint). As an addition to standard treatment consisting of exercises and cryotherapy, electrophoresis with diclofenac (popular non -steroidal anti -inflammatory drug) did not show effectiveness for tenditis of the shoulder joint compared to placebo. At the same time, electrophoresis with lidocaine and dexamethasone with plantar fascia (inflammation of the connective tissue that supports the arch of the foot) gave The results similar to shock wave therapy-after six weeks of use of any of the two methods, the pain took place. However, taking into account the possible recurrent character Diseases long -term effectiveness of both methods of therapy have not yet been evaluated. A similar technique (electrophoresis with lidocaine and dexamethasone) also facilitated Pain in patients with lateral epicondilitis ("tennis elbow"). Electrophoresis only with lidocaine It turned out Effective in facilitating spastics in patients with cerebral palsy. These data are consistent with the fact that lidocaine, like a stronger fentalist, is good Has sucks Through the skin and has an analgesic effect - more narrowly fired in the case of lidocaine and generalized in the case of opioid fentanyl.
There are also separate evidence of electrophoresis effectiveness in cosmetology. Procedures with vitamin C can Improve the appearance of atrophic scars after acne. However, these data require additional evidence, and the effectiveness of electrophoresis for other cosmetic problems does not have such insufficient evidence.
Thus, electric impulses can really improve the transdermal absorption of some drugs, but for this they must meet certain criteria. At the same time, it is possible to influence the internal organs using this method only by placing the electrodes of the device in the immediate vicinity of the effect of exposure. Therefore, the treatment of internal organs using electrophoresis is currently complicated. With a number of diseases of the musculoskeletal system, it can relieve pain, but not treat. Today, electrophoresis has proven itself exclusively to combat hyperhidrosis. However, animal experiments show that this method of administering the medicine has great potential - for example, in oncology.
Image on the cover: MedClinic
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