电磁疗法治疗慢性创面的基础与临床研究
|
摘要
慢性难愈合创面是一大类长期不愈合或难愈合的组织损伤,发病机制复杂、治疗难度大,目前临床疗效尚有待完善。广义的电磁疗法包括直流电疗法、低频电刺激疗法、电磁场疗法、高频电场疗法、高压电位疗法等,是物理疗法的重要组成部分。本综述阐述了电磁疗法治疗慢性创面的临床效应、安全性及可能的作用机制,电磁疗法具有非侵入性、无明显疼痛及副作用等特点,在加速组织再生修复、促进创面愈合方面具有独特优势,为慢性难愈合创面的治疗提供了新的选择。
Chronic refractory wound is a kind of long-term non healing or tissue injury which is difficult to heal,with the complex pathogenesis,and the treatment is difficult,the current clinical efficacy needs to be improved. Generalized electromagnetic therapy includes direct current therapy,low frequency electric stimulation therapy,electromagnetic field therapy,high frequency electric field therapy,high voltage potential current therapy,and so on,which is an important part of physical therapy. The review summarizes the effects and mechanisms of electromagnetic therapy( EMT) on the wound healing process,analyzes the clinical research evidence, and discusses indications, contraindications, precautions, and safety considerations. Extant literatures suggest that EMT is non-invasive,and has no obvious pain and side side effect. It provides a new choice for the treatment of chronic refractory wounds,which has a unique advantage in accelerating tissue regeneration and repair and promoting wound healing.
Chronic refractory wound is a kind of long-term non healing or tissue injury which is difficult to heal,with the complex pathogenesis,and the treatment is difficult,the current clinical efficacy needs to be improved. Generalized electromagnetic therapy includes direct current therapy,low frequency electric stimulation therapy,electromagnetic field therapy,high frequency electric field therapy,high voltage potential current therapy,and so on,which is an important part of physical therapy. The review summarizes the effects and mechanisms of electromagnetic therapy( EMT) on the wound healing process,analyzes the clinical research evidence, and discusses indications, contraindications, precautions, and safety considerations. Extant literatures suggest that EMT is non-invasive,and has no obvious pain and side side effect. It provides a new choice for the treatment of chronic refractory wounds,which has a unique advantage in accelerating tissue regeneration and repair and promoting wound healing.
引文
1姜玉峰.体表慢性难愈合创面的研究进展[J].感染、炎症、修复,2011,12(1):59-61.
2 Jiang Y,Huang S,Fu X,et al.Epidemiology of chronic cutaneous wounds in China[J].Wound Repair Regen,2011,19(2):181-188.
3 Fu X.Wound Care Study and Translation Application:A Team's Work in China[J].Int J Low Extrem Wounds,2014,13(2):84-87.
4 Heyer K,Augustin M,Protz K,et al.Effectiveness of advanced versus conventional wound dressings on healing of chronic wounds:systematic review and meta-analysis[J].Dermatology,2013,226(2):172-184.
5 付小兵.糖尿病足及其相关慢性难愈合创面的处理[M].2版.北京:人民军医出版社,2013:10-19.
6 Valle MF,Maruthur NM,Wilson LM,et al.Comparative effectiveness of advanced wound dressings for patients with chronic venous leg ulcers:a systematic review[J].Wound Repair Regen,2014,22(2):193-204.
7 Pilla AA.Nonthermal electromagnetic fields:from first messenger to therapeutic applications[J].Electromagn Biol Med,2013,32(2):123-136.
8 Aziz Z,Flemming K.Electromagnetic therapy for treating pressure ulcers[J].Cochrane Database Syst Rev,2012,12:CD002930.
9 Aziz Z,Cullum N,Flemming K.Electromagnetic therapy for treating venous leg ulcers[J].Cochrane Database Syst Rev,2013,2:CD002933.
10 Ramadan A,Elsaidy M,Zyada R.Effect of low-intensity direct current on the healing of chronic wounds:a literature review[J].J Wound Care,2008,17(7):292-296.
11 Gunja NJ,Dujari D,Chen A,et al.Migration responses of outer and inner meniscus cells to applied direct current electric fields[J].J Orthop Res,2012,30(1):103-111.
12 Dube J,Rochette-Drouin O,Levesque P,et al.Human keratinocytes respond to direct current stimulation by increasing intracellular calcium:preferential response of poorly differentiated cells[J].J Cell Physiol,2012,227(6):2660-2667.
13 Mohajeri-Tehrani MR,Nasiripoor F,Torkaman G,et al.Effect of low-intensity direct current on expression of vascular endothelial growth factor and nitric oxide in diabetic foot ulcers[J].J Rehabil Res Dev,2014,51(5):815-824.
14 Talebi G,Torkaman G,Firoozabadi M,et al.Effect of anodal and cathodal microamperage direct current electrical stimulation on injurypotential and wound size in guinea pigs[J].J Rehabil Res Dev,2008,45(1):153-159.
15 Adegoke BO,Badmos KA.Acceleration of pressure ulcer healing in spinal cord injured patients using interrupted direct current[J].Afr J Med Med Sci,2001,30(3):195-197.
16 Adunsky A,Ohry A.Decubitus direct current treatment(DDCT)of pressure ulcers:results of a randomized double-blinded placebo controlled study[J].Arch Gerontol Geriatr,2005,41(3):261-269.
17 Isseroff RR,Dahle SE.Electrical Stimulation Therapy and Wound Healing:Where Are We Now[J].Adv Wound Care(New Rochelle),2012,1(6):238-243.
18 岳海岭,彭代智.电刺激促进创面愈合的研究进展[J].中华烧伤杂志,2006,22(5):394-396.
19 Reid B,Zhao M.The Electrical Response to Injury:Molecular Mechanisms and Wound Healing[J].Adv Wound Care(New Rochelle),2014,3(2):184-201.
20 Polak A,Franek A,Taradaj J.High-Voltage Pulsed Current Electrical Stimulation in Wound Treatment[J].Adv Wound Care(New Rochelle),2014,3(2):104-117.
21 Howe DS,Dunning J,Zorman C,et al.Development of an integrated surface stimulation device for systematic evaluation of wound electrotherapy[J].Ann Biomed Eng,2015,43(2):306-313.
22 Liebano RE,Machado AF.Vascular Endothelial Growth Factor Release Following Electrical Stimulation in Human Subjects[J].Adv Wound Care(New Rochelle),2014,3(2):98-103.
23 梁玲,李新平,白文芳,等.低频电磁场在基因修饰表皮干细胞移植修复创面中的作用[J].中国组织工程研究,2013,17(32):5827-5833.
24 Asadi MR,Torkaman G.Bacterial Inhibition by Electrical Stimulation[J].Adv Wound Care(New Rochelle),2014,3(2):91-97.
25 Magnoni C,Rossi E,Fiorentini C,et al.Electrical stimulation as adjuvant treatment for chronic leg ulcers of different aetiology:an RCT[J].J Wound Care,2013,22(10):525-526,528-533.
26 Herberger K,Debus E,Larena-Avellaneda A,et al.Effectiveness,tolerability,and safety of electrical stimulation of wounds with an electrical stimulation device:results of a retrospective register study[J].Wounds,2012,24(4):76-84.
27 Houghton PE.Clinical Trials Involving Biphasic Pulsed Current,Micro Current,and/or Low-Intensity Direct Current[J].Adv Wound Care(New Rochelle),2014,3(2):166-183.
28 张嵘蓉,林艳冰.短波联合红外线、紫外线治疗糖尿病足的疗效观察[J].江苏医药,2011,37(18):2215-2216.
29 李湘云,邓爱萍,曹小军.紫外线与超短波联合治疗糖尿病足的临床研究[J].卫生职业教育,2010,28(20):144-145.
30 乔鸿飞,段虹昊,张巧俊,等.超短波对糖尿病大鼠创面愈合的影响[J].中国康复,2014,29(5):347-349.
31 柳清,闵好,林海涛,等.中西医结合配合超短波治疗烧伤后残余创面98例[J].中国医药指南,2012,10(28):261-262.
32 Naito Y,Yamaguchi S,Mori Y,et al.A randomized,doubleblind,sham-controlled study of static electric field therapy by high voltage alternating current for active rheumatoid arthritis[J].J Clin Biochem Nutr,2013,53(1):63-67.
33 Kim TH,Cho HY,Lee SM.High-voltage pulsed current stimulation enhances wound healing in diabetic rats by restoring the expression of collagen,alpha-smooth muscle actin,and TGF-beta1[J].Tohoku J Exp Med,2014,234(1):1-6.
34 Pedder VV,Kosenok VK,Belik DV,et al.On the use of photoplasmodynamic method in treatment of suppurative wounds[J].Med Tekh,2008,(3):39-43.
35 Franek A,Kostur R,Polak A,et al.Using high-voltage electrical stimulation in the treatment of recalcitrant pressure ulcers:results of a randomized,controlled clinical study[J].Ostomy Wound Manage,2012,58(3):30-44.
36 Recio AC,Felter CE,Schneider AC,et al.High-voltage electrical stimulation for the management of stage III and IV pressure ulcers among adults with spinal cord injury:demonstration of its utility for recalcitrant wounds below the level of injury[J].J Spinal Cord Med,2012,35(1):58-63.
2 Jiang Y,Huang S,Fu X,et al.Epidemiology of chronic cutaneous wounds in China[J].Wound Repair Regen,2011,19(2):181-188.
3 Fu X.Wound Care Study and Translation Application:A Team's Work in China[J].Int J Low Extrem Wounds,2014,13(2):84-87.
4 Heyer K,Augustin M,Protz K,et al.Effectiveness of advanced versus conventional wound dressings on healing of chronic wounds:systematic review and meta-analysis[J].Dermatology,2013,226(2):172-184.
5 付小兵.糖尿病足及其相关慢性难愈合创面的处理[M].2版.北京:人民军医出版社,2013:10-19.
6 Valle MF,Maruthur NM,Wilson LM,et al.Comparative effectiveness of advanced wound dressings for patients with chronic venous leg ulcers:a systematic review[J].Wound Repair Regen,2014,22(2):193-204.
7 Pilla AA.Nonthermal electromagnetic fields:from first messenger to therapeutic applications[J].Electromagn Biol Med,2013,32(2):123-136.
8 Aziz Z,Flemming K.Electromagnetic therapy for treating pressure ulcers[J].Cochrane Database Syst Rev,2012,12:CD002930.
9 Aziz Z,Cullum N,Flemming K.Electromagnetic therapy for treating venous leg ulcers[J].Cochrane Database Syst Rev,2013,2:CD002933.
10 Ramadan A,Elsaidy M,Zyada R.Effect of low-intensity direct current on the healing of chronic wounds:a literature review[J].J Wound Care,2008,17(7):292-296.
11 Gunja NJ,Dujari D,Chen A,et al.Migration responses of outer and inner meniscus cells to applied direct current electric fields[J].J Orthop Res,2012,30(1):103-111.
12 Dube J,Rochette-Drouin O,Levesque P,et al.Human keratinocytes respond to direct current stimulation by increasing intracellular calcium:preferential response of poorly differentiated cells[J].J Cell Physiol,2012,227(6):2660-2667.
13 Mohajeri-Tehrani MR,Nasiripoor F,Torkaman G,et al.Effect of low-intensity direct current on expression of vascular endothelial growth factor and nitric oxide in diabetic foot ulcers[J].J Rehabil Res Dev,2014,51(5):815-824.
14 Talebi G,Torkaman G,Firoozabadi M,et al.Effect of anodal and cathodal microamperage direct current electrical stimulation on injurypotential and wound size in guinea pigs[J].J Rehabil Res Dev,2008,45(1):153-159.
15 Adegoke BO,Badmos KA.Acceleration of pressure ulcer healing in spinal cord injured patients using interrupted direct current[J].Afr J Med Med Sci,2001,30(3):195-197.
16 Adunsky A,Ohry A.Decubitus direct current treatment(DDCT)of pressure ulcers:results of a randomized double-blinded placebo controlled study[J].Arch Gerontol Geriatr,2005,41(3):261-269.
17 Isseroff RR,Dahle SE.Electrical Stimulation Therapy and Wound Healing:Where Are We Now[J].Adv Wound Care(New Rochelle),2012,1(6):238-243.
18 岳海岭,彭代智.电刺激促进创面愈合的研究进展[J].中华烧伤杂志,2006,22(5):394-396.
19 Reid B,Zhao M.The Electrical Response to Injury:Molecular Mechanisms and Wound Healing[J].Adv Wound Care(New Rochelle),2014,3(2):184-201.
20 Polak A,Franek A,Taradaj J.High-Voltage Pulsed Current Electrical Stimulation in Wound Treatment[J].Adv Wound Care(New Rochelle),2014,3(2):104-117.
21 Howe DS,Dunning J,Zorman C,et al.Development of an integrated surface stimulation device for systematic evaluation of wound electrotherapy[J].Ann Biomed Eng,2015,43(2):306-313.
22 Liebano RE,Machado AF.Vascular Endothelial Growth Factor Release Following Electrical Stimulation in Human Subjects[J].Adv Wound Care(New Rochelle),2014,3(2):98-103.
23 梁玲,李新平,白文芳,等.低频电磁场在基因修饰表皮干细胞移植修复创面中的作用[J].中国组织工程研究,2013,17(32):5827-5833.
24 Asadi MR,Torkaman G.Bacterial Inhibition by Electrical Stimulation[J].Adv Wound Care(New Rochelle),2014,3(2):91-97.
25 Magnoni C,Rossi E,Fiorentini C,et al.Electrical stimulation as adjuvant treatment for chronic leg ulcers of different aetiology:an RCT[J].J Wound Care,2013,22(10):525-526,528-533.
26 Herberger K,Debus E,Larena-Avellaneda A,et al.Effectiveness,tolerability,and safety of electrical stimulation of wounds with an electrical stimulation device:results of a retrospective register study[J].Wounds,2012,24(4):76-84.
27 Houghton PE.Clinical Trials Involving Biphasic Pulsed Current,Micro Current,and/or Low-Intensity Direct Current[J].Adv Wound Care(New Rochelle),2014,3(2):166-183.
28 张嵘蓉,林艳冰.短波联合红外线、紫外线治疗糖尿病足的疗效观察[J].江苏医药,2011,37(18):2215-2216.
29 李湘云,邓爱萍,曹小军.紫外线与超短波联合治疗糖尿病足的临床研究[J].卫生职业教育,2010,28(20):144-145.
30 乔鸿飞,段虹昊,张巧俊,等.超短波对糖尿病大鼠创面愈合的影响[J].中国康复,2014,29(5):347-349.
31 柳清,闵好,林海涛,等.中西医结合配合超短波治疗烧伤后残余创面98例[J].中国医药指南,2012,10(28):261-262.
32 Naito Y,Yamaguchi S,Mori Y,et al.A randomized,doubleblind,sham-controlled study of static electric field therapy by high voltage alternating current for active rheumatoid arthritis[J].J Clin Biochem Nutr,2013,53(1):63-67.
33 Kim TH,Cho HY,Lee SM.High-voltage pulsed current stimulation enhances wound healing in diabetic rats by restoring the expression of collagen,alpha-smooth muscle actin,and TGF-beta1[J].Tohoku J Exp Med,2014,234(1):1-6.
34 Pedder VV,Kosenok VK,Belik DV,et al.On the use of photoplasmodynamic method in treatment of suppurative wounds[J].Med Tekh,2008,(3):39-43.
35 Franek A,Kostur R,Polak A,et al.Using high-voltage electrical stimulation in the treatment of recalcitrant pressure ulcers:results of a randomized,controlled clinical study[J].Ostomy Wound Manage,2012,58(3):30-44.
36 Recio AC,Felter CE,Schneider AC,et al.High-voltage electrical stimulation for the management of stage III and IV pressure ulcers among adults with spinal cord injury:demonstration of its utility for recalcitrant wounds below the level of injury[J].J Spinal Cord Med,2012,35(1):58-63.