卵磷脂注射溶脂的实验研究
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摘要
研究背景：随着年纪的增长,各种原因引起的脂肪堆积,面部脂肪随眶隔松弛膨出体表、脂肪萎缩等已经成为人们面部衰老重要成因。有很多种操作能够改善脂肪组织变形：吸脂消除脂肪堆积、射频热处理移位的脂肪(譬如眼袋)、自体脂肪填充解决面部凹陷以及新兴的中胚层药物注射到脂肪层进行局部溶解脂肪的方法。各式各样的方法针对脂肪的不同问题进行操作,以达到在视觉上延缓衰老保持年轻态的目的。传统吸脂技术的应用和近年从国外引进的中胚层疗法减肥,已经成为减肥行业中两种最主要的方法,也正因其各自的特色吸引着国内整形美容医师们的眼球。
如何对脂肪进行雕刻的不同方法进行选择,在整形外科领域已经成为整形美容外科医生们要解决的新生问题。随着国内学术界“中胚层疗法”这个名词的引入和业内人士对其了解的逐渐加深,其中溶脂和中胚层疗法的提法、内涵及其安全性和有效性；以及关于"Mesotherapy"词义及其汉译的商榷；溶脂方法所用的医疗设备和化学合成药品是否需要医疗相关机构的合法认证等问题在人们脑海中确实缺乏确定的答案。塑造完美体型是整形美容外科重要的组成部分,其中吸脂技术已经是临床上运用微创方法减肥并得到了广泛应用的一种手术方法。而目前国内又从国外引进一种新型技术,即中胚层疗法注射溶脂给人们提供了另一种似乎可行的方式——无创方法进行形体上的雕刻以达到良好的效果。前者安全性已经是可以肯定的,而后者的安全性是值得探讨的。卵磷脂注射溶脂已在国外广泛应用于临床,改善局部脂肪分布情况,以注射为主,临床并发症较少,但只是习惯用法。本次试验仅就溶脂中胚层疗法中的一个热点——即卵磷脂溶脂的实验研究进行探讨。
某种曾被广泛应用的注射隆胸药物在国内已经被大量案例证明不具有安全性；而国外关于中胚层应用于注射美容的报道与日俱增,并且有国外专家在国内不断地举办卵磷脂注射溶脂学习班：与此同时在一些医疗整形机构和美容院引进各种所谓国外药物注射赚取丰厚利润,在国内消费者心目中整形美容消费已深入人心,不仅仅是女士进行整形,而且男士也开始对不开刀不流血注射美容趋之若骛。综上所述,“卵磷脂注射溶脂的安全性”理所当然的成为我们整形医生热切想研究的课题。
卵磷脂：(lecithin)又称大豆卵磷脂,磷脂酰胆碱(PC),通常产品为白色蜡状物固体,极易吸潮,但难溶于水。磷脂酰胆碱同脂肪代谢密切相关。1996年9月在布鲁塞尔召开的第七届卵磷脂国际会议上,医药学家和营养学专家们研讨证实,卵磷脂(大豆磷脂)作为营养品,在增进健康及预防疾病方面所起到的重要的作用。早已赢得了世界营养专家、药物学家和医学家的普遍认同。卵磷脂作为一种功能性的健康食品,虽然不是立即见效,但有着全面、长远、稳定的效果,同时又没有药物的副作用,因此医学家们本着其特性,经过大量的研究表明,其对以下疾病的预防都有非常好的作用。
脱氧胆酸：(脱氧胆酸钠;deoxycholic acid)一种C-7上缺羟基的胆汁酸,是胆酸失去一个氧原子衍生而得的一种游离胆汁酸,在胆汁中主要以牛磺酸、甘氨酸结合形式存在。由胆酸氧化而成。具有促进胆汁分泌抗发炎作用。此处作为卵磷脂的溶剂存在,使之成为水溶性物质,便于注射和组织吸收。
目的：通过实验研究,对卵磷脂溶脂效果、安全性、药物成分特异性及对药物组合,分为三部分进行初步研究,结合临床应用进行初步探讨。
方法
实验一通过对两种不同动物皮下注射卵磷脂注射液,在脂肪外观上,观察不同动物脂肪对同一种药物的有效性。新西兰白兔和昆明小鼠各10只,脂肪分布集中的部位分别为颈背后和腹股沟脂肪。
实验二：卵磷脂卵磷脂(PC)注射液(以脱氧胆酸(DC)为溶剂)由北京知麟堂生物科技发展有限公司提供的美塑产品。动物分组：40日龄昆明小鼠雌性40只(由广东省医学实验动物中心提供),体重(22.080±3.032)g,分箱用小鼠专用饲料喂养,每组昆明小鼠饮用食水进行等量控制。随机将动物分为两组,每组20只：①实验组,②空白对照组。
实验具体方法：实验组：每5d进行一次注射。在实验组完成5个注射疗程完成后进行集中取材；进行脂肪重量对比观察。取材方法：小鼠注射药物的腹股沟一侧,单侧进行脂肪全部摘除,在生理盐水中进行清洗待称量。腹股沟脂肪重量称量。每组标本切取后,在光学高倍显微镜下观察微观组织变化情况。对各器官(肝、肾、骨骼肌及脂肪组织)取材进行组织切片染色。并且进行小鼠进食活动观察。
实验三：卵磷脂注射组和脱氧胆酸注射组,40日龄昆明小鼠雌性40只(由哈尔滨医科大学基础医学部动物实验中心提供),随机分为两组,每组20只：①卵磷脂实验组②脱氧胆酸实验组。实验具体方法同实验二。
结果
实验一大体观察,磷酸卵磷脂在两种不同动物的脂肪都有明显的溶解作用。无论是新西兰白兔的后颈部X形脂肪,还是昆明小鼠的腹股沟脂肪,都在体积上有明显的缩小。对大白兔X形脂肪长度进行统计学分析,说明具有统计学意义。注射药物对脂肪体积有意义。
实验二卵磷脂对脂肪的溶解作用较明显,但缺乏明显的特异性。肉眼观察：皮下注射组皮下脂肪较空白未注射侧脂肪组织明显减少,肌肉组织色泽稍暗淡,失去正常光泽。组织学观察：肌肉组织极个别肌纤维溶解断裂(图2-1)。脂肪细胞细胞壁通透性发生改变,脂滴溢出细胞发生一系列变化：细胞壁厚度不同部位相差较大,脂肪细胞破裂相互溶解成大小不等、形状不规则的空泡,空泡内外均可见成纤维细胞、吞噬脂滴的巨噬细胞和上皮样细胞增生,以及单核细胞和淋巴细胞浸润(图2-2)。肝、肾组织均存在水样变性产生和消失的组织变化,肝肾局部有生理性充血。
实验三卵磷脂组结果主要表现为：对肌肉纤维的溶解破坏作用卵磷脂和脱氧胆酸都具有,见图3-1和图3-4：对脂类代谢的影响作用,二者也均存在这样的作用,见图3-2、3-3、3-5和3-6。肝肾组织均存在空泡变。以脱氧胆酸对组织的损害更为严重见表3-1。
结论：
卵磷脂对促进脂肪溶解方面确实有作用。脂肪细胞细胞壁发生溶解,同一细胞细胞壁的不同部位厚薄不匀,破裂的细胞相互溶解形成大小不等、形态不规则的空泡。单纯卵磷脂和脱氧胆酸的大量注射仍然对肝、肾和肌肉组织破坏较大,而且发现市场上购买的卵磷脂和脱氧胆酸对脂类代谢和肌肉组织的溶解作用均有作用,按照一定比例配比之后的科学配方对组织损害较为轻微。
卵磷脂对脂肪溶解并非有严格的组织特异性,对肌肉、肝、肾等都存在损害,虽然比例不一的药物对组织损害程度不同,但仍建议临床医生持谨慎态度进行操作,尤其是严格把握卵磷脂的应用范围：板样脂肪的中层适量注射。
因其对肌肉有溶解作用,所以不适于应用于肌肉神经血管分布较为复杂的面部,仅适用于板样脂肪的中层注射。因其对肝肾有损害,所以不适用一次应用过多剂量,应少量多次进行注射,给机体一个代谢吸收的过程才能体现出卵磷脂溶解脂肪又损伤小的特点。因其卵磷脂亲油性特点,所以它的应用必须有适当的溶剂使其溶解于水中,否则不易于组织吸收。
Background
With the growth of age, fat accumulation, facial fat shift, fat atrophy, which are caused by a variety of reasons, become important factors in facial aging. There are many operations that can improve the adipose tissue deformation, liposuction to eliminate fat accumulation; Radiofrequency heat shift of fat(instance:baggy eyelids plasty); Facial depression filled with autologous fat and the emerging "Mesotherapy" for fat-dissolving--the use of drugs injected into the fatty layer.
A variety of methods for the operation of the fat different issues have been applied to achieve the goal of being young again. Traditional liposuction and the Mesotherapy imported from abroad, have become the two most important methods in weight-loss, and attracted all of the domestic doctors of plastic surgery because of their respective characteristics.
How to choose the different approaches to carve fat has become an emerging issue that need to be solved by cosmetic plastic surgeon. With the introduction of the term of "Mesotherapy" in domestic academic and the gradually increasing understanding of the term, lots of questions without definitive answers have raised, such as how to translate "Mesotherapy"; the safety and validity of Mesotherapy;whether the dissolving fat method of medical equipment and chemicals used in synthetic drugs need to be verified by medical-related institution. Perfect Body shaping is an important component of cosmetic surgery, in this field liposuction technique is a clinical use of minimally invasive method to lose weight and has been widely applied. Recently a new method, Mesotherapy, imported from abroad used into fat-dissolving has offered us another way which makes it possible to engrave on the body using non-invasive method in order to achieve good results. The security of the application of the liposuction technique is sure, while the security of the application of Mesotherapy is worth exploring. The lecithin is widely used as an experienced therapy in foreign countries, improving local fat distribution by injection with fewer clinical complications. Lecithin for fat-dissolving is the key in the mesotherapy, so it is the research object in my study.
Nowadays, some drugs breast augmentation have been widely used in injection for breast augmentation, a large number of cases have proven they do not have the security; the number of mesotherapy on the foreign reports is increasing; Injection of fat soluble lecithin has been organized in domestic classes continuously by some foreign experts. At the same time, some medical plastic hospitals and beauty parlours are introducing various foreign injection of drugs to make huge profits; in the eyes of domestic consumers consumption of plastic surgery has become firmly rooted, not only women but also men began to start a bloodless non-surgical cosmetic injections rush. To sum up, the safety of the lecithin for fat-dissolving, it's taken for granted as we orthopedic doctors eager to study.
Lecithin also known as soy lecithin, or phosphatidycholine(PC) is a white waxy material which is usually solid, easy to absorb moisture, but is insoluble in water. Phosphatidylcholine is closely related with the metabolism of fat. In September 1996 in the seventh international conference on lecithin held in Brussels, medicine and nutrition experts have confirmed that lecithin (soybean phospholipid) as a nutrition, played an important role in improving health and preventing disease. It has already won the world nutrition experts, pharmaceutical scientists and physicians of the generally recognized. Lecithin as a functional health food does not show immediate results, but show a comprehensive, long-term, stable effect without side effects of drugs. Therefore, physicians are interested in its characteristics, and a large number of studies have shown that their following diseases have a very good role in prevention.
Deoxycholic acid (DC), on the lack of a C-7-hydroxy bile acids, loss of oxygen atom is derived from bile acid derived from a kind of free bile acid, mainly in the bile of taurine, glycine binding form by acid oxidation. DC has the promotion of bile secretion of anti-inflammatory effects. DC, as a lecithin solvent, makes PC easy to injection of water-soluble substance and organization to absorb.
Objective:To make a preliminary study on the effects, safety, medicines specificity and combinations of lecithin during its introduction for fat dissolving in clinic applications.
Methods:
Experiment 1:Two different kinds of animals were selected:10 New Zealand white rabbits and 10 Kunming mice of 10. The fat of those animals concentrates behind the neck and groin. Then subcutaneous injection of lecithin was prepared in the fat appearance, the effects of different animal fats on the same effectiveness of a drug. New Zealand white rabbits and Kunming mice of 10, the site of fat distribution concentrated behind the neck and groin, respectively fat
Experiment 2:Lecithin Lecithin (PC) injection (in order to deoxycholic acid (DC) as the solvent) from Beijing Tong Zhi-lin Biotechnology Development Co., Ltd products. Animal groups:40-day-old female Kunming mice,40 (by the Guangdong Medical Experimental Animal Center), weight (22.080±3.032) g Sub-boxes using mouse-specific feed, feeding, each group of Kunming mice drinking water equivalent control. Animals were randomly divided into two groups of 20:①the experimental group,②blank control group.
Experimental specific methods:the experimental group:Every once 5d injection. In the experimental group completed five courses upon completion of injection of concentrated death, compared to observation the fat mass. Drawn Methods:the unilateral conduct of fat at the groin side with drugs of the mice was all removed, cleaned in the saline wash to be weighed. Inguinal fat weight weighing, accuracy of 0.001g.Each specimen was cut, and then observed under high power microscope to detent the microstructure change of various organs (liver, kidney, skeletal muscle and adipose tissue) derived for staining tissue sections. And actions about observation of mice eating were carried out.
Experiment 3:40 40-day-old female Kunming mice(from the Department of Basic Medicine, Harbin Medical University Experimental Animal Center), were randomly divided into two groups of 20:①Lecithin experimental group②Deoxycholate experimental group. Injection of phosphatidylcholine and deoxycholate was applied to the two groups; Experimental Methods were the same as those in experiment 2.
Results:
Experiment 1:Based on the visual observation point of view, phosphoric acid lecithin of fat in two different animals has clear dissolved. Both X-shaped fat in the New Zealand rabbit's neck and the fat in the groin of Kunming mice were significantly reduced on the volume.
Experiment 2:Dissolution of lecithin on the fat than the obvious, but the lack of apparent specificity. Visual observation:subcutaneous injection of subcutaneous fat than the group without injection of the blank side of adipose tissue decreased significantly. Muscle tissue color and slightly dim, loss of normal luster. Histological observation:very few muscle fibers dissolved fracture(Figure 2-1). Fat cells of the cell wall permeability change, Lipid droplets overflow cells a series of changes:The cell wall thickness of different parts was different, rupture of fat cells dissolve into each other in size, irregularly shaped vacuoles. Inside and outside the vacuoles, there are several kinds of cells:fibroblasts, lipid droplets engulfed by macrophages and epithelial-like cell proliferation, as well as monocytes and lymphocytes infiltration (Figure 2-2). The disappearance of organizational change of the degeneration of water and organizational congestion occurring in the liver, kidney.
Experiment 3:Lecithin group mainly as a result as follows:Lecithin, and deoxycholic acid both have the dissolution of the destructive effects of muscle fiber, figure 3-1 and Figure 3-4;as well as the role of lipid metabolism, figure 3-2,3-3,3-5 and 3-6. Vacuolization exists in liver and kidney. The Deoxycholate-breaking will be the role of more serious, table 3-1.
Conclusion:
Lecithin dissolved in the promotion of fat does play a role. Fat cells are dissolved at the cell walls, the cells wall thickness of the same cells is uneven, and in broken cells, the mutual dissolution of size, shape irregular vacuoles form. Pure injection of lecithin and deoxycholate are destructive on the liver, kidney and muscle tissue, and either has the effect on both of the lipid metabolism and muscle tissue. After a certain percentage of the ratio, scientific formula has a smaller damage for tissue.
Lecithin for fat-dissolving is not strict tissue-specific, damaged the muscles, liver and kidney. Although the proportion of different drugs on the tissue damage in varying degrees, it is recommended that clinicians be cautious to operate. In particular, strictly control the scope of application of lecithin:mid-level amount of fat injections into the middle of plate-like fat
Because of dissolution of the muscles, it's not suitable for the face in which there are more complex distribution of neuromuscular facial blood vessels, applies only to the middle plate-like fat injections. There is terrible damage to the liver and kidney, so it should not applied at excessive doses, and it should be used in a small amount of repeated injections, giving the body a metabolic process in order to reflect the absorption of fat soluble lecithin another injury in the small features.
如何对脂肪进行雕刻的不同方法进行选择,在整形外科领域已经成为整形美容外科医生们要解决的新生问题。随着国内学术界“中胚层疗法”这个名词的引入和业内人士对其了解的逐渐加深,其中溶脂和中胚层疗法的提法、内涵及其安全性和有效性；以及关于"Mesotherapy"词义及其汉译的商榷；溶脂方法所用的医疗设备和化学合成药品是否需要医疗相关机构的合法认证等问题在人们脑海中确实缺乏确定的答案。塑造完美体型是整形美容外科重要的组成部分,其中吸脂技术已经是临床上运用微创方法减肥并得到了广泛应用的一种手术方法。而目前国内又从国外引进一种新型技术,即中胚层疗法注射溶脂给人们提供了另一种似乎可行的方式——无创方法进行形体上的雕刻以达到良好的效果。前者安全性已经是可以肯定的,而后者的安全性是值得探讨的。卵磷脂注射溶脂已在国外广泛应用于临床,改善局部脂肪分布情况,以注射为主,临床并发症较少,但只是习惯用法。本次试验仅就溶脂中胚层疗法中的一个热点——即卵磷脂溶脂的实验研究进行探讨。
某种曾被广泛应用的注射隆胸药物在国内已经被大量案例证明不具有安全性；而国外关于中胚层应用于注射美容的报道与日俱增,并且有国外专家在国内不断地举办卵磷脂注射溶脂学习班：与此同时在一些医疗整形机构和美容院引进各种所谓国外药物注射赚取丰厚利润,在国内消费者心目中整形美容消费已深入人心,不仅仅是女士进行整形,而且男士也开始对不开刀不流血注射美容趋之若骛。综上所述,“卵磷脂注射溶脂的安全性”理所当然的成为我们整形医生热切想研究的课题。
卵磷脂：(lecithin)又称大豆卵磷脂,磷脂酰胆碱(PC),通常产品为白色蜡状物固体,极易吸潮,但难溶于水。磷脂酰胆碱同脂肪代谢密切相关。1996年9月在布鲁塞尔召开的第七届卵磷脂国际会议上,医药学家和营养学专家们研讨证实,卵磷脂(大豆磷脂)作为营养品,在增进健康及预防疾病方面所起到的重要的作用。早已赢得了世界营养专家、药物学家和医学家的普遍认同。卵磷脂作为一种功能性的健康食品,虽然不是立即见效,但有着全面、长远、稳定的效果,同时又没有药物的副作用,因此医学家们本着其特性,经过大量的研究表明,其对以下疾病的预防都有非常好的作用。
脱氧胆酸：(脱氧胆酸钠;deoxycholic acid)一种C-7上缺羟基的胆汁酸,是胆酸失去一个氧原子衍生而得的一种游离胆汁酸,在胆汁中主要以牛磺酸、甘氨酸结合形式存在。由胆酸氧化而成。具有促进胆汁分泌抗发炎作用。此处作为卵磷脂的溶剂存在,使之成为水溶性物质,便于注射和组织吸收。
目的：通过实验研究,对卵磷脂溶脂效果、安全性、药物成分特异性及对药物组合,分为三部分进行初步研究,结合临床应用进行初步探讨。
方法
实验一通过对两种不同动物皮下注射卵磷脂注射液,在脂肪外观上,观察不同动物脂肪对同一种药物的有效性。新西兰白兔和昆明小鼠各10只,脂肪分布集中的部位分别为颈背后和腹股沟脂肪。
实验二：卵磷脂卵磷脂(PC)注射液(以脱氧胆酸(DC)为溶剂)由北京知麟堂生物科技发展有限公司提供的美塑产品。动物分组：40日龄昆明小鼠雌性40只(由广东省医学实验动物中心提供),体重(22.080±3.032)g,分箱用小鼠专用饲料喂养,每组昆明小鼠饮用食水进行等量控制。随机将动物分为两组,每组20只：①实验组,②空白对照组。
实验具体方法：实验组：每5d进行一次注射。在实验组完成5个注射疗程完成后进行集中取材；进行脂肪重量对比观察。取材方法：小鼠注射药物的腹股沟一侧,单侧进行脂肪全部摘除,在生理盐水中进行清洗待称量。腹股沟脂肪重量称量。每组标本切取后,在光学高倍显微镜下观察微观组织变化情况。对各器官(肝、肾、骨骼肌及脂肪组织)取材进行组织切片染色。并且进行小鼠进食活动观察。
实验三：卵磷脂注射组和脱氧胆酸注射组,40日龄昆明小鼠雌性40只(由哈尔滨医科大学基础医学部动物实验中心提供),随机分为两组,每组20只：①卵磷脂实验组②脱氧胆酸实验组。实验具体方法同实验二。
结果
实验一大体观察,磷酸卵磷脂在两种不同动物的脂肪都有明显的溶解作用。无论是新西兰白兔的后颈部X形脂肪,还是昆明小鼠的腹股沟脂肪,都在体积上有明显的缩小。对大白兔X形脂肪长度进行统计学分析,说明具有统计学意义。注射药物对脂肪体积有意义。
实验二卵磷脂对脂肪的溶解作用较明显,但缺乏明显的特异性。肉眼观察：皮下注射组皮下脂肪较空白未注射侧脂肪组织明显减少,肌肉组织色泽稍暗淡,失去正常光泽。组织学观察：肌肉组织极个别肌纤维溶解断裂(图2-1)。脂肪细胞细胞壁通透性发生改变,脂滴溢出细胞发生一系列变化：细胞壁厚度不同部位相差较大,脂肪细胞破裂相互溶解成大小不等、形状不规则的空泡,空泡内外均可见成纤维细胞、吞噬脂滴的巨噬细胞和上皮样细胞增生,以及单核细胞和淋巴细胞浸润(图2-2)。肝、肾组织均存在水样变性产生和消失的组织变化,肝肾局部有生理性充血。
实验三卵磷脂组结果主要表现为：对肌肉纤维的溶解破坏作用卵磷脂和脱氧胆酸都具有,见图3-1和图3-4：对脂类代谢的影响作用,二者也均存在这样的作用,见图3-2、3-3、3-5和3-6。肝肾组织均存在空泡变。以脱氧胆酸对组织的损害更为严重见表3-1。
结论：
卵磷脂对促进脂肪溶解方面确实有作用。脂肪细胞细胞壁发生溶解,同一细胞细胞壁的不同部位厚薄不匀,破裂的细胞相互溶解形成大小不等、形态不规则的空泡。单纯卵磷脂和脱氧胆酸的大量注射仍然对肝、肾和肌肉组织破坏较大,而且发现市场上购买的卵磷脂和脱氧胆酸对脂类代谢和肌肉组织的溶解作用均有作用,按照一定比例配比之后的科学配方对组织损害较为轻微。
卵磷脂对脂肪溶解并非有严格的组织特异性,对肌肉、肝、肾等都存在损害,虽然比例不一的药物对组织损害程度不同,但仍建议临床医生持谨慎态度进行操作,尤其是严格把握卵磷脂的应用范围：板样脂肪的中层适量注射。
因其对肌肉有溶解作用,所以不适于应用于肌肉神经血管分布较为复杂的面部,仅适用于板样脂肪的中层注射。因其对肝肾有损害,所以不适用一次应用过多剂量,应少量多次进行注射,给机体一个代谢吸收的过程才能体现出卵磷脂溶解脂肪又损伤小的特点。因其卵磷脂亲油性特点,所以它的应用必须有适当的溶剂使其溶解于水中,否则不易于组织吸收。
Background
With the growth of age, fat accumulation, facial fat shift, fat atrophy, which are caused by a variety of reasons, become important factors in facial aging. There are many operations that can improve the adipose tissue deformation, liposuction to eliminate fat accumulation; Radiofrequency heat shift of fat(instance:baggy eyelids plasty); Facial depression filled with autologous fat and the emerging "Mesotherapy" for fat-dissolving--the use of drugs injected into the fatty layer.
A variety of methods for the operation of the fat different issues have been applied to achieve the goal of being young again. Traditional liposuction and the Mesotherapy imported from abroad, have become the two most important methods in weight-loss, and attracted all of the domestic doctors of plastic surgery because of their respective characteristics.
How to choose the different approaches to carve fat has become an emerging issue that need to be solved by cosmetic plastic surgeon. With the introduction of the term of "Mesotherapy" in domestic academic and the gradually increasing understanding of the term, lots of questions without definitive answers have raised, such as how to translate "Mesotherapy"; the safety and validity of Mesotherapy;whether the dissolving fat method of medical equipment and chemicals used in synthetic drugs need to be verified by medical-related institution. Perfect Body shaping is an important component of cosmetic surgery, in this field liposuction technique is a clinical use of minimally invasive method to lose weight and has been widely applied. Recently a new method, Mesotherapy, imported from abroad used into fat-dissolving has offered us another way which makes it possible to engrave on the body using non-invasive method in order to achieve good results. The security of the application of the liposuction technique is sure, while the security of the application of Mesotherapy is worth exploring. The lecithin is widely used as an experienced therapy in foreign countries, improving local fat distribution by injection with fewer clinical complications. Lecithin for fat-dissolving is the key in the mesotherapy, so it is the research object in my study.
Nowadays, some drugs breast augmentation have been widely used in injection for breast augmentation, a large number of cases have proven they do not have the security; the number of mesotherapy on the foreign reports is increasing; Injection of fat soluble lecithin has been organized in domestic classes continuously by some foreign experts. At the same time, some medical plastic hospitals and beauty parlours are introducing various foreign injection of drugs to make huge profits; in the eyes of domestic consumers consumption of plastic surgery has become firmly rooted, not only women but also men began to start a bloodless non-surgical cosmetic injections rush. To sum up, the safety of the lecithin for fat-dissolving, it's taken for granted as we orthopedic doctors eager to study.
Lecithin also known as soy lecithin, or phosphatidycholine(PC) is a white waxy material which is usually solid, easy to absorb moisture, but is insoluble in water. Phosphatidylcholine is closely related with the metabolism of fat. In September 1996 in the seventh international conference on lecithin held in Brussels, medicine and nutrition experts have confirmed that lecithin (soybean phospholipid) as a nutrition, played an important role in improving health and preventing disease. It has already won the world nutrition experts, pharmaceutical scientists and physicians of the generally recognized. Lecithin as a functional health food does not show immediate results, but show a comprehensive, long-term, stable effect without side effects of drugs. Therefore, physicians are interested in its characteristics, and a large number of studies have shown that their following diseases have a very good role in prevention.
Deoxycholic acid (DC), on the lack of a C-7-hydroxy bile acids, loss of oxygen atom is derived from bile acid derived from a kind of free bile acid, mainly in the bile of taurine, glycine binding form by acid oxidation. DC has the promotion of bile secretion of anti-inflammatory effects. DC, as a lecithin solvent, makes PC easy to injection of water-soluble substance and organization to absorb.
Objective:To make a preliminary study on the effects, safety, medicines specificity and combinations of lecithin during its introduction for fat dissolving in clinic applications.
Methods:
Experiment 1:Two different kinds of animals were selected:10 New Zealand white rabbits and 10 Kunming mice of 10. The fat of those animals concentrates behind the neck and groin. Then subcutaneous injection of lecithin was prepared in the fat appearance, the effects of different animal fats on the same effectiveness of a drug. New Zealand white rabbits and Kunming mice of 10, the site of fat distribution concentrated behind the neck and groin, respectively fat
Experiment 2:Lecithin Lecithin (PC) injection (in order to deoxycholic acid (DC) as the solvent) from Beijing Tong Zhi-lin Biotechnology Development Co., Ltd products. Animal groups:40-day-old female Kunming mice,40 (by the Guangdong Medical Experimental Animal Center), weight (22.080±3.032) g Sub-boxes using mouse-specific feed, feeding, each group of Kunming mice drinking water equivalent control. Animals were randomly divided into two groups of 20:①the experimental group,②blank control group.
Experimental specific methods:the experimental group:Every once 5d injection. In the experimental group completed five courses upon completion of injection of concentrated death, compared to observation the fat mass. Drawn Methods:the unilateral conduct of fat at the groin side with drugs of the mice was all removed, cleaned in the saline wash to be weighed. Inguinal fat weight weighing, accuracy of 0.001g.Each specimen was cut, and then observed under high power microscope to detent the microstructure change of various organs (liver, kidney, skeletal muscle and adipose tissue) derived for staining tissue sections. And actions about observation of mice eating were carried out.
Experiment 3:40 40-day-old female Kunming mice(from the Department of Basic Medicine, Harbin Medical University Experimental Animal Center), were randomly divided into two groups of 20:①Lecithin experimental group②Deoxycholate experimental group. Injection of phosphatidylcholine and deoxycholate was applied to the two groups; Experimental Methods were the same as those in experiment 2.
Results:
Experiment 1:Based on the visual observation point of view, phosphoric acid lecithin of fat in two different animals has clear dissolved. Both X-shaped fat in the New Zealand rabbit's neck and the fat in the groin of Kunming mice were significantly reduced on the volume.
Experiment 2:Dissolution of lecithin on the fat than the obvious, but the lack of apparent specificity. Visual observation:subcutaneous injection of subcutaneous fat than the group without injection of the blank side of adipose tissue decreased significantly. Muscle tissue color and slightly dim, loss of normal luster. Histological observation:very few muscle fibers dissolved fracture(Figure 2-1). Fat cells of the cell wall permeability change, Lipid droplets overflow cells a series of changes:The cell wall thickness of different parts was different, rupture of fat cells dissolve into each other in size, irregularly shaped vacuoles. Inside and outside the vacuoles, there are several kinds of cells:fibroblasts, lipid droplets engulfed by macrophages and epithelial-like cell proliferation, as well as monocytes and lymphocytes infiltration (Figure 2-2). The disappearance of organizational change of the degeneration of water and organizational congestion occurring in the liver, kidney.
Experiment 3:Lecithin group mainly as a result as follows:Lecithin, and deoxycholic acid both have the dissolution of the destructive effects of muscle fiber, figure 3-1 and Figure 3-4;as well as the role of lipid metabolism, figure 3-2,3-3,3-5 and 3-6. Vacuolization exists in liver and kidney. The Deoxycholate-breaking will be the role of more serious, table 3-1.
Conclusion:
Lecithin dissolved in the promotion of fat does play a role. Fat cells are dissolved at the cell walls, the cells wall thickness of the same cells is uneven, and in broken cells, the mutual dissolution of size, shape irregular vacuoles form. Pure injection of lecithin and deoxycholate are destructive on the liver, kidney and muscle tissue, and either has the effect on both of the lipid metabolism and muscle tissue. After a certain percentage of the ratio, scientific formula has a smaller damage for tissue.
Lecithin for fat-dissolving is not strict tissue-specific, damaged the muscles, liver and kidney. Although the proportion of different drugs on the tissue damage in varying degrees, it is recommended that clinicians be cautious to operate. In particular, strictly control the scope of application of lecithin:mid-level amount of fat injections into the middle of plate-like fat
Because of dissolution of the muscles, it's not suitable for the face in which there are more complex distribution of neuromuscular facial blood vessels, applies only to the middle plate-like fat injections. There is terrible damage to the liver and kidney, so it should not applied at excessive doses, and it should be used in a small amount of repeated injections, giving the body a metabolic process in order to reflect the absorption of fat soluble lecithin another injury in the small features.
引文
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[2]中胚层疗法有广阔前景的医疗理论和技术中国整形美容外科杂志2007Vol.18.No.3 161-162.
[3]高景恒,岳丽爽Mesotherapy---美容医学的新技术中国实用美容整形外科杂志2006,17(2)：119-21.
[4]聂毓秀主编。组织学与胚胎学[M]第二版,人民卫生出版社1999.295-308
[5]ACQUES Le COZ. History of Mesotherapy[J] American Journal of Mesotherapy,2006,3:16
[6]于芹超成人中胚层肾瘤1例临床泌尿外科杂志[J]2006 3.21 3期223
[7]骆建平绝经后阴道混合性中胚层瘤1例承德医学院学报[J]2002Vol.19No.1 2002
[8]ROBERT P, PITERA MD. Safety and future of mesotherapy. American Journal of Mesotherapy,2006,5:19.
[9]PRISARIP, PINRO R. Mesotherapy with phosphatidylcholine[J]. American Journal of mesotherapy,2007,6:9
[10]PINTO R, FRISATI P. Localized adipose tissue treatment with carboxy-therapy combined with phosphatidylcholine injections [J]. American Journal of Mesotherapy,2007,8:22-23
[11]PATRICIA RITTES MD Mesotherapy treatment of arms and inner thighs flaccidity[J] American Journal of Mesotherapy and Cosmetic Medicine,2007,7:12-13.
[12]刘宁、王琳穴位埋线结合中胚层疗法治疗单纯性肥胖中国美容整形外科杂志2007 Vol.18No.3 163-165
[13]Toshio Hasegawa, Tomoyuki Matsukura, Shigaku Ikeda. Mesotherapy for Benign Symmetric Lipomatosis [J] LLC and International Society of Aesthetic Plastic Surgery 2009,10; 9374
[14]HAPPY AD ADELSON N D. Management of side effects and adverse reactions from injection of phosphstidylcholine[J]. American Journal of Mesotherapy,2006,5;16-17
[15]AMITRANO C, CAPPELLETTIR, TORRE R. Doctor's repert. New trends in drug delivery systems:mesoporation, a novel technique[J]. American Journal of Mesotherapy,2005,1:24-25.
[16]JEFFREY M. Mesotherapy and the professional liability insurance market environment [J] American Journal of Mesotherapy,2005,1:20
[17]Patri'cia Guedes Rittes Injection of Phosphatidylcholine in Fat Tissue:Experimental Study of Local Action in Rabbits Aesth. Plast. Surg.,2006,30:474-478
[18]杨定文“消脂塑身”技术应用中药物注射的剂量与面积的关系 首届两岸四地美容医学学术会议论文汇编182-184
[19]刘恩岐主编 医学实验动物学[M]第一版人民卫生出版社2004常用哺乳类实验动物的给药途径及最大量P209、213
[20]李玉林主编 病理学第六版人民卫生出版社P12-18、46。
[21]RITTES P. Mesotherapy treatment of arms and inner thighs flaccidity[J]. American Journal of Mesotherapy and Cosmetic Medicine,2007,7:12-13.
[22]SCOFF KAROLCHY K. Stability and Compatibility of Mesotherapy Injections-Understanding the Pharmaceutics of the Preparations. American Journal of Mesotherapy,2007,4-20
[23]郑朝华 分光光度法测定卵磷脂注射液中总卵磷脂的含量海峡药学杂志 vol 13 no 42001
[24]蒋玲陈亮HPLC-ELSD法测定大都磷脂注射液中有关物质 药学进展2007 vol 31 8366-369
[25]高景恒等mesotherapy-中胚层疗法的药物配方中国美容整形外科杂志2007,vol.184294-299
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