在使用封闭敷料的情况下，药物透入疗法与地塞米松的吸收
Phonophoresis and the absorption of dexamethasone in the presence of an occlusive dressing.
作者信息
Saliba Susan, Mistry Dilaawar J, Perrin David H, Gieck Joe, Weltman Arthur
机构信息
Athletic Training & Sports Medicine, University of Virginia, 210 Emmet Street South, PO Box 400407, Charlottesville, VA 22904-4269, USA.
出版信息
J Athl Train. 2007 Jul-Sep;42(3):349-54.
CONTEXT
Phonophoresis is purported to represent a method to apply topical medications through the skin to treat soft tissue injuries and inflammatory conditions. Few data are available to demonstrate the clinical effectiveness of the treatment.
OBJECTIVE
To determine the effect of ultrasound on the transcutaneous absorption of dexamethasone when occluded with a dressing.
DESIGN
Crossover design.
SETTING
University general clinical research center.
PATIENTS OR OTHER PARTICIPANTS
Ten healthy subjects (age = 29.2 +/- 8.8 years; height = 170.0 +/- 3.9 cm; mass = 67.5 +/- 18.4 kg).
INTERVENTION(S): Two grams of 0.33% dexamethasone cream were applied to a 10-cm (2) area on the anterior forearm. The drug was applied to the skin and occluded with a dressing for 30 minutes before the ultrasound and sham ultrasound treatments. The treatments were applied over the drug and occlusive dressing. Ultrasound treatments were delivered at an intensity of 1.0 W/cm (2) (50% pulsed) at an output frequency of 3 MHz for 5 minutes and compared with sham ultrasound treatments that were delivered at an intensity of 0.0 W/cm (2) (50% pulsed) at an output frequency of 3 MHz for 5 minutes. All subjects received both the ultrasound and sham treatments, and the order in which subjects received the treatments was counterbalanced.
MAIN OUTCOME MEASURE(S): Serum samples were drawn before treatment and immediately posttreatment and at 2, 4, 6, 8, and 10 hours posttreatment. Using high-performance liquid chromatography, we analyzed serum to determine dexamethasone concentrations.
RESULTS
A 2-way repeated-measures analysis of variance (condition x time) revealed a significant main effect for ultrasound treatment ( P = .047). The rate of appearance and the total concentration of dexamethasone in the serum were greater in subjects after phonophoresis than after sham ultrasound. The sham group had only trace amounts of dexamethasone in the serum, indicating that drug absorption was negligible without the ultrasound energy. The effect size of the phonophoresis condition fell within a 95% confidence interval after the baseline measurement.
CONCLUSIONS
We found that a phonophoretic effect occurred with dexamethasone when its application saturated the skin.
背景
超声透药疗法据称是一种通过皮肤应用局部药物来治疗软组织损伤和炎症性疾病的方法。几乎没有数据可证明该治疗方法的临床有效性。
目的
确定超声在敷料封闭情况下对地塞米松经皮吸收的影响。
设计
交叉设计。
地点
大学综合临床研究中心。
患者或其他参与者
10名健康受试者（年龄 = 29.2±8.8岁；身高 = 170.0±3.9厘米；体重 = 67.5±18.4千克）。
干预措施
将2克0.33%的地塞米松乳膏涂抹在前臂前部10平方厘米的区域。在超声和假超声治疗前，将药物涂抹于皮肤上并用敷料封闭30分钟。治疗施加于药物和封闭敷料之上。超声治疗以1.0瓦/平方厘米（50%脉冲）的强度、3兆赫的输出频率进行5分钟，并与假超声治疗进行比较，假超声治疗以0.0瓦/平方厘米（50%脉冲）的强度、3兆赫的输出频率进行5分钟。所有受试者均接受超声和假超声治疗，且受试者接受治疗的顺序进行了平衡。
主要观察指标
在治疗前、治疗后即刻以及治疗后2、4、6、8和10小时采集血清样本。使用高效液相色谱法分析血清以测定地塞米松浓度。
结果
双向重复测量方差分析（条件×时间）显示超声治疗有显著的主效应（P = 0.047）。超声透药疗法治疗后受试者血清中地塞米松的出现速率和总浓度高于假超声治疗后。假超声组血清中只有微量地塞米松，表明在没有超声能量的情况下药物吸收可忽略不计。超声透药疗法条件的效应大小在基线测量后的95%置信区间内。
结论
我们发现，当地塞米松的应用使皮肤饱和时，会产生超声透药效应。
Zotero 插件