Medical Leech Therapy (Hirudotherapy)

Year 2019, GETAT Special Issue, 29 - 46, 30.09.2019

M.öner Küçük Ozan Yaman

https://doi.org/10.34084/bshr.576663

Cited By: 5

Abstract

Leeches
are a class of segmented invertebrates, known for their blood-feeding habits
and used in phlebotomy to treat various ailments since antiquity. Hirudotherapy
is the application of medicinal leeches for therapeutic use. The therapeutic
use of leech therapy is an established method and dates back to ancient Egypt
and the beginning of civilization. At the end of the 20th century new therapy
concepts took the place of leech therapy. With microvascular surgery techniques
there has been a “rebirth” in the use of medicinal leeches in recent years.
Hirudo medicinalis has widest therapeutic usage among the leeches, but
worldwide, many different species were tested and studied. Leech therapy
involves an initial bite, which is usually a painless bite, followed by the
sucking of 5 and 15 ml of blood. It’s major therapeutic benefits are not only
due to blood sucked during the biting, but also from the various bioactive
substances. Saliva of leech contains various bioactive compounds such as:
eglins, bdellins, hirudin, hyaluronidase, calin, destabilase, apyrase,
decorsin, hirustatin, tryptase inhibitors, and histamine like substances,
complement inhibitors, carboxypeptidase A- inhibitors and acetylcholine. These
substances are responsible for inhibiting blood coagulation, analgesic effect,
dilating effect on muscles and regulation on immune system. Hirudotherapy has a
broad spectrum of therapeutic application in the medical field ranging from
cardiology, orthopedy, gynaecology, ophthalmology, plastic and reconstructive
surgeries. This review presents an overview of leech including the history,
general characteristics and mechanisms of action of leeches, and its
application as medical device.

Keywords

Medicinal leech, Hirudotherapy, Indications

Tıbbi Sülük Terapisi (Hirudoterapi)

Abstract

Sülükler
halkalı omurgasızlar sınıfındadır, kan ile beslenirler ve antik dönemden beri
çeşitli hastalıkları tedavi etmek için flebotomide kullanılırlar. Hirudoterapi,
tedavi için tıbbi sülüklerin uygulanmasıdır. Sülük tedavisinin terapötik
kullanımı köklü bir yöntemdir ve eski Mısır'a, medeniyetin başlangıcına
dayanır. 20. yüzyılın sonunda yeni terapi kavramları sülük tedavisinin yerini
almıştır. Mikrovasküler cerrahi tekniklerle birlikte son yıllarda tıbbi
sülüklerin kullanımında bir “yeniden doğuş” olmuştur. Hirudo medicinalis, sülükler
arasında en geniş terapotik kullanıma sahiptir ancak dünya çapında birçok
farklı tür test edilmiş ve incelenmiştir. Sülük tedavisi genellikle ağrısız
olan bir ilk ısırığı, ardından 5 ila 15 ml kan emmeyi içerir. Başlıca terapötik
faydaları sadece ısırma sırasında emilen kandan değil, aynı zamanda çeşitli
biyoaktif maddelerden de kaynaklanmaktadır. Sülük tükürüğü; eglin, bdellin,
hirudin, hyaluronidaz, calin, destabilas, apiraz, dekorin, hirustatin, triptaz
inhibitörleri ve histamin benzeri maddeler, kompleman inhibitörleri,
karboksipeptidaz A-inhibitörleri ve asetilkolin gibi çeşitli biyoaktif
bileşikler içerir. Bu bileşikler; koagülasyonun inhibisyonundan, analjezik
etkiden, kas gevşetici etkiden ve bağışıklık sistemi üzerindeki düzenlemeden sorumludur.
Hirudoterapi; kardiyoloji, ortopedi, jinekoloji, oftalmoloji, plastik ve
rekonstrüktif cerrahi gibi alanlarda geniş bir terapötik uygulama yelpazesine
sahiptir. Bu derleme sülükler hakkında; tarihçesi, genel özellikleri, etki
mekanizmaları ve tıbbi bir cihaz olarak uygulanmasını içeren genel bir bakış
sunar.

Keywords

Tıbbi sülük, Hirudoterapi, Endikasyonlar

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