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Sağlıkta Galvanik Akımın Yeri ve Önemi

Yıl 2023, Cilt: 32 Sayı: 4, 237 - 245, 31.12.2023
https://doi.org/10.17827/aktd.1388563

Öz

Sağlıkta kas-sinir sistemi hastalıklarının tedavisinde; ısı enerjisi, ışık, elektrik ve elektromanyetik alanlar, basınç gibi fiziksel uygulama yöntemleri kullanılmaktadır. Tedavilerde, galvanik akım; iyontoforez (galvanoterapi), tıbbi galvanizm ve cerrahi galvanizm (elektroliz) yöntemleri kullanılmaktadır. Bu derlemede amacımız sağlıkta kullanılan galvanik akımın önemini ve kullanıldığı alanları literatür bilgileri ışığında açıklamaktır. Negatif ya da pozitif monofazik olan galvanik akım (DC: doğru akım), elektronların aynı şiddette ve aynı yönde hareket etmesi ile oluşan akımdır. Bu akım ile deri altına çeşitli iyonların veya tedavi edici ilaçların girişi sağlanır. Bu yönteme galvanoterapi veya iyontoforez denir1. İyontoforez yöntemi ile elektrik akımı kullanılarak deri içine istenilen veya tedavi edici ilaçların girmesi sağlanır. Başlangıçta aşırı terlemede etkin olan AlCl3 (alüminyum klorür) veya AlSO4 (alüminyum sülfat) gibi kimyasal ajanların deri içine verilmesi ile başladığından, adı iyontoforez olarak adlandırılmıştır. Sonradan terlemede galvanik akımın etken olduğu anlaşılmıştır. İyontoforez yöntemi, hiperhidrosiz (aşırı terleme) tedavisinde kullanılan, etkinliği ve güvenilirliği uzun yıllardır bilinen bir yöntemdir. Vücut sıcaklığından daha yüksek sıcaklıkta bir ortamda, vücudumuzun kendi sıcaklığını koruması için ter bezlerimizden vücut dışına ter atılarak ısı aktarımı gerçekleşir. Bu ısı aktarımı sonrası atılan ter buharlaşır. Genellikle el, ayak ve koltuk altında yer alan, çevresel ve merkezi sinir sistemi tarafından düzenlenen ekrin ter bezleri bir insanda yaklaşık 2-4 milyon kadardır. Çok fazla uyarılması durumunda hiperhidroz denilen aşırı terleme oluşur. Aşırı terleme bireylerin sosyal ve iş hayatını negatif yönde etkilemektedir. Aşırı terlemenin tedavisinde iyontoforez (galvanoterapi), botoks, endoskopik torasik sempatotomi (ETS) ve lokal antiperspirantlar kullanılmaktadır. Yapılan araştırmalar sonucu kadınlarda ve erkeklerde her yaşta ortaya çıkabilmekle birlikte yaklaşık nüfusun %1’i bu rahatsızlıkla karşı karşıyadır.

Kaynakça

  • 1. Blake, E., McMakin, C., Lewis, D. C., Buratovich, N., & Neary Jr, D. E. (2008). Electrotherapy Modalities. In Naturopathic Physical Medicine (pp. 539-562). Churchill Livingstone.
  • 2- Baker, L. B. (2019). Physiology of sweat gland function: The roles of sweating and sweat composition in human health. Temperature, 6(3), 211-259.
  • 3- Hussain, J. N., Mantri, N., & Cohen, M. M. (2017). Working up a good sweat–the challenges of standardising sweat collection for metabolomics analysis. The Clinical Biochemist Reviews, 38(1), 13.
  • 4- Leung AK, Chan PY, Choi MC. Hyperhidrosis. Int J Dermatol 1999;38:561-7
  • 5- Gee S, Yamauchi PS. Nonsurgical management of hyperhidrosis. Thorac Surg Clin 2008;18:141-55.
  • 6- Murota, H., Matsui, S., Ono, E., Kijima, A., Kikuta, J., Ishii, M., & Katayama, I. (2015). Sweat, the driving force behind normal skin: an emerging perspective on functional biology and regulatory mechanisms. Journal of dermatological science, 77(1), 3-10.
  • 7- Cui, C. Y., Childress, V., Piao, Y., Michel, M., Johnson, A. A., Kunisada, M., ... & Schlessinger, D. (2012). Forkhead transcription factor FoxA1 regulates sweat secretion through Bestrophin 2 anion channel and Na-K-Cl cotransporter 1. Proceedings of the National Academy of Sciences, 109(4), 1199-1203.
  • 8- Colvin, N. N., Hayes Jr, H., Chisum, A., & Joly-Brown, K. (2018). Don't Sweat It: An Overview of Hyperhidrosis. US PHARMACIST, 43(6), 15-18.
  • 9- Benzinger T.H. Heat Regulation: Homeostasis of central temperature in man, physiol. Rev 49: 671-759, 1969
  • 10- Hammel H.T., Jackson D.L., Stalwuk J.A.J., Hardy J.D. ve Stromme S.B.: Temperature regulation by hypothamic proportional control with an adjustable set-points. J. appl Phsiol 18: 1146-1154, 1963
  • 11- Renero-C, F. J. (2023). Dysautonomia, thermoregulation and prevention of the diabetes mellitus type 2. Medical Hypotheses, 176, 111086.
  • 12- Osilla, E., Marsidi, J., Shumway, K., & Sharma, S. (2023). Physiology, temperature regulation. StatPearls.
  • 13- Medica-Viola, V., Baressi Šegota, S., Mrzljak, V., & Štifanić, D. (2020). Comparison of conventional and heat balance based energy analyses of steam turbine. Pomorstvo, 34(1), 74-85.
  • 14- Web sitesi adı : Courses Lumenlearning Adresi : https://courses.lumenlearning.com/suny-ap2/chapter/energy-and-heat-balance Erişim : 28.09.2023
  • 15- Kisielnicka, A., Szczerkowska-Dobosz, A., Purzycka-Bohdan, D., & Nowicki, R. (2022). Hyperhidrosis: disease aetiology, classification and management in the light of modern treatment modalities. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 39(2), 251-257.
  • 16- Baker, D. (2022). Hyperhidrosis. Surgery (Oxford), 40(1), 70-75.
  • 17- Peñin-Franch, A., García-Vidal, J. A., Martínez, C. M., Escolar-Reina, P., Martínez-Ojeda, R. M., Gómez, A. I., ... & Pelegrín, P. (2022). Galvanic current activates the NLRP3 inflammasome to promote Type I collagen production in tendon. Elife, 11, e73675.
  • 18- Sheikh, N. K., & Dua, A. (2020). Iontophoresis analgesic medications.
  • 19- Marrow, E. A. (2017). Toward Hydrogel Microneedle Patches for The Passive Extraction of Subcutaneous Interstitial Fluid.
  • 20- Cheung JS, Solomon BA. Disorders of sweat glands: hyperhidrosis: unapproved treatments. Clin Dermatol 2002;20(6):638-42. http://dx.doi.org/10.1016/S0738-081X(02)00284-5
  • 21- Özcan D, Güleç T. Hiperhidroz ve Tedavisi. Klin J Dermatol 2005;15:96-103.
  • 22- Papa CM, Klugman AM. Mechanism of ecrine anhidrosis by iontophoresis. High level blockade. J Invest Derm 1966;47-1-9.
  • 23- Hill AC, Baker GF, Jansen GT. Mechanism of action of iontophoresis in the treatment of palmar hyperhidrosis. Cutis 1981;28(1):69-70, 72.
  • 24- Na GY, Park BC, Lee WJ, Park DJ, Kim do W, Kim MN. Control of palmar hyperhidrosis with a new "dry-type" iontophoretic device. Dermatol Surg 2007;33(1):57-61.
  • 25- Sato K, Timm DE, Sato F, Templeton EA, Meletiou DS, Toyomoto T, Soos G, Sato SK. Generation and transit pathway of H+ is critical for inhibition of palmar sweating by ion-tophoresis in water. Psychiatry Clin Neurosci 2001;55(6):549-57.
  • 26- Anliker MD, Kreyden OP. Tap water iontophoresis. Curr Probl Dermatol 2002;30:48-56.
  • 27- Lowe NJ, Yamauchi PS, Lask GP, Patnaik R, Iyer S. Efficacy and safety of botulinum toxin type a in the treatment of palmar hyperhidrosis: a double-blind, randomized, placebo-controlled study. Dermatol Surg 2002;28(9):822-7.
  • 28- Aydemir EH, Kalkan MT, Karakoç Y. Quantitative effect of anodal current in the treatment of primary hyperhidrosis by direct electrical current. Int J Dermatol 2006;45(7):862-4.
  • 29- Başkan EB, Sarıcaoğlu H. Hiperhidroz Tedavisinde Güncel Yaklaşımlar. T Klin J Cosmetal 2003;4:165-172.
  • 30- Karakoc Y, Aydemir EH, Kalkan MT. Placebo-controlled evaluation of direct electrical current administration for palmoplantar hyperhidrosis. Int J Dermatol 2004;43:503-505.
  • 31- Karakoç Y, Aydemir EH, Kalkan MT, Unal G. Safe control of palmoplantar hyperhidrosis with direct electrical current. Int J Dermatol 2004;43(7):503-5.
  • 32- Berliner MN. Reduced skin hyperemia during tap water iontophoresis after intake of acetylsalicylic acid. Am J Phys Med Rehabil 1997;76(6):482-7.
  • 33- Reinauer S, Neusser A, Schauf G, Holzle E. Pulsed direct current iontophoresis as a possible new treatment for hyperhidrosis. Hautarzt 1995;46:543-7.
  • 34- Lambert D, Guillet G, Denoeux JP, Thivolet J, Labeille B, Dalac S. Accidents caused by iontophoresis. Ann Dermatol Venereol 1993;120:907-908.
  • 35- Meffert JJ. Galvanic urticaria. Cutis 1999;63(6):327-8.
  • 36- Hölzle E, Alberti N. Long-term efficacy and side effects of tap water iontophoresis of palmoplantar hyperhidrosis--the usefulness of home therapy. Dermatologica 1987;175(3):126-35.
  • 37- Kavanagh GM, Oh C, Shams K. BOTOX delivery by iontophoresis. Br J Dermatol 2004;151(5):1093-5.
  • 38- Shen JL, Lin GS, Li WM. A new strategy of iontophoresis for hyperhidrosis. J Am Acad Dermatol 1990;22(2 Pt 1):239-41.
  • 39- Web Sitesi Adı : Iontophoresis Machines Adresi : https://iontophoresis-machines.co.uk/effect-and-mode-of-action/ Erişim : 3.10.2023

Importance and Use of Galvanic Current in Healthcare

Yıl 2023, Cilt: 32 Sayı: 4, 237 - 245, 31.12.2023
https://doi.org/10.17827/aktd.1388563

Öz

Physical application methods such as heat energy, light, electricity and electromagnetic fields, pressure are used in the treatment of musculo-nervous system diseases in health. Galvanic current, iontophoresis (galvanotherapy), medical galvanism and surgical galvanism (electrolysis) methods are used in treatments. In this review, aim is explain the importance of galvanic current used in health and the areas where it is used in the light of literature information. Galvanic current (DC: direct current), which is negative or positive monophasic, is a current generated by the movement of electrons in the same intensity and with the same direction. With this current, various ions or therapeutic drugs are introduced under the skin. This method is called galvanotherapy or iontophoresis. With the iontophoresis method, desired or therapeutic drugs are introduced into the skin by using electric current. Initially, it was called iontophoresis because it started with the intradermal administration of chemical agents such as AlCl3 (aluminium chloride) or AlSO4 (aluminium sulphate) which are effective in excessive sweating. Later, it was understood that galvanic current was effective in sweating. Iontophoresis method is used in the treatment of hyperhidrosis (excessive sweating) and its efficacy and reliability have been known for many years. In environment with a temperature higher than the body temperature, heat transfer takes place by excreting sweat from our sweat glands to the outside of the body in order for our body to maintain its own temperature. After this heat transfer, the sweat evaporates. Eccrine sweat glands, which are usually located in the hands, feet and armpits and regulated by the peripheral and central nervous system, are approximately 2-4 million in a person. In case of too much stimulation, excessive sweating called hyperhidrosis occurs. Excessive sweating negatively affects the social and business life of individuals. Iontophoresis (galvanotherapy), botox, endoscopic thoracic sympathotomy (ETS) and local antiperspirants are used in the treatment of excessive sweating. As a result of researches, approximately 1% of the population is faced with this disorder even though it can occur at any age in men and women.

Kaynakça

  • 1. Blake, E., McMakin, C., Lewis, D. C., Buratovich, N., & Neary Jr, D. E. (2008). Electrotherapy Modalities. In Naturopathic Physical Medicine (pp. 539-562). Churchill Livingstone.
  • 2- Baker, L. B. (2019). Physiology of sweat gland function: The roles of sweating and sweat composition in human health. Temperature, 6(3), 211-259.
  • 3- Hussain, J. N., Mantri, N., & Cohen, M. M. (2017). Working up a good sweat–the challenges of standardising sweat collection for metabolomics analysis. The Clinical Biochemist Reviews, 38(1), 13.
  • 4- Leung AK, Chan PY, Choi MC. Hyperhidrosis. Int J Dermatol 1999;38:561-7
  • 5- Gee S, Yamauchi PS. Nonsurgical management of hyperhidrosis. Thorac Surg Clin 2008;18:141-55.
  • 6- Murota, H., Matsui, S., Ono, E., Kijima, A., Kikuta, J., Ishii, M., & Katayama, I. (2015). Sweat, the driving force behind normal skin: an emerging perspective on functional biology and regulatory mechanisms. Journal of dermatological science, 77(1), 3-10.
  • 7- Cui, C. Y., Childress, V., Piao, Y., Michel, M., Johnson, A. A., Kunisada, M., ... & Schlessinger, D. (2012). Forkhead transcription factor FoxA1 regulates sweat secretion through Bestrophin 2 anion channel and Na-K-Cl cotransporter 1. Proceedings of the National Academy of Sciences, 109(4), 1199-1203.
  • 8- Colvin, N. N., Hayes Jr, H., Chisum, A., & Joly-Brown, K. (2018). Don't Sweat It: An Overview of Hyperhidrosis. US PHARMACIST, 43(6), 15-18.
  • 9- Benzinger T.H. Heat Regulation: Homeostasis of central temperature in man, physiol. Rev 49: 671-759, 1969
  • 10- Hammel H.T., Jackson D.L., Stalwuk J.A.J., Hardy J.D. ve Stromme S.B.: Temperature regulation by hypothamic proportional control with an adjustable set-points. J. appl Phsiol 18: 1146-1154, 1963
  • 11- Renero-C, F. J. (2023). Dysautonomia, thermoregulation and prevention of the diabetes mellitus type 2. Medical Hypotheses, 176, 111086.
  • 12- Osilla, E., Marsidi, J., Shumway, K., & Sharma, S. (2023). Physiology, temperature regulation. StatPearls.
  • 13- Medica-Viola, V., Baressi Šegota, S., Mrzljak, V., & Štifanić, D. (2020). Comparison of conventional and heat balance based energy analyses of steam turbine. Pomorstvo, 34(1), 74-85.
  • 14- Web sitesi adı : Courses Lumenlearning Adresi : https://courses.lumenlearning.com/suny-ap2/chapter/energy-and-heat-balance Erişim : 28.09.2023
  • 15- Kisielnicka, A., Szczerkowska-Dobosz, A., Purzycka-Bohdan, D., & Nowicki, R. (2022). Hyperhidrosis: disease aetiology, classification and management in the light of modern treatment modalities. Advances in Dermatology and Allergology/Postępy Dermatologii i Alergologii, 39(2), 251-257.
  • 16- Baker, D. (2022). Hyperhidrosis. Surgery (Oxford), 40(1), 70-75.
  • 17- Peñin-Franch, A., García-Vidal, J. A., Martínez, C. M., Escolar-Reina, P., Martínez-Ojeda, R. M., Gómez, A. I., ... & Pelegrín, P. (2022). Galvanic current activates the NLRP3 inflammasome to promote Type I collagen production in tendon. Elife, 11, e73675.
  • 18- Sheikh, N. K., & Dua, A. (2020). Iontophoresis analgesic medications.
  • 19- Marrow, E. A. (2017). Toward Hydrogel Microneedle Patches for The Passive Extraction of Subcutaneous Interstitial Fluid.
  • 20- Cheung JS, Solomon BA. Disorders of sweat glands: hyperhidrosis: unapproved treatments. Clin Dermatol 2002;20(6):638-42. http://dx.doi.org/10.1016/S0738-081X(02)00284-5
  • 21- Özcan D, Güleç T. Hiperhidroz ve Tedavisi. Klin J Dermatol 2005;15:96-103.
  • 22- Papa CM, Klugman AM. Mechanism of ecrine anhidrosis by iontophoresis. High level blockade. J Invest Derm 1966;47-1-9.
  • 23- Hill AC, Baker GF, Jansen GT. Mechanism of action of iontophoresis in the treatment of palmar hyperhidrosis. Cutis 1981;28(1):69-70, 72.
  • 24- Na GY, Park BC, Lee WJ, Park DJ, Kim do W, Kim MN. Control of palmar hyperhidrosis with a new "dry-type" iontophoretic device. Dermatol Surg 2007;33(1):57-61.
  • 25- Sato K, Timm DE, Sato F, Templeton EA, Meletiou DS, Toyomoto T, Soos G, Sato SK. Generation and transit pathway of H+ is critical for inhibition of palmar sweating by ion-tophoresis in water. Psychiatry Clin Neurosci 2001;55(6):549-57.
  • 26- Anliker MD, Kreyden OP. Tap water iontophoresis. Curr Probl Dermatol 2002;30:48-56.
  • 27- Lowe NJ, Yamauchi PS, Lask GP, Patnaik R, Iyer S. Efficacy and safety of botulinum toxin type a in the treatment of palmar hyperhidrosis: a double-blind, randomized, placebo-controlled study. Dermatol Surg 2002;28(9):822-7.
  • 28- Aydemir EH, Kalkan MT, Karakoç Y. Quantitative effect of anodal current in the treatment of primary hyperhidrosis by direct electrical current. Int J Dermatol 2006;45(7):862-4.
  • 29- Başkan EB, Sarıcaoğlu H. Hiperhidroz Tedavisinde Güncel Yaklaşımlar. T Klin J Cosmetal 2003;4:165-172.
  • 30- Karakoc Y, Aydemir EH, Kalkan MT. Placebo-controlled evaluation of direct electrical current administration for palmoplantar hyperhidrosis. Int J Dermatol 2004;43:503-505.
  • 31- Karakoç Y, Aydemir EH, Kalkan MT, Unal G. Safe control of palmoplantar hyperhidrosis with direct electrical current. Int J Dermatol 2004;43(7):503-5.
  • 32- Berliner MN. Reduced skin hyperemia during tap water iontophoresis after intake of acetylsalicylic acid. Am J Phys Med Rehabil 1997;76(6):482-7.
  • 33- Reinauer S, Neusser A, Schauf G, Holzle E. Pulsed direct current iontophoresis as a possible new treatment for hyperhidrosis. Hautarzt 1995;46:543-7.
  • 34- Lambert D, Guillet G, Denoeux JP, Thivolet J, Labeille B, Dalac S. Accidents caused by iontophoresis. Ann Dermatol Venereol 1993;120:907-908.
  • 35- Meffert JJ. Galvanic urticaria. Cutis 1999;63(6):327-8.
  • 36- Hölzle E, Alberti N. Long-term efficacy and side effects of tap water iontophoresis of palmoplantar hyperhidrosis--the usefulness of home therapy. Dermatologica 1987;175(3):126-35.
  • 37- Kavanagh GM, Oh C, Shams K. BOTOX delivery by iontophoresis. Br J Dermatol 2004;151(5):1093-5.
  • 38- Shen JL, Lin GS, Li WM. A new strategy of iontophoresis for hyperhidrosis. J Am Acad Dermatol 1990;22(2 Pt 1):239-41.
  • 39- Web Sitesi Adı : Iontophoresis Machines Adresi : https://iontophoresis-machines.co.uk/effect-and-mode-of-action/ Erişim : 3.10.2023
Toplam 39 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Nöroloji ve Nöromüsküler Hastalıklar
Bölüm Derleme
Yazarlar

Halil İbrahim Öksüz 0000-0003-0084-6738

Saygın Şan 0009-0003-3885-3551

Mustafa Tunaya Kalkan 0000-0001-9783-8835

Işıl Öcal 0000-0003-4680-5309

Yayımlanma Tarihi 31 Aralık 2023
Gönderilme Tarihi 9 Kasım 2023
Kabul Tarihi 7 Aralık 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 32 Sayı: 4

Kaynak Göster

AMA Öksüz Hİ, Şan S, Kalkan MT, Öcal I. Sağlıkta Galvanik Akımın Yeri ve Önemi. aktd. Aralık 2023;32(4):237-245. doi:10.17827/aktd.1388563