Medicinal electrophoresis. Electrophoresis: what is it, indications and contraindications for the use of modern techniques

Electrophoresis and galvanization are methods of physiotherapy that were developed in the second half of the 20th century, thanks to the research of doctors from the Soviet Union. At the same time, their main methods were developed. Today, electrophoresis is one of the simplest and safest ways to treat various diseases, combining drug treatment and exposure to an electric current on the body. It is easily tolerated by persons of any gender and age.

For electrophoresis, aqueous or other solutions of medicines are used, which are impregnated with a pad of fabric or filter paper. Another, protective, and then the electrode of the electrophoresis apparatus are placed on top of it. The electrodes are placed on the body in such a way that a line is created along which the movement of ions from the drug solution occurs. Most often, pads and electrodes are applied to the cervical-collar zone, in the face, on the sacrum. For the treatment of otitis media, the electrode can be placed endaurally; for young children, the endonosal method is used.

The basic techniques and methods of electrophoresis have been developed for the treatment of various diseases and are widely used in various branches of medicine. The following methods are most commonly used:

• electrophoresis on the collar zone (according to Shcherbak);
• ionic reflections (according to Shcherbak);
• galvanic (ionic) belt;
• general electrophoresis according to Vermel;
• facial electrophoresis (according to Bourguignon or Shcherbakova);
• electrophoresis endonosal and endaural.

It has a different name: ionic (galvanic) collar according to Shcherbak. The choice of the cervical-collar zone for electrophoresis is necessary if there are disturbances in the functioning of the nervous or vascular system. Diseases such as hypertension, neuroses, as well as sleep disorders or craniocerebral injuries, disorders associated with the muscles of the face - these are the reasons for prescribing electrophoresis for this area.

To perform electrophoresis, a large pad is placed in the neck-collar area, which covers the neck, shoulders and upper back. It is moistened with an aqueous medicinal solution heated to 38-39 degrees. The second electrode, with a pad of a smaller area, is located on the border of the sacral and lumbar spine. It is usually superimposed on a pad moistened with distilled water.

Depending on the diagnosis, electrophoresis is performed with bromine, iodine, magnesium, calcium, novocaine or aminophylline. The advantage of this technique is the possibility of simultaneous delivery of differently charged ions of two active substances. In this case, the solution is placed under both electrodes: both the cervical-collar zone and the lumbar. Thus, the collar may be, for example, novocaine-iodide, calcium bromide, etc.

The course of treatment is usually ten to twelve procedures performed daily or every other day. The duration of each session is no more than 15 minutes. The current strength gradually increases. However, the patient should not experience discomfort. In a small child who cannot yet voice his impressions, you can focus on facial expressions.

Ionic reflexes

In addition to the cervical-collar zone, for the treatment of hypertension and neurosis, as well as for peptic ulcer and joint disorders, a different electrophoresis scheme is used. In this case, the electrodes are applied not to the neck, but to the limbs. And in such a way that they are located diagonally. For example, left arm and right leg, or vice versa.

Pads with solutions of sodium, potassium, magnesium or bromine are applied to the shoulder and thigh. Above this place, the limb is pulled with a rubber bandage. The duration of the electrophoresis procedure can be up to 20-40 minutes with interruptions, depending on the identified disease. The course includes up to one and a half dozen procedures performed daily.

Galvanic (ionic) belt

Otherwise called "galvanic shorts". Electrophoresis, carried out according to this technique, is effective for diseases of the female genital organs or male sexual dysfunction, prostatitis, diseases of the pelvic organs, limbs, and some vascular disorders.

The belt can be top or bottom. In the first case, a belt soaked in a warm medical solution is applied to the thoracic and lumbar sections of the back, below the cervical. In the second - on the lumbar and sacral vertebrae. In this case, the solution should also have a body temperature or slightly higher. A second one, of the same area, is placed on the pad moistened with the medicine, and then an electrode is applied.

In contrast to the impact on the cervical-collar zone, the second pad is always wetted only with distilled water. It is placed on the anterior surface of the upper thigh for electrophoresis of the upper girdle, or on the back of the thigh for the treatment of the lower girdle.

The duration of the procedure is less, within 10 minutes, and the course of procedures can reach up to twenty.

General electrophoresis according to Vermel

Unlike all other methods, this electrophoresis involves not two, but three pads. A large area is located on the back, between the shoulder blades and is impregnated with a medicinal solution. One of the electrodes is installed on it.

The other two pads are placed on the calves. The electrodes located here are connected to one pole of the device using a forked cord. Thus, electrophoresis is carried out on almost the entire surface of the body, excluding the face, neck and head.

Research conducted in the 70s. of the last century showed that electrophoresis is effective in many diseases of internal organs, such as metabolic disorders, various consequences of diabetes, impaired immunity. The Vermel method has been successfully used in diseases of the cardiovascular and nervous systems. This procedure is well tolerated by both children and the elderly.

Facial electrophoresis

The impact on the cervical-facial region is indicated for neurosis, neuritis of the trigeminal or facial nerve, various pathologies of the brain, in particular traumatic, inflammatory or vascular. It is effective to carry out electrophoresis in the face area and with some menopausal manifestations.

When carrying out the procedure in the cervical region, the electrodes are applied on both sides, so that the ears are between the blades of the electrodes. If facial electrophoresis is performed, then the medicinal solution is applied to the pads placed on the closed eyelids and on the back of the neck.

In this case, the duration of the procedure will be short, and the reaction should be monitored so that discomfort or redness and swelling of the skin does not appear, since the skin of the face is more sensitive than in other parts of the body.

Electrophoresis endonosal and endaural

Such electrophoresis is carried out using not tissue pads, but small cotton swabs, which are also wetted with a medicinal substance. There are, however, slight differences from other methods. This is due to the fact that endonasal electrophoresis is carried out not through the skin, but through the mucous membrane. Such an impact allows you to treat not only ENT diseases, but also many other disorders, since the area of ​​​​the face and nose in particular is associated with many organs and their systems.

Most often, endonasal electrophoresis is used for children from three to five years of age. The electrodes are placed as follows. One of them, having two plates, is placed in both nostrils, and the second is placed on the back of the neck.

Contraindications for electrophoresis

Soviet physicians, developing various methods of treating diseases with the help of electrophoresis, also revealed a number of contraindications to the use of this sparing method of treatment. These include:

• Violations of the skin and mucous membranes. It does not matter if such damage is not in the places where the drug pads and electrodes are applied.
• Eczema and dermatitis. These skin diseases not only interfere with electrophoresis, but can be exacerbated by drugs and current.
• Acute inflammatory or purulent diseases, especially those accompanied by fever or fever. However, electrophoresis can be used for a definitive cure after the acute stage of the disease has passed.
• second half of pregnancy. During the first half of it, electrophoresis is often used to relieve a condition known as uterine hypertonicity. Or with the threat of premature birth.
• Heart disease such as heart failure.
• Vascular diseases associated with circulatory disorders, blood clotting, a tendency to external and internal bleeding.
• Tumors, both malignant and benign, regardless of their location relative to the application of the electrodes.
• Infant age up to six months. In general, electrophoresis is one of the most common methods of treating certain disorders of the nervous system or musculoskeletal system in infants.
• And, of course, individual allergic reactions both to drugs and to the effects of electric current on the skin or mucous membranes.

Electrophoresis is a method of physiotherapy that involves the introduction of a drug in the form of an ion into the human body through intact skin or mucous membranes using direct and impulsive current. A feature of this treatment is the impact of two factors - medicinal substances and galvanic current, which together significantly improve the result.

The mechanism of action of electrophoresis

In the process of electrophoresis of medicinal substances, penetration into the human body occurs through two main routes: through the introductory duct of the sebaceous and sweat glands, and to a lesser extent - intercellular gaps. The amount of medicinal substances upon administration reaches a minimum - no more than 10% applied to the pad.

Medical scientists, conducting research, concluded that the dose of the administered substance using electrophoresis depends on:

• From properties (solubility, size, charge).
• Features of the working solution (type of solvent, purity of the preparation, concentration).
• The age of the patient.
• Conduct area.
• The state of the human body before the onset of therapeutic action.
• The duration of the impact.
• Strength and type of current.
• Other medical procedures.

During the procedure using electrophoresis at a shallow depth, drugs usually accumulate in the epidermis and dermis, creating a “skin depot”, which subsequently forms slow delivery of the drug into the body. These drugs are under the skin from 2 to 20 days, and independently diffuse (penetrate) into the lymphatic and blood vessels, further spreading throughout the body.

Drugs administered by electrophoresis perform the following functions:

• They enter into local metabolic processes, thereby affecting the course of physiological and pathological reactions in tissues.
• They cause continuous and prolonged nerve endings of the skin, which creates the formation of reflex reactions.
• Drugs entering the lymph and blood from the “skin depot” have a humoral effect on more sensitive tissues.

Benefits of this treatment method

Compared to other methods of treatment, electrophoresis has the following advantages:

1. Medicinal substances retain specific effects in the body and do not have general toxic effects.
2. In the process of electrophoresis in the thickness of the skin, medicinal substances are retained in the human body much longer.
3. Medicinal ions are excreted from the body slowly.
4. There are no disturbances in the normal functioning of the tissue during the electrophoresis period.
5. The amount of injected medicinal substances is dosed by changing the electrode size, current strength, changing the concentration of injections, and the duration of exposure.
6. The use of the electrophoresis method allows you to enter several or one drug.
7. It is possible to remove the medicinal substance from the body with the help of a hydrophilic pad by changing the polarity of the direct current.
8. There is a possibility of introducing a drug into the tissue of the lesion.
9. The procedure for administering the drug does not cause pain.

The main indications for using the electrophoresis method:

1. Degenerative dystrophic diseases of the joints and spine: scoliosis, osteochondrosis, arthrosis and arthritis, spondylosis, herniated deviation of the intervertebral discs, Schmorl's hernia and protrusion, humeroscapular periarthritis and so on.
2. Adhesions and inflammation of the organs in the small pelvis.
3. Pathologies of peripheral nerves: neuritis, discogenic radiculitis, neuralgia.
4. Pathologies of the ligamentous apparatus of contracture.
5. Various forms of carpal tunnel syndrome.
6. After plastic surgery treatment of scars.
7. Cellulite treatment.

Electrophoresis technology

Conducting treatment by electrophoresis is based on the hardware generation of diadynamic, galvanic, fluctuating or sinusoidal modulated current. In particular, this technique is similar to electrotherapy procedures. The connection passes through the electrodes, which are installed on the patient's body, using a hydrophilic pad.

The drug is administered to the patient from an electrode that carries the same charge as the ionized particles. Ions of non-metals and acids are attracted to the cathode, and therefore, they are injected through the negative pole. Ions of alkaloid compounds and metals are attracted to the anode and are introduced through the positive pole. The dosage of the drug is determined taking into account the phoretic mobility of the aqueous solution and concentration. The current density is set depending on the state of the human body, its subjective sensation, but without exceeding 0.1 mA per centimeter squared. The course of the procedure normally indicates a slight tingling and tingling at the location of the electrodes. Burning symptoms require a reduction in electrical flux density.

Electrophoresis contraindications

1. Severe atherosclerosis.
2. Intolerance to the effects of galvanic current.
3. Cardiovascular diseases.
4. Common dermatoses.
5. Malignant neoplasms.
6. Tendency to bleed.
7. Purulent-inflammatory process in the stage of relapse.

Do you or your child have a weakened immune system and you do not know how to increase it? Do you often suffer from bronchial asthma? Do relatives have problems with the cardiovascular system and do they swallow all kinds of pills that have a negative effect on the liver? To cope with such situations, doctors often prescribe electrophoresis sessions for their patients. With the help of such procedures, a person will not only keep his liver healthy, but will quickly get back on his feet, getting rid of the ailment that bothered him. Thanks to electrophoresis, the drug reaches the desired organs faster, while providing the maximum effect. Today we will learn about the methods of conducting such sessions, in what cases they are prescribed, and also when they are forbidden to be held.

What is the procedure

Many people ask the question: "Electrophoresis - what is it and why is it better than taking drugs orally, intravenously or intramuscularly?". Now let's try to answer this question. Electrophoresis is a medical procedure that has several names: ionotherapy, iontophoresis, ionogalvanization, galvanoionotherapy. This is physiotherapy based on the effects of drugs delivered by electric current. The introduction of drugs in this way has the following advantages over the delivery of substances intravenously, intramuscularly or through the mouth:

Longer therapeutic effect.

The ability to deliver the drug to the desired area of ​​the body, while bypassing other organs.

Minimal risk of side effects.

Painless procedure.

Preservation of the normal structure of the patient's tissues during the administration of the drug.

Basic electrophoresis techniques

1. Galvanic belt.
2. General electrophoresis according to Vermel.
3. Ionic reflections according to Shcherbakov.
4. Facial electrophoresis according to Bourguignon.
5. Physiotherapy treatment is endonosal.

Galvanic Belt

Electrophoresis treatment in this case is indicated for diseases of the female genital organs. Also, this technique can be applied to men with prostatitis, sexual dysfunction, and vascular disorders.

The galvanic belt can be either upper or lower. In the first case, one pad is impregnated with a special warm solution and then applied to the thoracic and lumbar spine, in the second case, to the sacral and lumbar vertebrae.

The duration of the procedure is approximately 10 minutes. A course of such treatment can reach 20 sessions.

General electrophoresis according to Vermel

In this case, 3 pads with medicine are used. The first (largest) is determined on the back, between the shoulder blades. And the other two are superimposed on the calves. Thus, electrophoresis is done on almost the entire surface of the body, except for the face, neck and head. Electrophoresis - what is it? In what cases is it prescribed? This is a special technique designed to help adults and children with such problems as vegetative-trophic disorders, neurosis-like conditions, weakened immunity, metabolic disorders, diseases of the cardiovascular system.

The duration of the procedure according to the Vermel method can be from 20 to 40 minutes. The course of physiotherapy can be limited to 20 sessions.

Ionic reflexes according to Shcherbakov

For the treatment of hypertension and neurosis, as well as if the patient has peptic ulcers or joint disorders, this particular technique is used to carry out such a procedure as electrophoresis. What is it - physiotherapy according to Shcherbakov? In this case, the electrodes are applied to the upper and lower limbs of the patient. And you need to do this strictly diagonally. For example, right arm and right leg or vice versa. Overlays with solutions of potassium, magnesium, sodium or bromine are determined by the specialist on the shoulder and thigh. Above these places, the limbs are tied with a rubber bandage.

The duration of the procedure according to the Shcherbakov method can reach 40 minutes, no more. In this case, you need to take breaks. The course of such manipulations is usually 15-20 sessions.

Bourguignon facial electrophoresis

According to this technique, one electrode with a pad impregnated with medicine is placed on the closed eyelids, and the second on the back of the neck. In this case, electrophoresis is prescribed for patients who have diseases of the eyelids and anterior segment of the eyes.

The duration of such a procedure is small, it can reach 8 minutes. All the time while the manipulation is being carried out, the specialist must control the process. After all, the eyes are a sensitive organ, and any impact on them can cause discomfort, redness or swelling. Therefore, the nurse must strictly monitor the patient so that he does not have complications.

Endonosal electrophoresis: what is it

This is a procedure in which not cloth pads are used, but cotton swabs that are wetted with medicinal substances. Endonosal electrophoresis is done not through the skin, but through the mucous membrane. Thanks to this effect, ENT diseases are perfectly treated. Often, endonasal electrophoresis is done to children from the age of 3 years. In this case, the electrodes are placed as follows: one, which has two plates, is placed in both nostrils, and the second is placed on the back of the neck.

Effective hernia treatment with physiotherapy

Electrophoresis with "Karipazim" - a substance made on the basis of such biological additives as proteinases, papain, lysocin, chymopapain, has the following effect:

Softens cartilage.

Removes inflammatory processes.

It increases the secretion of collagen, as a result of which damaged fibers are scarred, and their elasticity is restored.

It is thanks to this effect that electrophoresis with "Karipazim" - an effective drug, has a positive effect on the body of a sick person, reducing the hernia in size, releasing the pinched nerve, and also alleviating inflammation and pain. Also, pads are wetted with this substance and are determined on the human body for the treatment of radiculitis, keloid scars, articular lesions, and neuralgic problems. Means "Karipazim" is a white powder, which is diluted with normal saline before the procedure.

Requirements for drugs used for physiotherapy

Any solution for electrophoresis must meet the following requirements:

1. To be pure, without impurities.
2. Prepare immediately before the procedure.
3. To prepare the solution, use only pure distilled water.
4. If the drug does not dissolve in water, then instead of this component you need to use purified alcohol, or the drug "Dimexide".

For electrophoresis, solutions are used from elements such as iodine, bromine, calcium, Novocain, Euphyllin and many others, which the doctor must prescribe.

Contraindications for the procedure

Many people ask themselves: “Is it possible to do electrophoresis if a person has a high temperature, has skin problems, wounds?”. No, by no means. However, these are not all contraindications through which the procedure cannot be performed. With the following health problems, it is forbidden to prescribe electrophoresis to the patient:

Tumors of any etiology and place of occurrence.

Acute stage of the inflammatory process.

Bronchial asthma.

Problems with blood clotting.

Allergy to the components of the drug to be administered.

Cost of the procedure

Electrophoresis, the price of which depends on many factors, can be carried out in a district hospital, in a private clinic, as well as at home. Naturally, the cost will vary. In the district hospital, the electrophoresis procedure will be the cheapest. The patient will need to buy medicines, and the manipulation itself is often carried out free of charge. If you do electrophoresis in a private clinic, then the cost of the procedure can range from 200 to 1000 rubles per session. It all depends on the status of the medical institution, equipment, area of ​​impact. At home, you can also carry out this procedure, but in this case the cost will also be high. Since the specialist will travel with the equipment, and this is an additional cost. But you can buy a special device and carry out manipulations yourself, but you will have to fork out for the equipment, since the cheapest device costs about 5 thousand rubles.

People's opinions about the procedure

Electrophoresis reviews from patients receive only positive. Parents who treat various problems in their children with the help of this procedure are especially happy. Moms note that during the session, the child does not experience stress, which he could get if he was given an intravenous or intramuscular injection of the medication. And in this case, boys and girls are not afraid, some even like to go to such procedures. And parents are glad that the medicine that enters the child's body in this way does not have a toxic effect. Also, many mothers like that this procedure allows you to achieve the maximum effect even with small doses of medication. But you don’t want to stuff your children with drugs in large quantities. However, with electrophoresis, this does not have to be done. After all, even a small dose of medicine will give a positive result. Plus, adult patients write that after electrophoresis sessions, excellent results of therapy are observed, the disease quickly passes. Also, people note that the medicine that enters the body in this way is there for a longer period due to its accumulation in the layers of the skin. And this, in turn, enhances the therapeutic effect of the drug.

Now you know what electrophoresis is, what popular methods are used. We also determined what requirements the medicines used for this physiotherapy must meet. And they learned about how patients respond to electrophoresis sessions.

Medicinal electrophoresis (synonym: iontophoresis, iontophoresis, ionogalvanization, galvanoionotherapy, electroionotherapy) is a combined effect on the body of galvanic current and drugs introduced with it through the skin or mucous membranes. Since 1953, in the USSR, it has been customary to use only the term "medicinal electrophoresis" to refer to the method of introducing into the body using a galvanic current not only ions of electrolyte solutions, but also larger particles associated with ions and complex molecules of organic compounds.

Ions of medicinal substances during drug electrophoresis, penetrating mainly through the excretory openings of the sweat and sebaceous glands, are retained in the thickness of the skin under the electrode. From such a skin depot, ions enter the lymph and blood stream gradually. This creates conditions for a longer exposure of the drug to the body - one of the important advantages of electrophoresis compared to other methods of administering drugs. With medicinal electrophoresis, not only stimulation of various protective physiological reactions by galvanic current is observed (see Galvanization), but also the specific effect of the medicinal substance, due to its pharmacological characteristics.

The complex mechanism of the physiological and therapeutic action of drug electrophoresis is based on the complex stimulation of the receptor apparatus of the skin by galvanic current and the ions of the medicinal substance introduced through it, transmitted through the nerve pathways to the higher autonomic centers of the brain, as well as the pharmacological action of the medicinal substance in an electrically active state. Thus, during electrophoresis, along with local changes in tissues, generalized vegetative reflexes arise (according to A.E. Shcherbak, general ionic reflexes). Ionic reflexes are universal: they can be called from any, even a small, area of ​​the skin with normal sensitivity. To obtain a therapeutic effect, it is not necessary to place electrodes in the area of ​​the affected organ or strive in all cases to create a high concentration of medicinal substances in the blood. In physiotherapy practice, extrafocal methods of electrophoresis of medicinal substances in the form of general calcium-, iodine-, zinc-, magnesium-, salicyl- and other ionic reflexes are widely used. Of therapeutic value are focal effects, which are realized through the reflex mechanism of action of the galvanic current and the introduced substance, and changes in the electroionic state of tissues under the influence of direct current electric field lines in the interpolar space. In this case, there is a local increase in blood and lymph circulation, an increase in local metabolism, a change in the permeability of histohematic barriers, which determines the preferential resorption by the tissues of the drug flowing through this area after its penetration from the skin depot into the general bloodstream.

Indications. Electrophoresis is prescribed for many diseases, including severe and long-term current, subject to treatment with galvanization (see) and various medicinal substances. When prescribing drug electrophoresis of certain drugs, it is necessary to take into account both the features of their pharmacological action and the indications for the use of these drugs with other methods of their administration. Medicinal electrophoresis should not be contrasted with other treatments; it should be considered as a method that expands the possibilities of using many drugs for therapeutic and prophylactic purposes in nervous, surgical, internal, gynecological diseases, diseases of the eyes, ear, etc. By electrophoresis, a wide variety of medicinal substances can be administered, if only the possibility of moving them under by direct current (table).

* Aloe extract is prepared from leaves aged for 15 days in the dark at t° 4-8°. A slurry is prepared and poured with distilled water (100 g of mass per 300 ml of water), infused for an hour at room temperature, boiled for 2 minutes, filtered and poured into a bowl of 50-200 ml. The bottles are boiled in a water bath for 15 minutes. The extract is stored in a dark place.
** 600-1000 IU per 1 cm 2 pads (5000-10,000 IU in 1 ml of solution).
*** Like penicillin.
**** 100,000-1,000,000 IU (in 0.1-1 g of powder) per pad (solvent - saline, 10-30 ml).

Depending on the characteristics of the clinical picture, the course of the process and the state of the body, reflex-segmental (see Segmental-reflex therapy), general or local electrophoresis procedures are prescribed.

Contraindications: neoplasms, decompensation of cardiac activity, acute inflammatory processes, a tendency to bleeding, some forms of eczema and dermatitis, individual intolerance to the prescribed medicinal substance or galvanic current.

Electrophoresis technique. For medicinal electrophoresis, galvanic current sources are used. Apply metal electrodes, thick cloth pads, observing all the rules for the procedures and location of the electrodes, as in galvanization. In contrast to galvanization, a piece of filter paper moistened with a solution of a medicinal substance prepared in distilled water is applied to the wet pad under the active electrode, or a piece of gauze folded in half - according to the size of the pad, and the pad under the indifferent electrode is moistened with warm water.

The procedures are carried out at a current density ranging from 0.01 to 0.1 mA/cm 2 depending on the technique (the larger the pad area, the lower the current density should be used to avoid over-irritation and adverse reactions). The duration of the procedure is 10-20 minutes, less often 30 minutes, if necessary, it is increased to 40-60 minutes. During the course of treatment, an average of 15-20 procedures should be carried out, prescribed daily, every other day or at other intervals with special techniques. With long-term or recurrent diseases, after a one-two-month break, you can repeat the courses of treatment.

In practice, in addition to topical application, the following methods of electrophoresis of medicinal substances are most common.

General ionic reflections according to Shcherbak. Two electrodes with pads with an area of ​​120-140 cm 2 each are placed transversely or diagonally, more often on the shoulder (Fig. 3) or on the thigh. The electrodes are connected by means of flexible insulated wires to sources of galvanic current in accordance with the polarity of the introduced ions. Usually, solutions of calcium chloride, potassium iodide, zinc sulfate, sodium bromide, magnesium sulfate, sodium salicylate are used. A rubber bandage is applied above the electrodes to induce a mild degree of congestive hyperemia. The current density is gradually increased from 0.05 mA/cm 2 to 0.15-0.2 mA/cm 2 . The duration of the procedure is 20 minutes. After the 10th and 17th minutes, a one-minute break is made to reduce the polarization resistance.

Rice. 3. The location of the electrodes when causing a common ionic reflex:
1 and 2 - lead plates with cloth pads;
3 - insulated wire;
4 - rubber bandage.

Rice. 4. Location of the electrodes at the ion collar.

Ionic collars(calcium, iodide, bromide, salicylic, magnesium, novocaine, aminophylline, etc.). Three layers of filter paper or gauze with an area of ​​1000 cm 2 dipped in 50 ml of a solution of a medicinal substance prepared in distilled water (t ° 38-39 °) are applied to the collar zone (cervical and two upper thoracic skin segments). A gasket of the same area of ​​flannel or calico 1 cm thick is placed on top of the metal electrode. Another electrode with a pad of 400 cm2 is placed in the lumbosacral region (Fig. 4). Cloth pads are moistened with warm water (t ° 38-39 °). With the help of an ionic collar, calcium from the anode and bromine from the cathode (calcium-bromide collar), novocaine from the anode and iodine from the cathode (novocaine-iodine collar) and some other combinations can be simultaneously injected. During the first procedures, the current is gradually increased from 4-6 to 10 mA, and the duration of the session is from 6 to 10 minutes. If necessary, the current can be increased to 16 mA, and the duration of the procedure - up to 20 minutes.

Ionic belts(calcium, bromide, iodide, magnesium, etc.). At the level of the lower thoracic and upper lumbar vertebrae (with the upper belt) or at the level of the lower lumbar and sacral vertebrae (with the lower belt), three layers of filter paper or gauze with an area of ​​​​1125 cm 2 (15X75 cm) moistened with 50 ml of a medicinal substance solution are applied, prepared with distilled water (t° 38-39°). A cloth pad of the same area 1 m thick and a metal electrode are placed on top. Two indifferent electrodes with pads with an area of ​​320 cm 2 each are placed on the front surface of the upper third of the thighs with the upper belt or on the back of the thighs with the lower belt (Fig. 5). The current is from 8 to 15 mA, the duration of the procedure is 8-10 minutes, if necessary, it is increased to 15-20 minutes.

General electrophoresis according to Vermel. An active electrode with filter paper on a 300 cm 2 pad moistened with a drug solution is placed in the interscapular region, and two indifferent electrodes with 150 cm 2 pads are placed on the back surface of the legs (Fig. 6). Current 10-30 mA, procedure duration 20-30 minutes.

Orbital-occipital electrophoresis according to Bourguignon. Two active round-shaped electrodes with a diameter of 5 cm with pads moistened with a solution of a medicinal substance are applied in the orbital area over closed eyes; an indifferent electrode with a gasket with an area of ​​40-60 cm 2 is placed on the back of the neck. Current up to 4 mA, procedure duration up to 30 minutes.

Nasal electrophoresis, proposed by N. I. Grashchenkov and G. N. Kassil, consists in the introduction into both nostrils of cotton swabs moistened with a medicinal substance on the tinned ends of the wires or gauze turundas, the ends of which are laid over a strip of oilcloth above the upper lip, covering with an active electrode 2x3 cm in size. An indifferent electrode with a pad of 80 cm 2 is placed on the back of the neck.

Sometimes electrophoresis of medicinal substances is used using four- or two-chamber baths. A number of special electrophoresis techniques are used in otiatry, ophthalmology, gynecology, and dermatology. Electrophoresis of medicinal substances can be combined with inductothermy (see) and mud applications (see. Mud therapy).

Medicinal electrophoresis - a combination of exposure to the body of a direct electric current and a medicinal substance introduced with its help. In this case, the therapeutic effects of the administered medicinal substance are added to the mechanisms of action of direct current. They depend on the mobility, the route of administration, the amount of the drug entering the body and the area of ​​​​its administration. Medicinal substances in solution decompose into ions and charged hydrophilic complexes. When such solutions are placed in an electric field, the ions contained in them move towards opposite electric poles (electrophoresis), penetrate deep into the tissues and have a therapeutic effect. From the gasket under the positive electrode, metal ions (from salt solutions), as well as positively charged particles of more complex substances, are introduced into the tissues of the body; from the gasket under the negative electrode - acid radicals, as well as negatively charged particles of complex compounds.

The penetrating power of drug ions depends on their structure and on the degree of electrolytic dissociation. It is not the same in different solvents and is determined by their permittivity (ε). Medicinal substances dissolved in water have greater mobility in an electric field (). Aqueous solutions of glycerin () and ethyl alcohol () are used to dissociate water-insoluble substances. The introduction of medicinal substances in an ionized form increases their mobility and enhances the pharmacological effect. The complication of the structure of the drug reduces its mobility.

Scheme of electrophoresis

Injected medicinal substances penetrate the epidermis and accumulate in the upper layers of the dermis, from which they diffuse into the vessels of the microvasculature and lymphatic vessels. The period of excretion of various drugs from the skin "depot" ranges from 3 hours to 15-20 days. This causes a long stay of medicinal substances in the body and their prolonged therapeutic effect. The amount of drug that enters the body by electrophoresis is 5-10% of the drug used during the treatment procedure. Increasing the concentration of solutions (over 5%) to increase the amount of substances introduced into the body does not improve the treatment effect. In this case, electrophoretic and relaxation braking forces arise due to the electrostatic interaction of ions (Debye-Hückel phenomenon). They inhibit the movement of drug ions into tissues.

The pharmacological effects of medicinal substances entering the body are manifested with the introduction of potent drugs and metal ions in small quantities. Medicines act locally on the tissues under the electrodes. They are able to cause pronounced reflex reactions of the corresponding organs, increase their blood flow and stimulate tissue regeneration. For example, iodine ions introduced into the body by electrophoresis increase the dispersity of the connective tissue and increase the degree of protein hydrophilicity:

Lithium ions dissolve lithium salts of uric acid.

Copper and cobalt ions activate the metabolism of sex hormones and participate in their synthesis.

Magnesium and calcium ions have a pronounced hypotensive effect.

Zinc ions stimulate regeneration and have a fungicidal effect.

Some of the introduced substances can change the functional properties of the skin fibers of tactile and pain sensitivity. Based on this, the combined effect of electric current and local anesthetics causes a decrease in the impulse flow from the painful focus and creates an analgesic effect of direct current. Such phenomena are expressed under the cathode. A constant electric current changes the pharmacological kinetics and pharmacological dynamics of administered drugs. As a result of the combined action, the therapeutic effects of most of them (with the exception of some anticoagulants, enzymes and antihistamines) are potentiated. Substances entering the skin accumulate locally. This allows you to create significant concentrations of these substances in the surface affected areas. With this method of administration, there are no side effects of oral and parenteral administration of drugs. The action of ballast ingredients is weakly expressed and the solutions do not require sterilization. This allows them to be used in the field. It is also possible to accumulate medicinal substances (in particular, antibiotics) in pathological foci of internal organs (intraorganic electrophoresis), cytostatics and immunostimulants in tumors (electrochemotherapy). In this case, the concentration of drugs in the interelectrode tissues increases by 1.5 times.

The total amount of electricity passed through the tissues should not exceed 200 pendants. The amount of drug used usually does not exceed its single dose for parenteral and oral administration.