Clinical Diathermy Performance Evaluation of Multi-hour Sustained Acoustic Medicine Treatment with 2.5% Diclofenac Ultrasound Coupling Patch.
Clinical Diathermy Performance Evaluation of Multi-hour Sustained Acoustic Medicine Treatment with 2.5% Diclofenac Ultrasound Coupling Patch.
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发表时间：
2023
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通讯作者：
Bavanasi K
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作者：
Hendren TF;Yeretzian NR;Bavanasi K
低强度连续超声(LICUS)治疗软组织损伤。它通过其传热性和力学传导性激活多种愈合过程，从而缓解急性和慢性肌肉骨骼疼痛。双氯芬酸已被FDA批准为非类固醇抗炎药(NSAID)。它是一种止痛和消炎药物，有口服和外用两种形式。在超声偶联凝胶中加入2.5%的双氯芬酸钠，除了双氯芬酸钠的止痛作用外，还可以用来传递LICUS，而不改变超声穿透的导热和声学效应，且没有不良反应。目的：研究在标准水溶液超声凝胶中添加2.5%双氯芬酸钠对长期持续声学药物(SAM)治疗的超声耦合和透热性能的影响。在两个阶段的研究中，首先，用水和2.5%双氯芬酸超声耦合贴片在牛组织中测定了长达4小时的SAM刺激1 cm、2 cm和5 cm时的声学和透热变化。然后，在第二阶段，在使用和不使用2.5%双氯芬酸凝胶的情况下，记录54名健康成年受试者在SAM治疗期间前臂和小腿的加热曲线。添加2.5%的双氯芬酸钠显著增加偶联凝胶密度、声阻抗和信号传播(p<；0.0001)，而对1 cm、2 cm和5 cm深度的透热曲线影响很小或没有影响。含2.5%双氯芬酸钠的偶联凝胶维持治疗超声强度的时间比含水偶合凝胶的长(5.5cmvs4.5p<；0.0009)。使用2.5%双氯芬酸超声凝胶偶联贴片，小腿和前臂皮肤上的透热没有显著差异。在超声凝胶中加入2.5%的双氯芬酸钠可增加声阻抗，改善超声信号与深层组织的耦合，在SAM治疗期间提供更长时间的深层组织加热，而不会对透热状况产生负面影响。
Low-intensity Continuous Ultrasound (LICUS) therapy heals soft tissue injuries. It alleviates acute and chronic musculoskeletal pain by activating multiple healing processes through its diathermic and mechanotransducive properties. Diclofenac has been FDA-approved as a Non-Steroidal Anti-Inflammatory Drug (NSAID). It is an analgesic and anti-inflammatory drug available in oral and topical forms. Adding 2.5% diclofenac sodium to ultrasound coupling gel can be used to deliver LICUS in addition to the analgesic effects of diclofenac sodium without altering the diathermic and acoustic effects of the ultrasound penetration with no undesired adverse effects. To determine the effects of adding 2.5% diclofenac sodium to standard aqueous ultrasound gel on the ultrasound coupling and diathermic properties of a long duration Sustained Acoustic Medicine (SAM) treatment. In a two-phase study, first, the acoustic and diathermic changes were determined in bovine tissue during 4-hour-long SAM stimulation at 1 cm, 2 cm, and 5 cm with aqueous and 2.5% diclofenac ultrasound coupling patch. Then, in the second phase, the heating profiles were recorded with and without 2.5% diclofenac gel in 54 healthy adult subjects at the forearm and calf during the SAM treatment. The addition of 2.5% diclofenac sodium significantly increased coupling gel density, acoustic impedance, and signal propagation (p<0.0001) with little or no effect on the diathermic profiles at 1 cm, 2 cm, and 5 cm depth. The coupling gel with 2.5% diclofenac sodium sustained the therapeutic ultrasound intensity longer than the aqueous coupling gel (5.5 cm relative to 4.5, p<0.0009). No significant diathermic difference was recorded on the calf and forearm skin with a 2.5% diclofenac ultrasound gel coupling patch. Adding 2.5% diclofenac sodium to ultrasound gel increases acoustic impedance, improves ultrasound signal coupling into deep tissue, and provides longer sustained deep tissue heating without negatively impacting the diathermic profile during SAM treatment.