Transcranial electrical stimulation (TES) in patients with atopic dermatitis

Violetta A. Marchenko, N. G. Kochergin, Maria I. Dodina
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Abstract

BACKGROUND: Atopic dermatitis is the most common diseases in dermatology, among the main pathogenetic mechanisms of development of which a complex interaction of a genetically determined defect in the barrier function of the skin, an overactive state of the immune system is considered, and a neurogenic theory of disease development is not excluded, which is based on the relationship of anxiety-stress reactions and neuropsychiatric stresses with the occurrence of pathological changes on the skin. Modern atopic dermatitis therapy is characterized by the appointment of a large number of medications according to clinical recommendations, and the associated increase in allergic and toxic-allergic reactions dictates the need to search for new non-drug treatments for this disease. In order to prevent the pathological effects of stress, as well as to increase resistance to its damaging effects, activation of opioidergic mechanisms may be useful. AIM: To evaluate the effectiveness and acceptability of the transcranial electrical stimulation technique in patients with atopic dermatitis. MATERIALS AND METHODS: A controlled study was conducted among 60 patients with moderate atopic dermatitis, 33 women (55.0%) and 27 men (45.0%) aged 19 to 72 years. Transcranial electrical stimulation was carried out by a pulsed bipolar electrical stimulator with an acoustic effect "TRANSAIR-07", stimulation was carried out by an electric current with a frequency of 77.5 Hz and a duration of 3.5 ms. Patients underwent 10 procedures, 1 time a day, lasting 30 minutes, with a current of 1−3 mA. SCORAD, EASI, IGA, DLQI, HADS, and BDI scales were used to assess the dynamics of clinical manifestations. The assessment was carried out on the first and last day of treatment. RESULTS: During statistical data processing, when comparing the scales in the first and last days of the procedures, depending on the patient groups: the 1st group was the main one, received transcranial electrical stimulation treatment in combination with therapy, according to clinical recommendations, the 2nd group was the control group, received treatment according to clinical recommendations, without the use of transcranial electrical stimulation, significant improvement of itching indicators, clinical manifestations and improvement of quality of life after 4 weeks of therapy in both groups. A statistically more significant dynamics of the indicators of the main clinical scales in favor of combination therapy was established: according to the SCORAD scale ― in the main group from 47.50±2.25 to 21.00±1.00, in the control group from 47.00±2.00 to 39.00±1.75; DLQI ― in the main group from 8.00±2.00 to 2.00±0.75, in the control group ― from 8.50±1.50 to 5.00±1.00. CONCLUSION: The paper presents the positive results of our own research and presents data confirming the clinical effectiveness of transcranial electrostimulation in patients with atopic dermatitis compared with the traditional drug treatment of this disease, which allows us to recommend the treatment regimen we have proposed for widespread implementation in the practice of a dermatovenerologist.
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经颅电刺激(TES)在特应性皮炎患者中的应用
背景:特应性皮炎是皮肤科最常见的疾病,其主要发病机制包括由基因决定的皮肤屏障功能缺陷、免疫系统过度活跃状态的复杂相互作用,也不排除疾病发生的神经源理论,该理论基于焦虑应激反应和神经精神压力与皮肤病理变化的发生之间的关系。现代特应性皮炎治疗的特点是根据临床建议使用大量药物,而与之相关的过敏反应和毒性过敏反应的增加决定了需要寻找新的非药物治疗方法。为了预防应激的病理效应,并增强对其破坏性影响的抵抗力,激活阿片能机制可能是有用的。目的:评估经颅电刺激技术对特应性皮炎患者的有效性和可接受性。材料与方法:对 60 名中度特应性皮炎患者进行了对照研究,其中女性 33 人(55.0%),男性 27 人(45.0%),年龄在 19 至 72 岁之间。经颅电刺激由具有声学效应的脉冲双极电刺激器 "TRANSAIR-07 "进行,刺激由频率为 77.5 赫兹、持续时间为 3.5 毫秒的电流进行。患者接受了 10 次治疗,每天 1 次,每次持续 30 分钟,电流为 1-3 毫安。采用 SCORAD、EASI、IGA、DLQI、HADS 和 BDI 量表评估临床表现的动态变化。评估在治疗的第一天和最后一天进行。结果:在统计数据处理过程中,在比较治疗第一天和最后一天的量表时,根据患者分组:第一组为主要组,根据临床建议接受经颅电刺激治疗,并结合治疗;第二组为对照组,根据临床建议接受治疗,但不使用经颅电刺激,两组患者在治疗 4 周后,瘙痒指标、临床表现和生活质量均有显著改善。在统计学上,主要临床量表指标的动态变化对联合疗法更为有利:根据 SCORAD 量表,主要治疗组从 47.50±2.25 降至 21.00±1.00,对照组从 47.00±2.00 降至 39.00±1.75;DLQI - 主要治疗组从 8.00±2.00 降至 2.00±0.75,对照组从 8.50±1.50 降至 5.00±1.00。结论:本文介绍了我们自己研究的积极成果,并提供数据证实经颅电刺激治疗特应性皮炎患者的临床疗效优于传统的药物治疗,因此我们建议在皮肤科医生的临床实践中广泛采用我们提出的治疗方案。
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