非生物降解型及生物降解型长效皮下埋植避孕剂的理论研究与应用进展

Non-biodegradable and biodegradable long-term subdermal contraceptive implants:advances in theoretical research and application

背景:皮下埋植避孕剂是一种新型的避孕方法,目前已在全世界推广使用。目的:论述非生物降解型及生物降解型长效皮下埋植避孕剂的发展现状,对其优缺点进行探讨。方法:由第一作者用计算机检索中国知网、万方数据库、Pub Med数据库1967至2015年收录的有关文献,中文检索词为"埋植避孕剂、非生物降解、生物降解",英文检索词为"contraceptive implants,non-biodegradable,biodegradable"。共检索到文献240篇,选取符合要求的70篇进行综述。结果与结论:长效皮下避孕埋植剂通过局部毛细血管进入血液循环系统,避免了肠胃吸收,提高了药物的生物利用度,同时降低了药物的不良反应。根据药物载体的性能分为非生物降解和可生物降解两类。非生物降解埋植剂已被广泛应用,但因其非降解特性,致使不被机体吸收或代谢,需二次手术取出;生物降解型埋植剂药物释放完毕后,可生物降解的材料也基本降解,但由于材料本身特性所导致的缺陷限制了其应用,因此,需要寻找更加适合的生物降解型缓释载体。

BACKGROUND： Subdermal contraceptive implants as a novel contraceptive method have been extensively used worldwide. OBJECTIVE： To review the research progress in the non-biodegradable and biodegradable long-term subdermal contraceptive implants and to explore their advantages and disadvantages. METHODS： A computer-based search of CNKI, Wanfang, and PubMed （1967-2015） was performed by the first author for relevant articles, using the key words of “contraceptive implants, non-biodegradable, biodegradable” in Chinese and English, respectively. Initially 240 articles were retrieved, and finally 70 articles were included in result analysis. RESULTS AND CONCLUSION： Long-term subdermal contraceptive implants that pass through the local capillaries into the blood circulation system can avoid the gastrointestinal absorption, improve the bioavailability of drugs, and reduce adverse drug reactions. According to the performance, there are two kinds of drug carriers, non-biodegradable and biodegradable. Although non-biodegradable implants have been widely used and the contraceptive effect is excellent, the implants must be removed surgically because they cannot be absorbed or metabolized in the body. Significant efforts have been devoted to developing biodegradable implants because they can degrade at the end of use. However, the utility of some biodegradable polymers as drug carriers in implantable applications has been hampered by their shortcomings, and further study on alternative materials is urgently required.