增生性瘢痕药物种类与药物透皮吸收治疗的新进展

New developments in the types of drugs and the treatment of transdermal absorption of drugs for hypertrophic scars

增生性瘢痕以真皮层的成纤维细胞异常增殖、胶原纤维过度堆积为主要特征。常见的治疗增生性瘢痕的药物包括类固醇激素、A型肉毒杆菌毒素、抗肿瘤药物、钙通道阻滞剂、免疫抑制剂、脂肪及其衍生物及细胞因子调控相关药物;可供选择的药物种类虽多,但疗效却不理想,主要原因是传统的口服给药和局部涂抹给药难以以有效的药物浓度到达瘢痕组织,尽管局部注射给药可针对性作用于瘢痕组织,但无法维持稳定的药物浓度,且常常因疼痛难以长久坚持。因此,研究人员试图寻求更多的方式促进药物的透皮吸收从而解决药物的定向和缓释问题,如微针、驻极体、脂质体、射频或激光联合超声药物导入技术(IMPACT)等。现就近年来国内外常见的治疗增生性瘢痕的药物及其相关调控机制和促进药物透皮吸收的方法作综述。

Hypertrophic scars are mainly characterized by abnormal proliferation of fibroblasts in the dermis and excessive accumulation of collagen fibers.Common drugs for the treatment of hypertrophic scars include steroid hormones,botulinum toxin type A,anti-tumor drugs,calcium channel blockers,immunosuppressants,fats and their derivatives,and cytokine regulation-related drugs.Although there are many types of drugs to choose from,the curative effect is not ideal.The main reason is that traditional oral administration and topical smear administration are difficult to reach the scar tissue at an effective drug concentration.Although local injection administration can target scar tissue,it cannot maintain a stable drug concentration,and it is often difficult to persist for a long time because of pain.Therefore,researchers are trying to find more ways to promote the transdermal absorption of drugs to solve the problem of drug orientation and sustained release,such as microneedles,electrets,liposome,radiofrequency or laser combined with ultrasonic drug delivery technology(IMPACT).This article reviews the common drugs used in the treatment of hypertrophic scars at home and abroad in recent years and their related regulatory mechanisms,as well as the methods to promote drug transdermal absorption.