Tıbbi Sülük Terapisi (Hirudoterapi)

Sülükler halkalı omurgasızlar sınıfındadır, kan ile beslenirler ve antik dönemden beri çeşitli hastalıkları tedavi etmek için flebotomide kullanılırlar. Hirudoterapi, tedavi için tıbbi sülüklerin uygulanmasıdır. Sülük tedavisinin terapötik kullanımı köklü bir yöntemdir ve eski Mısır'a, medeniyetin başlangıcına dayanır. 20. yüzyılın sonunda yeni terapi kavramları sülük tedavisinin yerini almıştır. Mikrovasküler cerrahi tekniklerle birlikte son yıllarda tıbbi sülüklerin kullanımında bir “yeniden doğuş” olmuştur. Hirudo medicinalis, sülükler arasında en geniş terapotik kullanıma sahiptir ancak dünya çapında birçok farklı tür test edilmiş ve incelenmiştir. Sülük tedavisi genellikle ağrısız olan bir ilk ısırığı, ardından 5 ila 15 ml kan emmeyi içerir. Başlıca terapötik faydaları sadece ısırma sırasında emilen kandan değil, aynı zamanda çeşitli biyoaktif maddelerden de kaynaklanmaktadır. Sülük tükürüğü; eglin, bdellin, hirudin, hyaluronidaz, calin, destabilas, apiraz, dekorin, hirustatin, triptaz inhibitörleri ve histamin benzeri maddeler, kompleman inhibitörleri, karboksipeptidaz A-inhibitörleri ve asetilkolin gibi çeşitli biyoaktif bileşikler içerir. Bu bileşikler; koagülasyonun inhibisyonundan, analjezik etkiden, kas gevşetici etkiden ve bağışıklık sistemi üzerindeki düzenlemeden sorumludur. Hirudoterapi; kardiyoloji, ortopedi, jinekoloji, oftalmoloji, plastik ve rekonstrüktif cerrahi gibi alanlarda geniş bir terapötik uygulama yelpazesine sahiptir. Bu derleme sülükler hakkında; tarihçesi, genel özellikleri, etki mekanizmaları ve tıbbi bir cihaz olarak uygulanmasını içeren genel bir bakış sunar.

Anahtar Kelimeler:

Tıbbi sülük, Hirudoterapi, Endikasyonlar

Medical Leech Therapy (Hirudotherapy)

Leeches are a class of segmented invertebrates, known for their blood-feeding habits and used in phlebotomy to treat various ailments since antiquity. Hirudotherapy is the application of medicinal leeches for therapeutic use. The therapeutic use of leech therapy is an established method and dates back to ancient Egypt and the beginning of civilization. At the end of the 20th century new therapy concepts took the place of leech therapy. With microvascular surgery techniques there has been a “rebirth” in the use of medicinal leeches in recent years. Hirudo medicinalis has widest therapeutic usage among the leeches, but worldwide, many different species were tested and studied. Leech therapy involves an initial bite, which is usually a painless bite, followed by the sucking of 5 and 15 ml of blood. It’s major therapeutic benefits are not only due to blood sucked during the biting, but also from the various bioactive substances. Saliva of leech contains various bioactive compounds such as: eglins, bdellins, hirudin, hyaluronidase, calin, destabilase, apyrase, decorsin, hirustatin, tryptase inhibitors, and histamine like substances, complement inhibitors, carboxypeptidase A- inhibitors and acetylcholine. These substances are responsible for inhibiting blood coagulation, analgesic effect, dilating effect on muscles and regulation on immune system. Hirudotherapy has a broad spectrum of therapeutic application in the medical field ranging from cardiology, orthopedy, gynaecology, ophthalmology, plastic and reconstructive surgeries. This review presents an overview of leech including the history, general characteristics and mechanisms of action of leeches, and its application as medical device.

Keywords:

Medicinal leech, Hirudotherapy, Indications,

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Journal of Biotechnology and Strategic Health Research-Cover

Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2017
Yayıncı: Deneysel, Biyoteknolojik, Klinik ve Stratejik Sağlık Araştırmaları Derneği

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