Eficacia de medicamentos antihomotóxicos en el tratamiento del síndrome miofascial cervical y de cintura escapular: estudio comparativo versus toxina botulínica tipo A

Introduction: Myofascial pain syndrome is a common cause of muscle pain in cervical region and shoulder girdle. Treatment has included conservative means and invasive procedures; conservative means include drugs, modalities of physical therapy, massage and therapeutic exercise; Invasive procedures include dry nedling and trigger point injections of various substances such as botulinum toxin type A, steroids and local anesthetics and even has been reported effective with the injection of complex homeopathic medicines known as antihomotoxic drugs. Objective: To compare the effectiveness of the intramuscular injections in trigger points using a Botulinum toxin type A versus antihomotóxic drugs. Materials and methods: We conducted a pilot study, longitudinal, prospective, randomized and blind, type controlled clinical trial, which included 31 patients with diagnosis of myofascial syndrome of cervical region and shoulder girdle, divided in 3 groups; each group received intramuscular injections in trigger points. One group was treated with botulinum toxin type A with a dose of 10U by trigger point, another group was treated with a combination of antihomotoxic drugs that included a mixture of Traumeel(r) S, Spascupreel(r), Gels Homaccord(r) y Lymphomyosot(r) at a rate of 1 ml of this combination by trigger point; the third group received placebo treatment with saline solution at 0.9 % at the rate of 1 ml. for trigger point. The three groups were evaluated mobility, muscular strength, pain intensity with EVA, number of trigger points and disability index of the neck at the start of treatment and at 6 weeks. Results: It was observed a decrease of pain and the number of trigger points in the 3 groups, however it was only statistically significant in the group treated with antihomotoxic drugs. Conclusions: The use of antihomotoxic drugs applied by intramuscular injection in the trigger points can be an effective treatment option in patients with cervical myofascial pain syndrome.Introducción: El síndrome de dolor miofascial es una causa común de dolor muscular en región cervical y cintura escapular. El tratamiento ha incluido medios conservadores y procedimientos invasivos; los medios conservadores incluyen fármacos, modalidades de terapia física, masaje y ejercicio terapéutico; los procedimientos invasivos incluyen punción seca e inyecciones en los puntos gatillo de diversas sustancias como toxina botulínica tipo A, esteroides, anestésicos locales e incluso se ha reportado eficacia con la inyección de medicamentos homeopáticos complejos conocidos como medicamentos antihomotóxicos. Objetivo: Comparar la eficacia de las inyecciones intramusculares en puntos gatillo, usando toxina botulínica tipo A versus medicamentos antihomotóxicos. Materiales y métodos: Se realizó un estudio experimental, longitudinal, prospectivo, aleatorizado y ciego, tipo ensayo clínico controlado, que incluyó 31 pacientes con diagnóstico de síndrome miofascial de región cervical y cintura escapular, divididos en 3 grupos; cada grupo recibió inyecciones intramusculares en puntos gatillo. Un grupo fue tratado con toxina botulínica tipo A con una dosis de 10 U por punto gatillo, otro grupo se trató con una combinación de medicamentos antihomotóxicos que incluyó una mezcla de Traumeel(r) S, Spascupreel(r), Gels Homaccord(r) y Lymphomyosot(r) a razón de 1 ml de esta combinación por punto gatillo; el tercer grupo recibió tratamiento placebo con solución salina al 0,9 % a razón de 1 ml por punto gatillo. A los tres grupos se les evaluó arcos de movilidad, fuerza muscular, intensidad del dolor con la EVA, número de puntos gatillo e índice de discapacidad del cuello al inicio del tratamiento y a las 6 semanas. Resultados: Se observó una disminución del dolor y del número de puntos gatillo en los 3 grupos, sin embargo solo fue estadísticamente significativa en el grupo tratado con medicamentos antihomotóxicos. Conclusiones: El uso de medicamentos antihomotóxcos aplicados mediante inyección intramuscular en los puntos gatillo puede ser una opción de tratamiento eficaz en pacientes con síndrome doloroso miofascial cervical

Is Ozone therapy an adjunct treatment for SARS-CoV-2 / COVID-19 infection?

Up to today, there is no specific treatment against SARS-CoV-2 / COVID-19 infection; there the necessity to search for alternatives that help patients with COVID-19. The objective of this study was to review the use of ozone therapy as adjunct treatment for SARS-CoV-2 / COVID-19 infection, highlighting the mechanisms of action, forms of application and current clinical evidence. A systematic review was conducted in electronic databases, searching the terminology Ozone “or” Ozone therapy “and” SARS-CoV-2 or COVID-19 or Coronavirus. Results: nineteen studies were included; ten were editorials, comments, brief reports or reviews, and nine clinical studies. We found that ozone therapy could be favorable for treating patients infected with SARS-CoV-2 / COVID-19, through a direct antiviral effect, regulation of oxidative stress, immunomodulation and improvement of oxygen metabolism. Patients who were treated with ozone therapy responded favorably; therefore, ozone therapy appears to be a promising treatment for patients infected with SARS-CoV-2 / COVID-19. Its mechanism of action justifies its use as an adjuvant therapy; however, scientific evidence is based on case series and clinical trials are necessary to corroborate its effectiveness and safety