Treatment of finger spasm after stroke with wheat grain moxibustion at Shixuan (EX-UE 11) combined with rehabilitation training: a randomized controlled trial / 中国针灸

OBJECTIVE@#To compare the clinical effect of wheat grain moxibustion combined with rehabilitation training and simple rehabilitation training on finger spasm after stroke.@*METHODS@#A total of 80 patients with finger spasm after stroke were randomly divided into an observation group and a control group, 40 cases in each group. The control group was given routine rehabilitation training, once a day, 30 min each time. The observation group was given wheat grain moxibustion at Shixuan (EX-UE 11) on the basis of the control group, 8~10 moxibustion cones at each point, once a day. Both groups were treated for 6 days as one course of treatment for 4 courses. The motor function of the affected hand (Fugl-Meyer assessment [FMA] score) and muscle tension (modified Ashworth scale [MAS] grading), surface EMG indexes (wrist dorsiflexor muscle and flexor carpal metacarpal muscle mean square [RMS] value), hand muscle strength (neurological deficit score [NDS]) and daily living ability (modified Barthel index [MBI] score) were compared between the two groups before and after treatment, and clinical efficacy was evaluated.@*RESULTS@#After treatment, FMA and MBI scores in the 2 groups were increased compared with before treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The RMS value of wrist dorsiflexor muscle and flexor carpal metacarpal muscle in relaxation and passive function testsand and NDS in the 2 groups were lower than those before treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05). MAS grading in the 2 groups was improved compared with before treatment (P<0.05), and that in the observation group was better than the control group (P<0.05). The total effective rate of the observation group was 92.5% (37/40), which was higher than that of the control group (80.0%, 32/40, P<0.05).@*CONCLUSION@#Wheat grain moxibustion at Shixuan (EX-UE 11) combined with rehabilitation training can improve the hand motor function and daily living ability of patients with finger spasm after stroke, improve the degree of spasm and the function of wrist dorsiflexor muscle and flexor carpal metacarpal muscle, the clinical effect is better than simple rehabilitation training.

Antispasmodic effect of hydroalcoholic extract of thymus vulgaris on the guinea-pig ileum

The widespread use of medicinal herbs among the general population gives rise to the possibility of therapeutic or toxic effects in patients that use these plants. The effects of Thymus vulgaris [TV] hydroalcoholic extract on the contractile responses of the isolated guinea-pig ileum were investigated. Male guinea pigs that were starved for 24 hours were decapitated after cervical dislocation, and terminal ileum were removed. Segments were fixed at a resting tension of 0.5 g in an organ bath containing in Tyrode solution at 37°C, which was bubbled with 95% oxygen and 5% carbon dioxide. The effects of the Thymus vulgaris extracts at six concentrations ranging from 0.02 to 6 mg/ml. Each segment served as its own control. Paired Student's t-test was used for statistical analysis. p < 0.05 was considered to be significant. Thymus vulgaris inhibited the contractile response in a dose-dependent manner in 0.6mg/mI concentration decreased the amplitude of the muscles up to 60% [t = -5.67, P<0.02]. This inhibitory activity was blocked by Granisetron and inhibited the contractions induced by acetylcholine, the activities of this plant may be due to the anticolinergic effect and block of serotoninergic pathways. Regression analysis had shown that with increasing in extract concentration the effect of extract was increased [r = 0.96, p<0.001]. The coefficient of extract dose was 0.089 mg. Our results demonstrate that extract prepared from the plant of Thymus vulgaris inhibited electrical induced contractions of the guinea-pig ileum when tested in vitro. This effect is dose dependent and reversible

Composition of the Volatile Oil of Thymus daenensis Celak. subsp. daenensis

Thymus daenensis Celak. subsp. daenensis is one of the endogenous Thymus species in Iran. The plant is traditionally used as carminative, digestive, antispasmodic, antitussive and expectorant in Iran. To study the Composition of the Volatile Oil of Thymus daenensis Celak. subsp. Daenensis. In this study, the hydrodistilled oil of the aerial parts of T. daenensis subsp. daenensis was analyzed using GC/FID and GC/MS. The result indicates that the oil contains over twenty-six components [99.7%]. The main components were thymol [74.7%], p-cymene [6.5%], B-caryophyllene [3.8%] and methyl carvacrol [3.6%]. This species has rich in phenolic substances specially thymol which might considered as a substitute for Thymus vulgaris

Pharmacognosical and plant tissue culture studies of Melissa officinalis L.

Melissa officinalis is a traditional herbal medicine used widely as a mid sedative, spasmolytic and antibacterial agent. This paper focuses on the analysis of the chemical composition of essential oil from the upper parts of plant and calli of Melissa officinalis. Growing the calli of Melissa officinalis L. and production its secondary metabolites studied and compared with those in the whole plant. Melissa seeds were first surface sterilized by shaking in 0.3% [W/V] aqueous hydrogen peroxide solution containing 1 drop tween 80, then by shaking in 5% Na hypochlorite and 70% aqueous Ethanol solution then, under aseptic condition, strile petrydishes containing autoclaved agar [0.8%] and kept in the dark at a temprature of 25-27°C. Seedlings were developed in one week. Then they were transferred to strile Murashing and skoog [MS] culture media which were containing 2, 4- D [1 mg/l], IAA [1 mg/l] and K [0.2 mg/l] as plant grow regulators. The amorph masses [calli] were produced and subcultvred every 20-25 days. The result obtained from GC/MS of essential oil if upper parts of plant indicated that the major compounds of the essential oil are Citronellal, Neral, Geranial and ?- Caryophyllene. In contrast, calli lacked essential oil, this was indicated upon GC of its dichlorometanic extract, however phytochemical tests indicated that some tannins were produced by calli

Tratamento do espasmo e da contratura da hemiface por infiltraçäo alcoólica (avaliaçäo de cinco pacientes) / Treatment of hemifacial spasm and contracture with alcohol injection (evaluation of 5 patients)

O espasmo hemifacial (EHF) é caracterizado por contraçoes tônico-clônicas involuntárias e proxísticas dos músculos da hemiface. Estudamos a eficácia da infiltraçao alcoólica dos ramos extra-temporais do nervo facial no tratamento dos espasmos e das contraturas em cinco pacientes que nao apresentaram melhora com o uso de carbamazepina e cujos exames subsidiários afastaram doenças do sistema nervoso central. Apesar do número pequeno de casos, pudemos concluir que a alcoolizaçao do nervo facial pode ser usada em casos selecionados com bons resultados.

Tratamiento del espasmo hemifacial y blefaroespasmo con toxina botulínica: resultados a largo plazo / Treatment of hemifacial spasm and blepharospasm whit botulinum toxin

Se revisaron las historias clínicas de 234 pacientes con diagnóstico de blefaroespasmo (BE) (68) y espasmo hemifacial (EH) (166) que fueron infiltrados entre 1987 y 1995 en el Servicio de Neurología del Hospital de Clínicas de la ciudad de Buenos Aires. De los pacientes con EH, 55 fueron varones y 111 mujeres, con una edad promedio de 57,5 años, mientras que 17 varones y 51 mujeres presentaron BE/BE-distonía oromandibular con una edad promedio de 63 años. La edad general de comienzo fue de 56,3 años para los EH y 56,8 para los BE. Trece EH fueron postparalíticos, dos secundarios a tumores de tronco, uno secundario a una lesión vascular protuberancial y uno a enfermedad de Paget, el resto fueron diagnosticados como primarios, aunque en las IRM y TC cerebrales resultó evidente en muchos de ellos la presencia de ectasias en el circuito vertebrovasilar. La dosis promedio en pacientes con EH fué de 21,8 I.U. con un rango entre 12,5 I.U. y 50 u, mientras que la dosis promedio en pacientes con BE fué de 33,1 con un rango entre 25 y 75 u. El número total de infiltraciones fué de 1910 con un promedio de 9,8 para los EH y 5,5 para los BE. La duración promedio del efecto beneficioso de cada dosis fué de 3 meses para ambos grupos. Todos los pacientes se beneficiaron marcadamente (77 por ciento) y moderadamente (27 por ciento) con las infoltraciones aunque el 12,5 por ciento experimentó una ptosis transitoria como efecto colateral en algunas de las aplicaciones. Los pacientes con BE requirieron un incremento progresivo de un 21 por ciento de la dosis de toxina botulínica a lo largo de todo el tratamiento, mientras que en los EH se necesitó un 20 por ciento de aumento. Nuestra experiencia ilustra la utilidad de la toxina botulínica en el manejo del EH y el BE constituyendo un arma terapéutica sencilla y eficaz que debe ser considerada como el tratamiento de elección en este tipo de patología

The use of botulinum toxin type A for the treatment of facial spasm

We describe our experience with the use of botulinum A toxin for the treatment of patients with facial spasms. Thirty four patients with blepharospasm, thirty eight with hemifacial spasms and three with spastic entropion were injected with the use of Botulinum A toxin. Length of follow up ranged from 6 to 60 months. The effect of toxin lasted an average of 12.1 weeks in patients with blepharospasm and 15.5 weeks in patients with hemifacial spasms. This difference in mean response was statistically significant (p = 0.0001). The most common side effect was ptosis and dry eyes. All side effects were transient in nature, lasting between three and twelve weeks. Botulinum toxin type A injections represent a good alternative for the treatment of facial spasms. It is a safe and effective office procedure. Most patients tolerate the procedure well. Its principal drawback is its transient effect and the need for repeated injections

Two hundred and fifty patients with hemifacial spasm treated with botulinum toxin injection.

Two hundred and fifty patients with hemifacial spasm from the Movement Disorder Clinic, at Siriraj Hospital have been treated with botulinum toxin injection since January 1989 as a collaborating research project with Smith-Kettlewell Eye Research Institute in San Francisco. Each patient received 30 units in four injection sites over the hyperkinetic facial muscles. There were 169 female and 81 male patients, the sex ratio of female to male was 2.1:1. The mean age of all patients was 50.2 +/- 12.6 years with the range of 22 to 78 years. The majority of patients had been suffering for 3-10 years. The results of botulinum toxin injection were classified as excellent in 81.2 per cent, moderate improvement 10.0 per cent, mild improvement 6.8 per cent and no improvement or worse in 2.0 per cent. There were complications of mild transient facial weakness in 44 patients (17.6%) mild ptosis in 7 patients (2.8%) and excessive lacrimation in 1 patient (0.4%). The effect of botulinum toxin treatment lasted for 3-6 months duration. Botulinum toxin injection is a simple and effective out-patient treatment for patients with hemifacial spasm with no systemic side effects and minor transient local complications.

Espasmo hemifacial: dez anos de experiência / Hemifacial spasm: ten years experience

Os autores apresentam sua experiência em 10 anos no tratamento do espasmo hemifacial do Grupo de Paralisia Facial do Hospital das Clínicas da Faculdade de Medicina da Universidade de Säo Paulo. Apresentam e discutem ainda todas as formas de tratamento na literatura. Säo estudados 35 casos de espasmo hemifacial idiopático e apresentados os resultados do tratamento clínico e cirúrgico. O tratamento clínico indicado foi com carbamazepina, clonazepan e diazepan e aqueles casos que näo responderam satisfatoriamente a tratamento cirúrgico através de neurectomia seletiva ou descompressäo do "loop" vascular a nível da fossa posterior ou ainda descompressäo do nervo a nível de segmento mastoídeo. Dos resultados apresentados conclui-se: a) a importância do estudo radiológico. b) que a etiologia mais frequente é pós galvanoterapia. c) o tratamento clínico deve sempre ser a primeira opçäo. d) o tratamento cirúrgico de escolha é a neurectomia seletiva principalmente nos casos EH pós galvanoterapia