Sunday 24 November 2013

Polymalagia Arthritis Treatments in Herbal Medicine

Polymalagia Arthritis Polymalagia Arthritis is defined as a condition a common inflammatory rheumatic disease which cause pain, stiffness and tenderness in large muscles, including muscles shoulders and pelvic girdleas a result of the presence of a synovitis in proximal joints and periarticular structures, causing musculoskeletal symptoms in PMR. 

In Herbal medicine perspective
1. Comfrey
Comfrey is a perennial Plant in the genus of Symphytum, belonging to the family Boraginaceae, native to Europe. It has been used in herbal and traditional medicine to ease excessive bleeding or on open wounds, relief pain and swollen, treat circulation issues, reduce cholesterol, etc.
In the investigation of the effect of a daily application of 6g Kytta-Salbe f (3 x 2 g) over a 3 week period with patients suffering from painful osteoarthritis of the knee with the complaints relating to osteoarthritis of the knee had persisted for 6.5 years found that the comfrey root extract ointment is well suited for the treatment of osteoarthritis of the knee. Pain is reduced, mobility of the knee improved and quality of life increased, according to “Efficacy of a comfrey root (Symphyti offic. radix) extract ointment in the treatment of patients with painful osteoarthritis of the knee: results of a double-blind, randomised, bicenter, placebo-controlled trial” by Grube B, Grünwald J, Krug L, Staiger C.(46)
2. Devil’s claw
Devil’s claw also known as wood spider, is a plant of genus Harpagophytum in the family of Pedaliaceae, native to South Africa.The plant has been used as herb in traditional and herbal medicine to treat fever, rheumatoid arthritis, skin, gallbladder, pancreas, stomach and kidneys conditions, etc.
1. Antiinflammatory effects
In the investigation of Harpagophytum procumbens (Hp) and it effect on inflammatory and degenerative disease, found that standardized ethanol Hp extract from Harpagophytum procumbensinhibits induction of pro-inflammatory gene expression, possibly by blocking the AP-1 pathway. This is novel evidence of a possible mechanism of action of this antiinflammatory drug, according to “Molecular Targets of the Antiinflammatory Harpagophytum procumbens (Devil’s claw): Inhibition of TNFα and COX-2 Gene Expression by Preventing Activation of AP-1.” by Fiebich BL, Muñoz E, Rose T, Weiss G, McGregor GP.(47)
2. Osteoarthritis
a. In the observation of Harpagophytum procumbens and it effects on chronic inflammatory conditions such as Osteoarthritis found that Devil’s Claw appeared effective in the reduction of the main clinical symptom of pain. The assessment of safety is limited by the small populations generally evaluated in the clinical studies. From the current data, Devil’s Claw appears to be associated with minor risk (relative to NSAIDs), but further long-term assessment is required, according to the study of “Devil’s Claw (Harpagophytum procumbens) as a treatment for osteoarthritis: a review of efficacy and safety” by Brien S, Lewith GT, McGregor G.(48)
 b. In the study of Devil’s Claw (Harpagophytum procumbens) and it effects on osteoarthritis found that fourteen studies were identified: eight observational studies; 2 comparator trials (1 open, the other randomized to assess clinical effectiveness); and 4 double-blinded, placebo-controlled, randomized controlled trials to assess efficacy. Many of the published trials lacked certain important methodological quality criteria. However, the data from the higher quality studies suggest that Devil’s Claw appeared effective in the reduction of the main clinical symptom of pain, according to the study of “Devil’s Claw (Harpagophytum procumbens) as a treatment for osteoarthritis: a review of efficacy and safety” by Brien S, Lewith GT, McGregor G.(49)
4. Degenerative diseases of the musculoskeletal system
Extracts of the secondary tubers of Devil’s Claw (Harpagophytum procumbens) and it degenerative painful rheumatism effects found that Pharmacological experiments have shown analgesic, antiphlogistic and antiinflammatory actions. Most important constituents are iridoid glycosides, which are supposed to contribute mainly to the observed effects. However, the entire extract has to be considered as active ingredient, according to”[Therapy of degenerative diseases of the musculoskeletal system with South African devil's claw (Harpagophytum procumbens DC)].[Article in German]” by Wegener T.(50)
5. Arthrosis of hip or knee
In observation of Preparations made from the secondary tubers of Devil’s claw (Harpagophytum procumbens) and it effects on rheumatic diseases (arthrosis and low back pain) found that a continuous improvement in typical clinical findings such as 45.5% for pain on palpation, 35% for limitation of mobility and 25.4% for joint crepitus. Only two cases of possible adverse drug reactions were reported (dyspeptic complaints and a sensation of fullness), according to “Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil’s claw (Harpagophytum procumbens DC.)” by Wegener T, Lüpke NP.(51)
6. Low back pain
In the analyzing Harpagophytum procumbens and it osteoarthritis and low back pain effects found that the use of an aqueous extract of Harpagophytum procumbens at 60 mg harpagoside being non-inferior to 12.5 mg rofecoxib per day for chronic non-specific low-back pain (NSLBP) in the short term. Strong evidence exists for the use of an aqueous Harpagophytum extract at a daily dose equivalent of 50 mg harpagoside in the treatment of acute exacerbations of chronic NSLBP., according to the study of “Harpgophytum procumbens for osteoarthritis and low back pain: a systematic review” by Gagnier JJ, Chrubasik S, Manheimer E.(52)
3. Valerian
Valerian is a perennial flowering plant, in the genus Valeriana, belonging to the family Valerianaceae, native to Europe and parts of Asia. The herb has been used as a sedative and relaxing agent and to treat the liver, the urinary tract, the digestive tract problem, nerve conditions, etc.
In the classification of V. officinalis extracts and its antioxidant properties against iron in hippocampal neurons in vitro, found that The effect of V. officinalis in deoxyribose degradation and reactive oxygen species (ROS) production was also investigated. In brain homogenates, V. officinalis inhibited thiobarbituric acid reactive substances induced by all pro-oxidants tested in a concentration dependent manner. Similarly, V. officinalis caused a significant decrease on the LPO in cerebral cortex and in deoxyribose degradation. QA-induced ROS production in cortical slices was also significantly reduced by V. officinalis, according to “In vitro antioxidant activity of Valeriana officinalis against different neurotoxic agents” by Sudati JH, Fachinetto R, Pereira RP, Boligon AA, Athayde ML, Soares FA, de Vargas Barbosa NB, Rocha JB.(53). The herb valerian may be useful as a mild sleep aid in clinical populations, such as persons with rheumatoid arthritis, according to the research team at the University of Virginia, School of Nursing(54).

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Sources
 (46) http://www.ncbi.nlm.nih.gov/pubmed/17169543
(47) http://www.ncbi.nlm.nih.gov/pubmed/22072539
(48) http://www.ncbi.nlm.nih.gov/pubmed/17212570
(49) http://www.ncbi.nlm.nih.gov/pubmed/17212570
(50) http://www.ncbi.nlm.nih.gov/pubmed/10483693
(51) http://www.ncbi.nlm.nih.gov/pubmed/14669250
(52) http://www.ncbi.nlm.nih.gov/pubmed/15369596
(53) http://www.ncbi.nlm.nih.gov/pubmed/19191025
(54) http://www.ncbi.nlm.nih.gov/pubmed/15222600

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