Apiterapia como modalidad terapéutica complementaria a la fisioterapia en pacientes con Artritis Reumatoide

espanolIntroduccion. La fisioterapia en la artritis reumatoide (AR) se orienta a reducir el dolor, prevenir la limitacion articular, la atrofia muscular y rehabilitar la funcionalidad. Este estudio introduce el uso de apiterapia como modalidadfisica coadyuvante de la rehabilitacion de la AR, aprovechando los beneficios conocidos de la apitoxina: analgesia,antiinfiamatoria y coadyuvante en la reparacion de tejidos. Materiales y metodos. Se escogieron 4 pacientes con AR, segun criterios del ACR, que desearon participar en un estudio descriptivo abierto.Tres mujeres y un varon adultos, con AR clinicamente activa, a quienes se les informo de los riesgos y posibles beneficios de la apiterapia, y se descarto alergia o hipersensibilidad a la apitoxina u otras enfermedades sistemicas, fueron evaluados con el HAQ, la EVA, el AHI, el Test de Movilidad Articular y el Mapa del Cuerpo Humano.El manejo consistio en fisioterapia convencional en una primera etapa y un mes despues conjugando fisioterapia con apiterapia. Resultados. Tres de los cuatro pacientes, todos mujeres, presentaron una mayor tolerancia al manejo fisioterapeutico y reduccion de sus sintomas y signos luego de la conjugacion de fisioterapia y apiterapia, respecto de la fisioterapia aislada. El cuarto paciente presento pocos cambios con la introduccion de apiterapia. Conclusiones, la apiterapia conjugada con el manejo fisioterapeutico de pacientes con AR genera cambios positivos en la evolucion funcional que son mejores que la fisioterapia aislada; su durabilidad, beneficios y efectos a largo plazo deben evaluarse en estudios controlados posteriores. EnglishIntroduction: Physical therapy in Reumatoid Arthritis (RA) patients seek reduce pain, improve join mobility, avoid muscular atrophy and increase functional activity. Our study introduces Apitherapy (bee venom therapy) like acomplementary physical modality in the rehabilitation management of RA patients in acute phase. Apitoxin or bee venom has demonstrated analgesic, anti-inflammatory, and tissue repair proprieties. Materials and methods: We selectfour AR patients, following the ACR yardsticks. They were tree adult woman anda one male who accept to participate like voluntaries in a simple observational study. All patients were full informed about the risk and potential benefit of bevenom therapy. We evaluate all patients with allergy tests and reject sensibility to apitoxin, as well other systemic diseases. All patients were evaluated with HAQ, EVA, AHI, join mobility test, and whit pain body map. The patients received conventional Physical Therapy treatment in the first phase, and them one month later, they received Physical Therapy with Apiteraphy. Outcomes: Tree of four patients (all woman) answered best to the Physical Therapy plus Apitherapy that to the Physical Therapy alone. All patients reported decreased of symptoms and greater reduction of RA sings after Physical Therapy plus Apitherapy treatment that Physical Therapy alone. The last patient hasn't changes with Apitherapy. However, none of these findings got statistics significance. Conclusions: Is possible to conjugate Physical Therapy with Apitherapy in the rehabilitation treatment of RA patients and wait positive changes in pain and physical function in some of them that can be best that Physical Therapy alone; although, his durability and long time benefits or secondary effects, must be evaluate in new studies with most patients and mainly control methods.