Ting A C, Cheng S W, Wu L L, Cheung G C
Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong, China.
Vasc Surg. 2001 Nov-Dec;35(6):443-7. doi: 10.1177/153857440103500604.
The aim of this study was to prospectively investigate the clinical efficacy of Daflon therapy in patients with mild to moderate chronic venous insufficiency (CVI) (clinical class 1-4) and to assess the changes in venous hemodynamics by using air plethysmography (APG). Fifty-six limbs in 28 patients were studied. They all had primary venous insufficiency with no venous obstruction, and mixed deep and superficial venous incompetence was found in 64% of the limbs. There was a significant decrease in symptom score for swelling and heaviness after 6 months of Daflon therapy. The symptom score for cramps also showed improvement though it did not reach statistical significance. Pain was significantly reduced with a mean pain score of 21.8 +/- 19.3% before comparing to 10.4 +/- 20.2% after 6 months of Daflon therapy (p < 0.01). This was also associated with a decrease in mean calf circumference from 37.0 +/- 4.3 to 36.4 +/- 4.3 cm (p < 0.001). There was no significant change in the venous filling index (VFI), ejection fraction (EF), and residual volume fraction (RVF) before and after 6 months of Daflon therapy (VFI: 3.7 +/- 3.5 vs 3.4 +/- 2.5 mL/s, EF: 54.5 +/- 15.9% vs 57.7 +/- 19.7%, RVF: 41.4 +/- 19.2% vs 39.4 +/- 24.2%). The clinical improvement without associated changes in venous hemodynamics as measured by APG suggests that Daflon mainly works by modifying the microcirculatory environment not detected by APG and this microcirculatory change is associated with clinical improvement. In this regard, Daflon would be especially useful for symptomatic relief in patients with functional venous insufficiency who do not have clinical evidence of varicose veins but suffer from symptoms of venous insufficiency.
本研究的目的是前瞻性地调查达弗隆治疗轻至中度慢性静脉功能不全（CVI）（临床分级1 - 4级）患者的临床疗效，并使用空气体积描记法（APG）评估静脉血流动力学的变化。对28例患者的56条肢体进行了研究。他们均患有原发性静脉功能不全且无静脉阻塞，64%的肢体存在深浅静脉混合性反流。达弗隆治疗6个月后，肿胀和沉重感的症状评分显著降低。痉挛症状评分也有所改善，尽管未达到统计学意义。疼痛明显减轻，达弗隆治疗前平均疼痛评分为21.8±19.3%，治疗6个月后为10.4±20.2%（p<0.01）。这也伴随着小腿平均周长从37.0±4.3降至36.4±4.3厘米（p<0.001）。达弗隆治疗6个月前后，静脉充盈指数（VFI）、射血分数（EF）和残余容积分数（RVF）无显著变化（VFI：3.7±3.5对比3.4±2.5毫升/秒，EF：54.5±15.9%对比57.7±19.7%，RVF：41.4±19.2%对比39.4±24.2%）。APG测量显示临床改善但静脉血流动力学无相关变化，这表明达弗隆主要通过改变APG未检测到的微循环环境起作用，且这种微循环变化与临床改善相关。在这方面，达弗隆对于没有静脉曲张临床证据但有静脉功能不全症状的功能性静脉功能不全患者的症状缓解特别有用。
