Gohel Manjit S, Davies Alun H
Imperial Vascular Unit, Charing Cross Hospital, Fulham Palace Road, London, UK.
Curr Vasc Pharmacol. 2009 Jul;7(3):303-8. doi: 10.2174/157016109788340758.
Varicose veins and the complications of venous disease are thought to affect over a quarter of the adult population and the management of these conditions are a major cause of health service expense. Advances in the understanding of venous pathophysiology have highlighted numerous potential targets for pharmacotherapy. This review considers the evidence for pharmacological agents used for the treatment of chronic venous disease. A literature search using Pubmed, Embase and Cinahl databases was performed. The initial search terms 'varicose vein', 'venous ulcer' and 'venous disease' were used with appropriate search limits to identify prospective studies of pharmacotherapy in venous disease. A wide range of venoactive and non-venoactive drugs have been studied in patients with venous disease. The use of micronized purified flavonoid fraction (Daflon) can reduce symptoms of pain, heaviness and oedema in patients with venous reflux and a recent meta-analysis concluded that Daflon improves healing in patients with venous ulceration treated with compression. Pentoxifylline may be a useful adjunct to compression therapy for patients with venous ulceration. Oxerutins and calcium dobesilate may be of benefit in reducing oedema and rutosides may help to relieve the symptoms of varicose veins in pregnancy. The clinical benefits of other medications remain unproven. Although numerous pharmacological agents have been proposed and studied, Daflon has demonstrated the greatest clinical benefits in patients with venous disease. Further research is needed to define the role of venoactive drugs in clinical care and improve our understanding of the pathophysiology of venous disease to help identify new therapeutic avenues.
静脉曲张及静脉疾病的并发症被认为影响着超过四分之一的成年人口，而这些病症的治疗是医疗服务费用的主要支出原因。对静脉病理生理学认识的进展突出了众多药物治疗的潜在靶点。本综述探讨了用于治疗慢性静脉疾病的药物的证据。使用PubMed、Embase和Cinahl数据库进行了文献检索。最初的检索词为“静脉曲张”“静脉溃疡”和“静脉疾病”，并设置了适当的检索限制以识别静脉疾病药物治疗的前瞻性研究。在静脉疾病患者中对多种静脉活性和非静脉活性药物进行了研究。使用微粉化纯化黄酮类成分（达芙通）可减轻静脉反流患者的疼痛、沉重感和水肿症状，最近的一项荟萃分析得出结论，达芙通可改善接受压迫治疗的静脉溃疡患者的愈合情况。己酮可可碱可能是静脉溃疡患者压迫治疗的有用辅助药物。奥昔芦丁和羟苯磺酸钙可能有助于减轻水肿，芸香苷可能有助于缓解孕期静脉曲张的症状。其他药物的临床益处尚未得到证实。尽管已经提出并研究了多种药物，但达芙通在静脉疾病患者中显示出最大的临床益处。需要进一步研究来确定静脉活性药物在临床护理中的作用，并增进我们对静脉疾病病理生理学的理解，以帮助确定新的治疗途径。
