Allaert F A
Ceren ESC and Dijon University Hospital, Dijon, France.
Int Angiol. 2012 Aug;31(4):310-5.
The aim of this study was to compare the reduction of venous ankle edema in randomized controlled trials of the main venoactive drugs versus a placebo or versus another venoactive drug and thereby to confirm or invalidate the existing recommendations on the pharmacological treatment of venous edema.
Publications of randomized controlled trials of venoactive drugs versus either a placebo or another venoactive drug on the reduction of ankle circumferences (AC) were searched through Medline and selected according to the Jadad and the Cucherat evaluation grids.
Ten publications dated between 1975 and 2009 including a total of 1010 patients were identified for the meta-analysis. Included were the following venoactive drugs: micronised purified flavonoid fraction (MPFF), hydroxyethylrutoside, ruscus extracts and diosmin. The mean reduction in AC was -0.80 ± 0.53 cm with MPFF , -0.58 ± 0.47 cm with ruscus extract, -0.58 ± 0.31 cm with hydroxyethylrutoside, -0.20 ± 0.5 cm with single diosmin, and -0.11 ± 0.42 cm with placebo. The reduction in AC was significantly superior to that of placebo whatever the drug concerned (P<0.0001). The comparison between MPFF, ruscus extract and hydroxyethylrutoside on the reduction of ankle edema was in favour of MPFF. This was significant (P<0.0001), while the efficacy of the latter two venoactive agents was comparable.
This meta-analysis confirms the validity of the grade A assigned to MPFF in the management of symptoms and edema in recent international guidelines.
本研究旨在比较主要静脉活性药物与安慰剂或其他静脉活性药物在随机对照试验中减轻踝部静脉性水肿的效果，从而证实或推翻现有关于静脉性水肿药物治疗的建议。
通过Medline检索静脉活性药物与安慰剂或其他静脉活性药物对比减轻踝围（AC）的随机对照试验的出版物，并根据Jadad和Cucherat评估标准进行筛选。
确定了1975年至2009年间的10篇出版物，共1010例患者纳入荟萃分析。纳入的静脉活性药物如下：微粒化纯化黄酮类成分（MPFF）、羟乙基芦丁、红没药提取物和地奥司明。使用MPFF时AC平均减少-0.80±0.53厘米，使用红没药提取物时为-0.58±0.47厘米，使用羟乙基芦丁时为-0.58±0.31厘米，使用单一地奥司明时为-0.20±0.5厘米，使用安慰剂时为-0.11±0.42厘米。无论使用何种药物，AC的减少均显著优于安慰剂（P<0.0001）。MPFF、红没药提取物和羟乙基芦丁在减轻踝部水肿方面的比较显示MPFF更具优势。这具有显著性（P<0.0001），而后两种静脉活性药物的疗效相当。
这项荟萃分析证实了近期国际指南中赋予MPFF在症状和水肿管理方面A级推荐的有效性。
