Belczak Sergio Q, Sincos Igor R, Campos Walter, Beserra Julio, Nering Gilberto, Aun Ricardo
São Camilo Medical School, São Paulo, SP, Brazil
São Camilo Medical School, São Paulo, SP, Brazil.
Phlebology. 2014 Aug;29(7):454-60. doi: 10.1177/0268355513489550. Epub 2013 May 16.
Our current understanding of the pathophysiology of chronic venous disease (CVD) suggests that veno-active drugs (VAD) can provide effective symptom relief. Few studies have conducted head-to-head comparisons of VAD and placebo while also assessing objective measures (such as water plethysmography findings and tibiotarsal joint range of motion) and patient-reported quality of life outcomes.
To compare the effects of different VAD on limb volume reduction, tibiotarsal range of motion, and quality of life.
136 patients with CVD (CEAP grades 2-5) were randomly allocated into four groups to receive micronized diosmin + hesperidin, aminaphthone, coumarin + troxerutin, or placebo (starch). Patients were administered a questionnaire consisting of a quality of life (QoL) measure designed specifically for persons with CVD, and underwent tibiotarsal joint angle measurement and water plethysmography of the lower extremity before and 30 days after pharmacological intervention. Assessors were blind to the treatment groups.
Nine patients dropped out of the trial. Data collected from the 127 remaining patients was considered for statistical analysis. There were no differences in tibiotarsal joint range of motion. Volume reductions ≥100 mL were more frequent in the diosmin + hesperidin group than in any other group. QoL scores were best in the aminaphthone group, and between-group differences were found on individual analysis of questionnaire items.
Use of VAD was associated with significant improvements in QoL as compared with placebo. VAD may be effective for providing symptom relief in patients with CVD.
我们目前对慢性静脉疾病(CVD)病理生理学的理解表明,静脉活性药物(VAD)可以有效缓解症状。很少有研究对VAD和安慰剂进行直接比较,同时评估客观指标(如水容积描记法结果和跗关节活动范围)以及患者报告的生活质量结果。
比较不同VAD对肢体容积减少、跗关节活动范围和生活质量的影响。
136例CVD患者(CEAP分级2 - 5级)被随机分为四组,分别接受微粒化地奥司明+橙皮苷、氨基萘酮、香豆素+曲克芦丁或安慰剂(淀粉)治疗。患者接受一份专门为CVD患者设计的生活质量(QoL)调查问卷,并在药物干预前和干预后30天进行跗关节角度测量和下肢水容积描记法检查。评估人员对治疗组情况不知情。
9名患者退出试验。对其余127名患者收集的数据进行统计分析。跗关节活动范围没有差异。地奥司明+橙皮苷组容积减少≥100 mL的情况比其他任何组都更频繁。氨基萘酮组的QoL评分最佳,对问卷项目的个体分析发现组间存在差异。
与安慰剂相比,使用VAD与QoL的显著改善相关。VAD可能对缓解CVD患者的症状有效。