Barry University School of Podiatric Medicine, Miami Shores, FL.
Wounds. 2020 Jul;32(7):195-207.
Compression therapy is the gold standard treatment for venous leg ulcers (VLUs); however, with adjunctive pharmacological therapies and poor patient adherence using compressive dressings, clinicians are looking to find the advantage in treating VLUs. This literature review focuses on the efficacy of pharmacological agents, quality of life using agents in addition to compression therapy, and cost effectiveness to indicate the best outcomes for pharmacological treatment of VLUs. The following available venotonic, hemorheologic, and fibrinolytic agents were reviewed for oral management in treating VLUs: pentoxifylline, flavonoids (diosmin, hidrosmin, rutosides, and micronized purified flavonoid fraction, Vasculera), Red-Vine-Leaf-Extract AS 195, Ruscus, Ginkgo biloba, Centella asiatica, Pycnogenol (French maritime pine bark), escin/horse chestnut extract, nutritional supplements (ie, zinc and magnesium, glycosaminoglycans [sulodexide], mesoglycans), Axaven, cilostazol, fibrinolytic enhancers (stanozolol and defibrotide), calcium dobesilate, aspirin, antibiotics (antimicrobials, doxycycline, levamisole), diuretics, cinnarizine, naftazone, and benzarone. Venous leg ulcer pharmacological treatment options were searched in the English language from February 2020 to March 2020 using numerous databases and sites, such as PubMed. Drugs used adjunctively with compression therapy that facilitate healing in long-standing or large VLUs include micronized purified flavonoid fraction, pentoxifylline, sulodexide, and mesoglycan.
压迫疗法是治疗静脉性腿部溃疡（venous leg ulcers，VLU）的金标准治疗方法；然而，由于附加的药理学治疗和患者对压迫性敷料的依从性差，临床医生正在寻找治疗 VLU 的优势。本文综述重点关注药理学治疗的疗效、药物治疗联合压迫疗法对生活质量的影响以及成本效益，以确定治疗 VLU 的最佳药理学治疗方案。本文对以下可用的静脉活性、血液流变学和纤维蛋白溶解剂进行了评估，以探讨其在治疗 VLU 中的口服管理：己酮可可碱、黄酮类（地奥司明、羟苯磺酸、芦丁、米诺环素和微粉化纯化黄酮类）、红葡萄叶提取物 AS 195、鼠尾草、银杏叶、积雪草、碧萝芷（法国松树皮提取物）、七叶皂苷/欧洲七叶树提取物、营养补充剂（如锌和镁、糖胺聚糖[舒洛地特]、弥凝）、Axaven、西洛他唑、纤维蛋白溶解增强剂（司坦唑醇和达肝素）、羟苯磺酸钙、阿司匹林、抗生素（抗菌药、多西环素、左旋咪唑）、利尿剂、桂利嗪、萘呋唑酮和苯扎酮。本研究于 2020 年 2 月至 2020 年 3 月间，通过使用包括 PubMed 在内的多个数据库和网站，以英语搜索静脉性腿部溃疡的药理学治疗选择。与压迫疗法联合使用以促进慢性或大 VLU 愈合的药物包括米诺环素、己酮可可碱、舒洛地特和弥凝。
