Research Officer (Ay), NARIP, Cheruthurthy, CCRAS, Ministry of Ayush, Govt of India, 679531, India.
Research Officer (Ay), NARIP, Cheruthurthy, CCRAS, Ministry of Ayush, Govt of India, 679531, India; Research Officer (Ay), CCRAS, Ministry of Ayush, Govt of India, 679531, India.
J Vasc Nurs. 2024 Mar;42(1):53-59. doi: 10.1016/j.jvn.2023.11.009. Epub 2024 Jan 2.
Chronic venous insufficiency (CVI) manifests in various clinical presentations ranging from asymptomatic but cosmetic problems to severe symptoms, such as lower limb edema, skin trophic changes, and ulceration. CVI substantially affects the quality of life and work productivity of the patients. Ayurveda, an ancient traditional medicine in India, evaluates the various pathological stages of CVI with a wide range of pathological conditions such as Siragranthi (venous abnormalities), Raktavaritavāta (disorders of vāta occluded by rakta ∼ blood), ApanaVaigunya (vitiated apānavāyu), Arsha (hemorrhoids), VataRakta (rheumatism due to rakta), Kushtha (integumentary disease) and Dushta Vrana (putrefied wound) depending upon the presentations of the patient. Ayurvedic texts mention Terminalia arjuna as a potential herb for treating various conditions related to the circulatory system. The drug is an effective anti-inflammatory, anti-oxidant, and anti-hypertensive and has a definite role in improving cardiovascular hemodynamics and wound healing. These attributes suggest that the potential of Terminalia arjuna needs to be explored as a promising venoactive drug.
This prospective observational study included 25 patients (31 limbs) with CVI who were treated with Tab Terminalia arjuna (Bark extract of Terminalia arjuna in a dose of 500 mg, given twice a day) and were observed on two visits on day 30 and day 90. Follow-up was carried out for three months to evaluate post-treatment complications or adverse effects. The clinical outcome assessment was done using Venous Clinical Severity Score (VCSS), and clinical grading was performed using clinical classification (C0 - C6) of CEAP (Clinical-Etiology-Anatomy-Pathophysiology) classification.
The median VCSS score (of both limbs) during the third visit was comparatively lower than the first, with a statistically significant improvement at 0.05 level. Further, there was a substantial positive improvement in the clinical classification of CEAP among the patients in pre and post treatment phase.
The prospective observational study shows that Tab Terminalia arjuna is safe and effective in CVI, reducing the symptoms like pain, edema, inflammation, pigmentation, induration and also expediting ulcer healing.
慢性静脉功能不全（CVI）表现为各种临床表现，从无症状但影响美观的问题到严重的症状，如下肢水肿、皮肤营养变化和溃疡。CVI 极大地影响了患者的生活质量和工作效率。印度古老的传统医学阿育吠陀，用广泛的病理条件来评估 CVI 的各种病理阶段，如 Siragranthi（静脉异常）、Raktavaritavāta（被rakta 阻塞的 vāta 紊乱，rakta∼血）、ApanaVaigunya（失调的 apānavāyu）、Arsha（痔疮）、VataRakta（因 rakta 引起的风湿病）、Kushtha（皮肤疾病）和 Dushta Vrana（腐烂的伤口），这取决于患者的表现。阿育吠陀文献提到诃子（Terminalia arjuna）是一种治疗与循环系统相关的各种疾病的潜在草药。该药物具有抗炎、抗氧化和抗高血压的作用，并在改善心血管血液动力学和伤口愈合方面有明确的作用。这些特性表明，诃子（Terminalia arjuna）的潜力需要作为一种有前途的静脉活性药物进行探索。
这项前瞻性观察性研究纳入了 25 名（31 条肢体）患有 CVI 的患者，他们接受了诃子（Terminalia arjuna）片（诃子（Terminalia arjuna）树皮提取物，剂量为 500mg，每日两次）治疗，并在第 30 天和第 90 天进行了两次随访。进行了三个月的随访，以评估治疗后并发症或不良反应。使用静脉临床严重程度评分（VCSS）进行临床疗效评估，使用 CEAP（临床-病因-解剖-病理生理学）分类的临床分级（C0-C6）进行临床分级。
第三次就诊时的中位数 VCSS 评分（双腿）低于第一次就诊，在 0.05 水平上有统计学意义的改善。此外，在治疗前和治疗后阶段，患者的 CEAP 临床分级有明显的积极改善。
前瞻性观察性研究表明，诃子（Terminalia arjuna）片治疗 CVI 安全有效，可减轻疼痛、水肿、炎症、色素沉着、硬结等症状，并加速溃疡愈合。
