Yang Xinrui, Jin Jian, Huang Siyi, Qiu Peng, Wang Ruihua, Ye Kaichuang, Lu Xinwu
Department of Vascular Surgery, Shanghai Ninth People's Hospital, School of Medicine, Shaihai JiaoTong Univeresity, Shanghai, China.
Vascular Center of Shanghai JiaoTong University, Shanghai JiaoTong University, Shanghai, China.
Vascular. 2025 Jun;33(3):567-573. doi: 10.1177/17085381241249288. Epub 2024 Apr 26.
BackgroundEndovenous interventions and minimally invasive procedures are effective in the management of varicose veins. However, they can cause postoperative discomfort.ObjectiveTo evaluate the clinical efficacy of sodium aescinate (SA) in improving edema, pain, vein-specific symptoms, and quality of life in patients following endovenous laser ablation (EVLA) for varicose veins.MethodsIn this single-center randomized controlled trial (RCT), patients were allocated into two groups: in Group A, 60 mg SA was administered twice daily for 20 days, and in Group B (control), no venoactive drug was prescribed. The Clinical-Etiology-Anatomy-Pathophysiology (CEAP) classification system for chronic venous disorders was used to assess the varicose veins. The circumferences of the calf and ankle were recorded for evaluating edema. The 10-point Visual Analog Scale (VAS), Venous Clinical Severity Score (VCSS), and Aberdeen Varicose Veins Questionnaire (AVVQ) were used to measure the pain intensity, overall varicose vein severity, and patient's quality of life, respectively.ResultsThe study included 87 patients (mean age, 59.9 ± 10.7 years; 54 men) with CEAP class C2-C5 varicose veins who underwent EVLA and phlebectomy or foam sclerotherapy. The calf circumference recovered quicker in Group A than in Group B by days 10, 21, and 30 (difference from baseline was 1.04 ± 0.35 vs 2.39 ± 1.15 [ < .001], 0.48 ± 0.42 vs1.73 ± 1.00 [ < .001], and 0.18 ± 0.64 vs 0.82 ± 0.96 [ < .001], respectively). The ankle circumference recovered quicker in Group A than in Group B by days 10 and 21 (the difference from baseline was 1.37 ± 0.52 vs 2.36 ± 0.93 [ < .001] and 0.58 ± 0.60 vs 1.14 ± 0.88 [ = .002], respectively). Pain relief was achieved quicker in Group A than in Group B (0.257 ± 1.097 [ = .0863] vs 0.506 ± 1.250 [ = .0168] by day 21). There were no significant differences in the VCSS and AVVQ scores between both groups. There were no drug-related adverse effects.ConclusionsSA, in combination with compression therapy, can relieve edema and alleviate pain in patients following EVLA for varicose veins.
背景
腔内干预和微创手术在治疗静脉曲张方面有效。然而,它们可能导致术后不适。
目的
评估七叶皂苷钠(SA)对接受静脉曲张腔内激光消融术(EVLA)的患者改善水肿、疼痛、静脉特异性症状及生活质量的临床疗效。
方法
在这项单中心随机对照试验(RCT)中,患者被分为两组:A组患者每天服用两次60mg SA,共20天;B组(对照组)未开具任何静脉活性药物。采用慢性静脉疾病的临床-病因-解剖-病理生理学(CEAP)分类系统评估静脉曲张。记录小腿和脚踝的周长以评估水肿情况。分别使用10分视觉模拟量表(VAS)、静脉临床严重程度评分(VCSS)和阿伯丁静脉曲张问卷(AVVQ)来测量疼痛强度、静脉曲张总体严重程度和患者生活质量。
结果
该研究纳入了87例CEAP C2-C5级静脉曲张患者(平均年龄59.9±10.7岁;男性54例),这些患者接受了EVLA及静脉切除术或泡沫硬化疗法。在第10天、21天和30天时,A组小腿周长恢复速度比B组更快(与基线的差值分别为1.04±0.35对2.39±1.15[<.001]、0.48±0.42对1.73±1.00[<.001]、0.18±0.64对0.82±0.96[<.001])。在第10天和21天时,A组脚踝周长恢复速度比B组更快(与基线的差值分别为1.37±0.52对2.36±0.93[<.001]、0.58±0.60对1.14±0.88[=.002])。A组比B组更快实现疼痛缓解(第21天时为0.257±1.097[=.0863]对0.506±1.250[=.0168])。两组的VCSS和AVVQ评分无显著差异。未出现与药物相关的不良反应。
结论
SA联合压迫疗法可缓解接受EVLA治疗静脉曲张患者的水肿并减轻疼痛。