Guilhou J J, Dereure O, Marzin L, Ouvry P, Zuccarelli F, Debure C, Van Landuyt H, Gillet-Terver M N, Guillot B, Levesque H, Mignot J, Pillion G, Février B, Dubeaux D
Department of Service de Dermatologie-Phlébologie, Hospital Saint Charles, Montpellier, France.
Angiology. 1997 Jan;48(1):77-85. doi: 10.1177/000331979704800113.
The objective of this study was to evaluate the efficacy of Daflon 500 mg (Dios)* in venous ulcers. A multicenter, double-blind, randomized, controlled versus placebo (Plac) trial was conducted, with stratification according to the size of ulcer (< or = 10 cm and > 10 cm). The protocol called for a two-month treatment with Dios (one tablet = 450 mg micronized purified Diosmin) or a placebo, two tablets/day, in addition to compression therapy. Evaluations were performed every fifteen days, from D0 to D60. The primary endpoint, in accordance with Alexander House group requirements were: percentage of patients with complete ulcer healing, ie, comparison between Dios and Plac group at D60, and comparison of survival curves in each group between D0 and D60 (log rank test). Secondary endpoints included ulcer surface area assessed by computerized planimetric measurements, qualitative evaluation of ulcers, and symptoms. The patients were 105 men and women ranging in age from eighteen to eighty-five years, with standard compression stocking, who were undergoing standardized local care of ulcer and had no significant arterial disease (ankle/arm systolic pressure index > 0.8). Fifty-three patients received Dios, and 52 received Plac. The 2 groups were well matched for age (m +/- 1 SD = seventy-one +/- eleven years), gender, ulcer size, and associated disorders. Among patients with ulcer size < or = 10 cm (Dios = 44, Plac = 47) a significantly larger number of patients had a complete ulcer healing at two months in the Dios group (n = 14) in comparison with the Plac group (n = 6) (32% vs 13%, P = 0.028) with a significantly shorter time duration of healing (P = 0.037). No difference was shown for the secondary criteria, except for sensation of heavy legs (P = 0.039) and a less atonic aspect of ulcer (P = 0.030) in favor of Dios. Among the 14 patients with ulcer size > 10 cm (Dios = 9, Plac = 5), subjected to a descriptive analysis only, no ulcer healed. This study showed that a two-month course of Daflon 500 mg at a daily dose of two tablets, in addition to conventional treatment, is of benefit in patients with venous ulcer < or = 10 cm by accelerating complete healing.
本研究的目的是评估500毫克达弗隆(地奥司明)治疗静脉性溃疡的疗效。开展了一项多中心、双盲、随机、与安慰剂对照的试验,根据溃疡大小(≤10厘米和>10厘米)进行分层。方案要求用地奥司明(一片含450毫克微粉化纯化地奥司明)或安慰剂进行为期两个月的治疗,每日两片,同时进行加压治疗。从第0天至第60天,每15天进行一次评估。根据亚历山大之家组织的要求,主要终点指标为:溃疡完全愈合的患者百分比,即第60天时地奥司明组与安慰剂组的比较,以及第0天至第60天每组生存曲线的比较(对数秩检验)。次要终点指标包括通过计算机平面测量评估的溃疡表面积、溃疡的定性评估以及症状。患者为105名年龄在18至85岁之间的男女,均穿着标准压力袜,接受溃疡的标准化局部护理且无明显动脉疾病(踝/臂收缩压指数>0.8)。53名患者接受地奥司明治疗,52名患者接受安慰剂治疗。两组在年龄(均值±1标准差 = 71±11岁)、性别、溃疡大小及相关疾病方面匹配良好。在溃疡大小≤10厘米的患者中(地奥司明组 = 44例,安慰剂组 = 47例),与安慰剂组(6例,13%)相比,地奥司明组在两个月时溃疡完全愈合的患者数量显著更多(14例,32%)(P = 0.028),愈合时间显著更短(P = 0.037)。除了腿部沉重感(P = 0.039)和溃疡张力较低方面(P = 0.030)有利于地奥司明外,次要标准方面未显示出差异。在仅进行描述性分析的14例溃疡大小>10厘米的患者中(地奥司明组 = 9例;安慰剂组 = 5例),无溃疡愈合。本研究表明,除常规治疗外,每日两片500毫克达弗隆治疗两个月对溃疡大小≤10厘米的静脉性溃疡患者有益,可加速溃疡完全愈合。