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Chronic Venous Insufficiency

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Chronic Venous Insufficiency Rutin Chronic venous insufficiency (CVI), and related signs and symptoms of venous and diabetic microangiopathy, can be effectively treated with O-(β-hydroxyethyl)-rutosides.22 A study evaluating the clinical efficacy of O-(beta-hydroxyethyl)-rutosides in subjects with severe CVI demonstrated the long-term efficacy of HR in CVI patients. HR also prevents the most severe complications of CVI along with controlling signs/symptoms and edema in CVI.23 A Cochrane review study involving 53 trials and 6013 participants; mean age 50 years showed that rutosides, diosmine, Horse Chestnut Fruit Powder extract 200mg + Sweet Orange Extract 200mg + hidrosmine, calcium dobesilate, chromocarbe, Centella asiatica, disodium flavodate, french maritime pine bark extract, grape seed Menaquinone 1.5mg + Ascorbic Acid 30mg + D Alpha Tocopheryl 60mcg + extract and aminaftone in patients with CVI at any stage of the disease have beneficial effects on oedema and on some signs and Niacin 10mg + Run 50mg + Cholecalciferol 400mcg Horse Chestnut Fruit Powder extract 200mg + Sweet Orange Extract 200mg + symptoms related to CVI such as trophic disorders, cramps, restless legs, swelling and paraesthesia when compared with placebo Menaquinone 1.5mg + Ascorbic Acid 30mg + D Alpha Tocopheryl 60mcg + but also can produce more adverse effects.24 Niacin 10mg + Run 50mg + Cholecalciferol 400mcg α-D-Tocopherol, Rutin in CVI A comparative clinical study showed that oral administration of alpha-tocopherol, rutin, Melilotus officinalis and Centella asiatica in 30 patients with chronic venous insufficiency had a significant improvement of the clinical symptomatology suggesting the use Chronic Venous insufficiency: of these compounds in chronic venous insufficiency.25 A Natural remedy for Spotlight on the combination of Horse Chestnut extract, Cholecalciferol Sweet Orange Extract, Menaquinone, Ascorbic Acid, Number of Varicose veins... Studies suggest that there is an increased prevalence of influential studies Alpha Tocopherol, Niacin, Rutin and Cholecalciferol Vitamin D deficiency in patients with chronic venous leg ulcers.26 Compound Recommendation RCTs Meta-analyses Calcium dobesilate Grade A 3 2 Guideline recommendations MPFF Grade A 4 1 Grade B recommendation was assigned for HSCE and Hydroxyethylrutosides Grade A 5 1 Calcium dobesilate, Micronized Purified Flavonoid HCSE (escin) Grade B 1 2 Fraction (MPFF), and hydroxyethylrutoside (ie, Ruscus extracts Grade B 2 1 References oxerutins) were assigned a Grade A recommendation, the 1.Veraart JC. Ned Tijdschr Geneeskd. 2002;146(5):199-203. 2.Brunner F et al. Br J Clin Pharmacol. 2001;51(3):219-24. 3.Grudzińska E et al. Cent Eur J Immunol. highest level of recommendation by the International Diosmin (synthetic) Grade C 1 2014;39(4):525-31. 4.Dudek-Makuch M et al. Revista Brasileira de Farmacognosia.2015; 25:533-541. 5.Patel SK and Surowiec SM. Venous Insufficiency. Accessed Consensus Statement (Siena, 2005) and the Consensus Troxerutin Grade C 2 from website https://www.ncbi.nlm.nih.gov/books/NBK430975/ as on 14.12.2018. 6.Rusak A et al. Adv Clin Exp Med. 2018;27(5):695-701. 7.Spiridon M et al. Maedica (Buchar). 2017;12(1):59-61. 8.Hyder ON et al. R I Med J (2013). 2017;100(5):37-39. 9.Aesculus hippocastanum (Horse chestnut). Alternative Medicine Statement led by Nicolaides in 2008, with regard to Chronic Ginkgo biloba Grade C 2 Review. 2009;14(3):278-283. 10.Pittler MH et al. Cochrane Database Syst Rev. 2012 Nov 14;11:CD003230. 11.Underland V et al. Global Adv Health Med. Venous Disease-related symptoms. The use of MPFF and Proanthocyanidines Grade C 2 2012;1(1):122-123. 12.Dickson S et al. J Herb Pharmacother. 2004;4(2):19-32. 13.Lv X et al. Chem Cent J. 2015;9:68. 14.Carballo-Villalobos AI et al. Biomed Res Int. 2016;2016:8263463. 15.Krief I. Lille Med. 1980;25(8):470-472. 16.Ramelet AA. Angiology. 2001;52 Suppl 1:S49-56. 17.Jawien A et al. Int Angiol. pentoxifylline in combination with compression in Troxerutin + coumarin Grade C 1 2017;36(1):31-41. 18.Glowinski J et al. Eur J Vasc Endovasc Surg. 2002;23(6):550-555. 19.Beulens JW et al. Br J Nutr. 2013;110(8):1357-1368. 20.Cario- longstanding or large venous ulcers was recommended and Centella asiatica Grade C 1 T o u m a n i a n t z C e t a l . J V a s c R e s . 2 0 0 7 ; 4 4 ( 6 ) : 4 4 4 - 4 5 9 . 2 1 . S c h u r g e r s L J . A c c e s s e d f r o m w e b s i t e assigned Grade 1B in the latest edition of the Handbook of https://pdfs.semanticscholar.org/f844/9e649856f09bd017d4b4432f4fb1a7e02404.pdf as on 15.12.2018. 22.Stuard S et al. Int J Angiol. 2008;17(3):143-148. Naftazone Grade C 1 Venous Disorders (2009).27 23.Cesarone MR et al. Panminerva Med. 2010;52(2 Suppl 1):43-8. 24.Martinez-Zapata MJ et al. Cochrane Database Syst Rev. 2016 Apr 6;4:CD003229. 25.Cataldi A et al. Minerva Cardioangiol. 2001;49(2):159-163. 26.Burkievcz CJ et al. Rev Col Bras Cir. 2012;39(1):60-63. 27.Gillet JL. Medicographia. 2011;33:285-291. Abbreviations: HCSE, horse chestnut seed extract; MPFF, Table 1. Grades of recommendation of the International Consensus micronized purified flavonoid fraction; RCT, randomized Statement clinical trial. Indications: Used as a supplement to treat · Varicose veins · Pigmentation Summary · Oedema and Inflammation · Achy, Tired or swollen legs • Chronic venous insufficiency (CVI) is a complex of symptoms occurring on the lower leg, which includes varicose veins, oedema, pigmentation and venous leg ulceration. Dosage • Varicose veins of the lower limb affect a sizable fraction of the adult population and result in considerable suffering. · One capsule 1-2 times daily as advised by the Physician • The limited possibilities of non-invasive treatment and prevention calls for the analysis of new potential targets of pharmacotherapy. • Medicines from plant origin play a significant role in the pharmacological treatment of CVI. • Clinical review data suggests that Horse chestnut extract is an efficacious and safe short-term treatment for CVI. • Micronized purified flavonoid fraction containing diosmin and hesperidin is a potent venotropic drug used in the treatment of venous insufficiency. • Supplementation of Ascorbic Acid, α-D-Tocopherol, Menaquinone, Rutosides and Cholecalciferol may have beneficial outcome in treatment of varicose veins. • International Consensus Statement recommends the use of Horse chestnut extract, Micronized Purified Flavonoid Fraction. Disomin and hydroxyethylrutoside for Chronic Venous Disease-related symptoms. Thus a combination of Horse Chestnut extract, Sweet Orange Extract, Menaquinone, Ascorbic Acid, D Alpha 61/C, 6th Main Road, 4th Phase, 7th Block, B.S.K 3rd Stage, Bangalore - 560085. Tocopheryl, Niacin, Rutin and Cholecalciferol may be a useful combination in treating Chronic Venous Disease-related 2018 symptoms. A Natural remedy for Varicose veins... Chronic Venous insufficiency: Spotlight on the combination of Horse Chestnut extract, Sweet Orange be "good" or "fairly good." Only 2 patients rated 70 Extract, Menaquinone, Ascorbic Acid, Alpha Tocopherol, Niacin, Rutin and Cholecalciferol tolerability as poor at visit 3 (Figure 2). 65 Hypoxia of endothelium ↓ ATP Counteracting In total, 91 adverse events were reported, of which the reduction of ATP only 4 were rated as probably related to the study drug. 60 Introduction The majority of patients rated efficacy to be "very Release of PLA 51 Visit 2 Chronic venous insufficiency (CVI) is a complex of symptoms occurring on the lower leg, which includes varicose veins, 2 ↑ Prostaglandins Ihibition of PLA2 good" or "good," with only 10 patients reporting no Release of PAF oedema, pigmentation and venous leg ulceration.1 Varicose veins of the lower limb affect a sizable fraction of the adult effect by the end of the study. The results of this study 50 Visit 3 population and result in considerable suffering. Visible varicose veins are found in 20-25% of females and 10-15% of male adults, HCSE / indicated that horse chestnut tablets were a safe, well- 2 with a high familial incidence. Dilated veins and incompetent valves are the common manifestation of the disease. tolerated and efficacious treatment for Widmer stage I 40 Inflammation 12 CVI is caused by a decompensation of the venous system together with reflux in the superficial, deep and/or perforating veins of AESCIN and II CVI. the lower leg in supine position. The exact pathogenesis of the skin symptoms is still largely unclear. Treatment of varicose veins involves several methods: compression therapy, if need be combined with sclerotherapy or surgery, or with supportive 30 Sweet Orange Extract – Source of No.of Patients medication.1 The limited possibilities of non-invasive treatment and prevention calls for the analysis of new potential targets of Neutrophil adhesion and Edema Neutrophil activation 3 aggregation inhibition neutrophil adhesion Hesperidin and Diosmin pharmacotherapy. AESCIN 19 20 Inhibition of Citrus fruits are good sources of nutrition with an Medicines from plant origin play a significant role in the pharmacological treatment of CVI. The most popular ones include the Ion channel Release of elastase and other enzymes 4 ↓ Blood flow elastase and other ample amount of Vitamin C. Plenty of active natural horsechestnut seed extract and flavonoids: diosmin, hesperidin, rutin, and its derivative – troxerutin. HCSE / sensitization; enhanced Release of fibroblast growth factor venous tension/capillary enzymes metabolites including flavonoids, alkaloids, coumarins, 10 6 7 This article outlines the role of Horse chestnut extract, Flavonoids and Vitamins in the treatment of Chronic Venous sealing Release of PGF limonoids, carotenoids, phenolic acids and essential insufficiency. Damage to venous walls 2α 3 Hypoxia Vein enlargment oils, have been found in Citrus fruits.
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