Affiliation:
1. Pyatigorsk Medical and Pharmaceutical Institute – Branch of the Volgograd State Medical University
Abstract
Introduction. Varicose veins are a common disease with a chronic course and a high risk of complications and cosmetic defects. Venotonic drugs are widely used in conservative treatment of varicose veins.Aim. To study the comparative efficacy of venotonic drugs for local application in experimental conditions.Materials and Methods. Varicose veins were modeled in Wistar rats by partial stricture of the deep femoral vein. The studied drugs were applied in the course of 14 days from the operation. The assessed parameters were the change of local blood flow velocity in the skin in the dynamics and the degree of vascular permeability. The rate of local blood flow was assessed by Doppler ultrasound. Changes in vascular permeability were studied by the degree of extravasation of Evans blue dye in the Miles test. The results were processed using the methods of variation statistics.Results. The study showed that under the conditions of experimental chronic venous insufficiency, a course of application of all the analyzed drugs resulted in an increase in the rate of local blood flow in the skin and a decrease in the degree of vascular permeability. It was noted that application of the investigated gel based on escin, heparin and essential phospholipids to the skin of animals resulted in reliably (p < 0,05) lower indices of vascular permeability in comparison with the rats which received a course therapy with the heparin-containing gel; combined cosmetic agent as well as the gel based on troxerutin, heparin and dexpanthenol.Discussion. The results obtained testify that application of external dosage forms of combined venotonic drugs promotes the regression of chronic venous insufficiency manifestations. Maximum evident effect was registered while applying the studied drug, that can be related to its complex composition including essential phospholipids, heparin and aescin. It is known that aescin is a phlebotonic with a high degree of percutaneous absorption, the effect of which is significantly potentiated by the phospholipid component.Conclusions. The application of the combined product based on heparin, aescin and essential phospholipids provided an optimum rate of onset of pharmacological effect compared to the other analysed compositions.
Subject
Urology,Surgery,Gastroenterology,Cardiology and Cardiovascular Medicine,Anesthesiology and Pain Medicine
Reference22 articles.
1. Rabe E., Guex J.-J., Puskas A., Scuderi A., Fernandez Quesada F. Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol. 2012;31(2):105–115. Available at: https://pubmed.ncbi.nlm.nih.gov/22466974.
2. Bergan J.J., Schmid-Schönbein G.W., Smith P.D., Nicolaides A.N., Boisseau M.R., Eklof B. Chronic venous disease. N Engl J Med. 2006;355(5):488–498. https://doi.org/10.1056/NEJMra055289.
3. Gloviczki P., Comerota A.J., Dalsing M.C., Eklof B.G., Gillespie D.L., Gloviczki M.L. et al. The care of patients with varicose veins and associated chronic venous diseases: clinical practice guidelines of the Society for Vascular Surgery and the American Venous Forum. J Vasc Surg. 2011;53(5 Suppl.):2–48. https://doi.org/10.1016/j.jvs.2011.01.079.
4. Langer R.D., Ho E., Denenberg J.O., Fronek A., Allison M., Criqui M.H. Relationships between symptoms and venous disease: the San Diego population study. Arch Intern Med. 2005;165(12):1420–1424. https://doi.org/10.1001/archinte.165.12.1420.
5. Bradbury A., Evans C., Allan P., Lee A., Ruckley C.V., Fowkes F.G. What are the symptoms of varicose veins? Edinburgh vein study cross sectional population survey. BMJ. 1999;318(7180):353–356. https://doi.org/10.1136/bmj.318.7180.353.