Цитата:
Сообщение от frolen
Из препаратов лекарственных на сегодняшний день доказана эффективность Детралекса,
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По моему, доказана лишь некоторая эффективность в отношении отеков. На которые пациент не указывает.
Поддержываю рекоммендации коллег по поводу эластической компрессии и дуплексного сканирования. Кроме того, что не вставать с постели перед одеванием чулка, можно еще подержать ногу в вертикальном положении.
Cochrane Database of Systematic Reviews Martinez, MJ. Bonfill, X. Moreno, RM. Vargas, E. Capella, D. Phlebotonics for venous insufficiency. 1, 2007.
Main results:
Fifty-nine RCTs of oral phlebotonics were included, but only 44 trials involving 4413 participants contained quantifiable data for the efficacy analysis: 23 of rutosides, ten of hidrosmine and diosmine, six of calcium dobesilate, two of centella asiatica, one of french maritime pine bark extract, one of aminaftone and one of grape seed extract. No studies evaluating topical phlebotonics, chromocarbe, naftazone or disodium flavodate fulfilled the inclusion criteria.
Outcomes included oedema, venous ulcers, trophic disorders, subjective symptoms (pain, cramps, restless legs, itching, heaviness, swelling and paraesthesias), global assessment measures and side effects. The results of many variables were heterogeneous. Phlebotonics showed some global benefit (i.e. oedema reduction) (relative risk 0.72, 95% confidence interval 0.65 to 0.81). The benefit for the remaining CVI signs and symptoms must be evaluated by phlebotonic group.
There were no quantifiable data on quality of life.
Authors' conclusions:
There is not enough evidence to globally support the efficacy of phlebotonics for chronic venous insufficiency.
There is a suggestion of some efficacy of phlebotonics on oedema but this is of uncertain clinical relevance. Due to the limitations of current evidence, there is a need for further randomised, controlled clinical trials with greater attention paid to methodological quality.
В RELIEF study, где все чудесно - не было рандомизации
В Чешском многоцентровом, где тоже все гуд - оценивали эффективность после венэктомии - контрольной группе не давали плацебо.
Из положительного находил только это:
Dominguez C, Brautigam I, Gonzalez E, Gonzalez JA, Nazco J, Valiente R, Boada J
Therapeutic effects of hidrosmin on chronic venous insufficiency of the lower limbs. Current medical research and opinion. 12(10):623-30, 1992.
A double-blind, placebo-controlled trial was carried out to assess the effectiveness of a new synthetic bioflavonoid, hidrosmin, in patients with chronic venous insufficiency of the lower limbs. Fifty-seven patients, showing varicose veins and ankle swelling and suffering from local pain and heaviness of the legs, were allocated at random to receive treatment for 45 days with 1 capsule 3-times daily of either 200 mg hidrosmin (30 patients) or placebo (27 patients). Pain and heavy legs were assessed using rating scales; swelling was assessed by a photographic method. The results showed that hidrosmin produced a significant clinical improvement in all of the parameters evaluated; compared with placebo, there was a marked reduction in the main subjective symptoms accompanied by a 10% reduction in swelling.
На нем, видимо основной оптимизм и сосредоточен.
Или нет?