beta-escin and Chronic-Disease

Escin, hydroxyethylrutoside (HR), and Daflon have been shown to be safe and effective for the treatment of chronic venous insufficiency (CVI). They seem to work differently than compression therapy, suggesting that they would usefully augment this therapy. All three phlebotonics attenuate the drop in adenosine triphosphate in venous endothelial cells during hypoxia. This attenuates (1) the inflammation response, (2) the attraction of neutrophils, (3) damage to the veins, and (4) the release of growth factors. These factors otherwise would perpetuate venous insufficiency and contribute to varicose veins. Additional independent effects that would be useful for the treatment of CVI are that they reduce permeability and fragility; HR, Daflon, and perhaps escin increase venous tone; escin inhibits hyaluronidase; Daflon and probably HR are attracted to the veins. With regard to similarity, no differences in effect have been established among these phlebotonics.

Topics: Chronic Disease; Clinical Trials as Topic; Diosmin; Escin; Humans; Hydroxyethylrutoside; Venous Insufficiency

To assess the evidence for or against horse-chestnut seed extract (HCSE) as a symptomatic treatment of chronic venous insufficiency (CVI).. Computerized literature searches were performed in MEDLINE, EMBASE, BIOSIS, CISCOM, and the Cochrane Library (all from their respective institution to December 1996). The search terms were "horse chestnut," "Aesculus hippocastanum," "escin," and "Rosskastanie" (German for "horse chestnut"). There were no restrictions on the language of publication.. Double-blind, randomized controlled trials of oral HCSE for patients with CVI were included. Identifiers were removed from all publications before assessment.. Data were extracted in a standardized, predefined manner. Trial outcomes and the methodological quality of each trial were independently assessed by the 2 reviewers.. The superiority of HCSE is suggested by all placebo-controlled studies. The use of HCSE is associated with a decrease of the lower-leg volume and a reduction in leg circumference at the calf and ankle. Symptoms such as leg pain, pruritus, and a feeling of fatigue and tenseness are reduced. Five comparative trials against the reference medication indicate that HCSE and O-(beta-hydroxyethyl)-rutosides are equally effective. One trial suggests a therapeutic equivalence of HCSE and compression therapy. Adverse effects are usually mild and infrequent.. These data imply that HCSE is superior to placebo and as effective as reference medications in alleviating the objective signs and subjective symptoms of CVI. Thus, HCSE represents a treatment option for CVI that is worth considering.

Topics: Chronic Disease; Escin; Humans; Plant Extracts; Randomized Controlled Trials as Topic; Venous Insufficiency

The aim of this study was to compare the efficacy of Venostasin (horse chestnut seed extract) and Pycnogenol (French maritime pine bark extract) in the treatment of chronic venous insufficiency (CVI). In an open, controlled comparative study 40 patients with diagnosed CVI were treated either with 600 mg chestnut seed extract per day or 360 mg Pycnogenol per day over a period of 4 weeks. The following parameters were investigated before the start of treatment and after 2 and 4 weeks of treatment: circumference of the lower legs and rating of subjective symptoms (scores) of pain, cramps, night-time swelling, feeling of "heaviness", and reddening of the skin. In addition, blood levels of cholesterol LDL and HDL were determined before and at the end of treatment. Pycnogenol significantly reduced the circumference of the lower limbs and significantly improved subjective symptoms. Furthermore, Pycnogenol significantly decreased cholesterol and LDL values in the blood, whereas HDL remained unaffected. Venostasin only moderately but not significantly, reduced the circumference of the lower limbs and marginally improved symptoms. Venostasin had no influence on the determined lipid values. Both medications were equally well tolerated. In conclusion, Pycnogenol was found to be more efficacious than Venostasin for the treatment of CVI.

Topics: Adult; Aged; Cholesterol; Cholesterol, HDL; Cholesterol, LDL; Chronic Disease; Drug Combinations; Escin; Female; Flavonoids; Humans; Leg; Male; Middle Aged; Phytotherapy; Pinus; Plant Bark; Plant Extracts; Platelet Aggregation Inhibitors; Sapindaceae; Seeds; Treatment Outcome; Venous Insufficiency

We report two clinical studies, one already published, performed in patients with early and advanced chronic venous insufficiency (CVI). In both, compression therapy and oral therapy with horse-chestnut seeds extracts (HCSE) were compared to placebo.. The published study in early CVI (Grade I) showed HCSE and compression to be superior to placebo and to be equivalent to each other in reducing lower leg volume, a measure for oedema. In the study, in advanced CVI (Grade II and IIIa), compression appeared to be superior to placebo, whereas HCSE was not. HCSE fared better in Grade II than in Grade IIIa patients. These results are discussed in the light of data from an in vitro model, where HCSE has been able to close the intercellular gaps in the venular endothelium. Not fully specified factors lead to an opening of these gaps, resulting in oedema as well as in local coagulation and thrombosis. The subsequent inflammation keeps these gaps open and initiates and maintains a chronic disease process, which may be the starting point of CVI.. Due to its ability to close the venular endothelial gaps, HCSE seems to be a suitable and protecting therapy during the early stages of CVI. In later more severe stages compression therapy is indicated. Taking into account the observed negative impact of compression on quality of life, pharmacological CVI therapy should start early to avoid progress and to spare patients compression therapy.

Topics: Aesculus; Bandages; Chronic Disease; Double-Blind Method; Drug Combinations; Escin; Humans; Phytotherapy; Plant Extracts; Quality of Life; Venous Insufficiency

The effect of horse-chestnut seed extract (standardized on aescin; Venostasin retard) was assessed in a randomized placebo-controlled crossover double-blind trial of 22 patients with proven chronic venous insufficiency by measuring the capillary filtration coefficient and the intravascular volume of the lower leg by venous-occlusion plethysmography. Three hours after taking two capsules of Venostasin (600 mg; each capsule containing 50 mg aescin) the capillary filtration coefficient had decreased by 22%, whereas after administration of an identical-looking placebo capsule it rose but slightly over three hours. The difference in the effect of Venostasin and placebo is statistically significant (P = 0.006). The intravascular volume was reduced 5% more after Venostasin than the placebo, but this is not statistically significant. It is concluded that Venostasin has an inhibitory effect on oedema formation via a decrease in transcapillary filtration and thus improves oedema-related symptoms in venous diseases of the legs.

Topics: Capillary Permeability; Chronic Disease; Clinical Trials as Topic; Double-Blind Method; Drug Combinations; Escin; Female; Humans; Middle Aged; Plant Extracts; Random Allocation; Saponins; Venous Insufficiency

Topics: Administration, Oral; Administration, Topical; Adult; Aged; Chronic Disease; Clinical Trials as Topic; Drug Combinations; Escin; Female; Flavonoids; Hesperidin; Humans; Male; Middle Aged; Phosphatidylcholines; Random Allocation; Rutin; Saponins; Venous Insufficiency

To perform a differential analysis of the efficacy of combination therapy by the drugs with different modalities (mexidol, aescusan, halidorum) in outpatients with chronic cerebral ischemia (CCI), stages I- III.. A study included 50 patients with CCI of atherosclerotic, hypertensive and mixed genesis (stage I - 20 patients, stage II - 20, stage III - 10 patients). In addition to somatic therapy, patients received three courses of mexidol, halidorum and aescusan combination therapy during 6 weeks with a 3 month interval between the courses. The changes in subjective complaints and objective clinical manifestations were evaluated after each course.. The therapeutic efficacy after durable complex therapy by repeated courses of antioxidants is supported by the results of clinical and neurological examinations. Mexidol in the combination with aescusan and halidorum contributed to the improvement of cognitive, adaptive, motor functions of the patients with CCI, stages I and II. To increase treatment efficacy in patients with CCI, stage III, we recommend to use the drugs that improve cognitive functions of the patients.. Цель исследования - проведение дифференцированного анализа эффективности комбинированного лечения препаратами различной модальности (мексидол, эскузан, галидор) у пациентов с хронической ишемией мозга (ХИМ) I, II и III стадий в амбулаторных условиях. Материал и методы. В исследование включены 50 пациентов с диагнозом хроническая ишемия головного мозга I-III стадии атеросклеротического, гипертонического и смешанного генеза (I стадия - 20 больных, II стадия - 20 больных, III стадия - 10 больных). На фоне базисной терапии пациенты получали три курса комбинированной терапии препаратами мексидол, галидор, эскузан в течение 6 нед с интервалом между курсами 3 мес. После каждого курса оценивались динамика субъективных жалоб пациентов и объективных клинических проявлений. Результаты и заключение. На основании данных клинико-неврологического обследования показана терапевтическая эффективность длительного комплексного лечения неоднократными курсами антиоксидантов. Применение мексидола в сочетании с эскузаном и галидором способствовало улучшению когнитивных, адаптационных, двигательных функций пациентов при ХИМ I и II стадий. С целью повышения эффективности лечения у пациентов с ХИМ III стадии нейропротективное действие используемых лекарственных средств целесообразно дополнить препаратами, улучшающими когнитивные функции.

Topics: Aged; Antioxidants; Bencyclane; Brain Ischemia; Chronic Disease; Drug Therapy, Combination; Escin; Female; Humans; Male; Middle Aged; Neuroprotective Agents; Picolines; Treatment Outcome

Topics: Chronic Disease; Escin; Humans; Plant Extracts; Randomized Controlled Trials as Topic; Reproducibility of Results; Treatment Outcome; Venous Insufficiency

In 15 patients with primary or secondary chronic venous insufficiency (CHVI) the authors evaluated the action of three weeks' treatment with beta-aescin (Yellon caps). The regression of clinical symptoms of CHVI (sensation of "heavy" and "tired" legs, swollen ankles, nocturnal cramps was complete in five patients, partial or slight in seven patients, and none in three patients (with secondary venous insufficiency associated with thrombosis of the deep venous system). Undesirable effects of the agent were not revealed by common screening tests. No change of the basic parameters of haemostasis occurred. The haemodynamic action on the venous and capillary circulation of the lower extremities was evaluated by the method of venous occlusion plethysmography. Already after the first week of treatment a significant drop of capillary filtration to 74% of the original mean value before treatment occurred (0.265 +/- 0.084 ml/100 ml tissue). After the second and third week of treatment the values of capillary filtration decreased on average to 66% of the original mean value. The venous capacity (before treatment on average 3.5 +/- 0.9 ml/100 ml tissue) and venous drainage (before treatment on average 24.5 +/- 13.5 ml min/100 ml) did not change significantly during treatment.

Topics: Adult; Aged; Chronic Disease; Escin; Female; Hemodynamics; Humans; Leg; Male; Middle Aged; Venous Insufficiency

Topics: Adult; Animals; Chronic Disease; Disease Models, Animal; Drug Evaluation; Escin; Humans; Male; Microcirculation; Middle Aged; Platelet Aggregation Inhibitors; Prostate; Prostatitis; Rabbits; Saponins