rutin and Pain

The aim of this article was first to review the complex pathophysiological mechanisms responsible for symptoms and signs of primary chronic venous disease (CVD) that allow the identification of targets for pharmacological treatment. The results of CVD treatment with venoactive drugs (VADs) were emphasised and presented in the form of recommendations. The last section raises key questions to be answered to improve protocols for good clinical trials and to draw up future guidelines on these agents.. The literature has been reviewed here using PubMed and Embase.. Venous hypertension appears to underlie all clinical manifestations of primary CVD. Inflammation is key in wall remodelling, valve failure and subsequent venous hypertension. Changes in the haemodynamics of veins are transmitted to the microcirculation, resulting in capillary alteration leading to oedema, skin changes and eventually venous ulceration. Venous symptoms may be the result of interplays between pro-inflammatory mediators and nerve fibres located in the venous wall. Therefore, venous inflammation constitutes a promising therapeutic target for pharmacological intervention, and some available VADs could attenuate various elements of venous inflammation. Based on recent studies, reviews and guidelines, tentative recommendations for the use of VADs were proposed and strong recommendations were given to two of them (micronised purified flavonoid fraction and oxerutins).. VADs should be accorded a better role in the management of CVD. However, larger and more definitive clinical trials are needed to improve the existing recommendations.

Topics: Anticoagulants; Blood Viscosity; Capillaries; Capillary Permeability; Capillary Resistance; Chronic Disease; Diosmin; Edema; Humans; Hydroxyethylrutoside; Inflammation; Lymphatic System; Pain; Skin Diseases; Vasodilator Agents; Veins; Venous Insufficiency

Oxerutins (Venoruton) and troxerutin (CAS 7085-55-4) are both mixtures of O-(beta-hydroxyethyl)-rutosides used for the treatment of chronic venous insufficiency. As di-O-(beta-hydroxyethyl)-rutosides and 7-mono-O-(beta-hydroxyethyl)-rutoside were found to be more active with regard to free radical scavenging compared to tri-O-(beta-hydroxyethyl)-rutoside the aim of this study was to compare oxerutins and troxerutin clinically. 12 female, post-menopausal patients with chronic venous insufficiency grade II participated in this double-blind study with random allocation to the treatment groups. They received 900 mg/day oxerutins or troxerutin for 12 weeks and were observed for 4 further weeks without treatment. Leg volumes (water displacement) and subjective symptoms (VAS, visual analogue scale) were evaluated before and following 2, 4, 8, 12 and 16 weeks. Both treatments were active in reducing leg volumes and in ameliorating subjective symptoms (mean volume reduction -167 +/- 157 ml x week). Volume reduction totalled to -261 +/- 154.2 ml x week for oxerutins and -73.2 +/- 97.1 ml x week for troxerutin. The difference is statistically significant (p = 0.04). The findings with subjective symptoms were in good accordance to the objective volume measurement. Oxerutins revealed a remarkable carry over effect.

Topics: Anticoagulants; Chronic Disease; Double-Blind Method; Edema; Female; Humans; Hydroxyethylrutoside; Leg; Middle Aged; Pain; Pain Measurement; Venous Insufficiency

The contemporary view of the cause of pain in case of histological lesions is discussed, i.e. the mechanisms of the formation of local high-protein oedemas in connexion with disorders of lymphatic drainage. 295 patients of an oral-surgical department were subjected to a systematic therapeutic study for investigating the possibilities of medicamentously influencing oedema and pain. Tested by way of comparison were a benzopyrone preparation (Venalot) and oxyphenbutazone. A group of control patients could only make use of an analgetic. The assessment of the reduction of oedema was done by means of anthropometric measurements. The analgetic action was judged by the need of analgetics. The result of it was that the benzopyrone preparation possesses a strong analgetic and antioedematous action which also exceeds that of the comparative therapy. The benzopyrones' clinical mechanisms of action are discussed in the light of experimental results.

Topics: Apicoectomy; Coumarins; Drug Combinations; Edema; Humans; Hydroxyethylrutoside; Maxillary Sinus; Nociceptors; Oxyphenbutazone; Pain; Rutin; Trismus; Vestibuloplasty

Topics: Analgesics; Animals; Female; Hydroxyethylrutoside; Mice; Naloxone; Pain; Rutin

Pain in the legs is a common diagnostic problem. Diagnosis is made on an anatomical basis and by a process of exclusion. Deep vein thrombosis is still an exceedingly difficult condition to diagnose; however, investigation by ultrasound with the Doppler Flow Meter often provides a definite answer. There is a large group of patients, nearly always female and in their twenties and thirties, in whom chronic leg pain without demonstrable underlying cause poses a problem. These cases respond very favourably to Paroven 250 mg three or four times daily, as well as light support pantyhose.

Topics: Adolescent; Adult; Age Factors; Aged; Child; Doppler Effect; Female; Humans; Hydroxyethylrutoside; Joint Diseases; Male; Medical History Taking; Pain; Pain Management; Physical Examination; Physicians, Family; Sex Factors; Thrombophlebitis; Wounds and Injuries