A sclerosant with astringent properties developed in China for oesophageal varices: comparison with ethanolamine oleate and polidocanol.
BACKGROUND
Xiao zhi ling (XZL), which consists of Chinese nutgalls and aluminium potassium sulphate, is used as a local injection for the treatment of internal haemorrhoids in China. It is also used for endoscopic sclerotherapy of oesophageal varices. To date, however, it has not been compared with other sclerosants with regard to its safety and efficacy.


METHODS
In the present study, the effect on the endothelium and the haemolytic and thrombosing effects of XZL were compared with those of 5% ethanolamine oleate and 1% polidocanol, using an endothelial cell line and red blood cells taken from rats and the dorsal marginal ear vein of rabbits. In addition, XZL was injected into the area surrounding varices in rats and its efficacy was studied endoscopically and histologically.


RESULTS
Xiao zhi ling reduced the size of varices in rats after causing severe damage in the injected region. Compared with the other two sclerosants, however, XZL had little effect on the endothelium and was the least haemolytic compound. Furthermore, XZL did not cause thrombosis in the injected vein of a rabbit.


CONCLUSIONS
These results suggest that XZL is another type of sclerosant with astringent rather than detergent properties. This compound should be used to treat oesophageal varices by paravariceal injection in smaller doses than 5% ethanolamine oleate and 1% polidocanol.
Nishida
R
R
Department of Geriatric Medicine, Faculty of Medicine, Kyoto University, Japan.
Inoue
R
R
Takimoto
Y
Y
Kita
T
T
D000534:Alum Compounds / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D000818:Animals; D001252:Astringents / Q000627:therapeutic use*; D002417:Cattle; D002460:Cell Line; D002681:China; D004305:Dose-Response Relationship, Drug; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D004730:Endothelium, Vascular / Q000166:cytology / Q000187:drug effects; D004912:Erythrocytes / Q000187:drug effects; D004932:Esophageal and Gastric Varices / Q000628:therapy*; D006461:Hemolysis; D008297:Male; D009829:Oleic Acids / Q000627:therapeutic use*; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011817:Rabbits; D051381:Rats; D017208:Rats, Wistar; D012597:Sclerosing Solutions / Q000627:therapeutic use*; D015911:Sclerotherapy; D013927:Thrombosis / Q000139:chemically induced
D000534:Alum Compounds; D001252:Astringents; D004365:Drugs, Chinese Herbal; D009829:Oleic Acids; D012597:Sclerosing Solutions; C120431:xiao zhi ling; D000077423:Polidocanol; D011092:Polyethylene Glycols; C033343:ethanolamine oleate