[Microcirculatory changes in patients with chronic venous and lymphatic insufficiency and heavy leg symptoms before and after therapy with procyanidol oligomers (laser-Doppler study)].
BACKGROUND
To study the efficacy of venotonica and medicaments having anti-edema effect is very actual.


OBJECTIVE
Patients suffering from venous-lymphatic insufficiency were treated with procyanidol oligomers in an open, prospective study. The effective substance of this medication protects the fibrous connective tissue protein, thus improving the function of the venous and lymphatic capillaries.


METHODS
For three months, the daily dose was 2 x 150 mg 30 patients were included into the study. The efficacy of the treatment was evaluated by statistical methods analysing the changes of the clinical symptoms and the satisfaction of the patients. For the first time, laser-Doppler method was used to determine the pathological condition of the dermal microcirculation before and after 3 months of treatment. The laser-Doppler tests used as indicators of the functional changing of the microcirculations were as follows: venoarterial response, reactive hyperemic response, and thermal stimulation response. The authors established the standard values and compared the measurement scores to those. According to the resulting scores, the status before and after the treatment can be compared by statistic analysis. Subjective complaints of the patients such as pain, heaviness of the leg, nightly muscle cramps were estimated by a visual analog scale.


RESULTS
The treatment (procyanidol oligomers) significantly reduced lymphedema (p < 0.001) in the "heavy leg" syndrome. Symptoms as pain, heaviness of the leg, muscle cramps, improved significantly (p < 0.001) after treatment. The microcirculatory status was pathologic before treatment. After treatment, there was no significant improvement in the laser-Doppler results.


CONCLUSIONS
The study revealed that in venous-lymphatic insufficiency, the arterial-capillary system is also damaged. The authors bring to attention that the disorder of the dermal arteries playing a role in the pathogenesis of venous-lymphatic insufficiency first detected in this study needs to be further investigated.
Fovárosi Onkormányzat Szent István Kórház, Borgyógyászati Osztály, Budapest.
Judit
J
Daróczy
András
A
Pál
György
G
Blaskó
D000328:Adult; D000368:Aged; D044946:Biflavonoids; D002392:Catechin / Q000008:administration & dosage* / Q000494:pharmacology*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D007866:Leg; D008209:Lymphedema / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D044945:Proanthocyanidins; D012039:Regional Blood Flow / Q000187:drug effects; D016896:Treatment Outcome; D014463:Ultrasonography; D014689:Venous Insufficiency / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*
D044946:Biflavonoids; D044945:Proanthocyanidins; C017674:procyanidin; D002392:Catechin