logo
Медицинский вестник
Северного Кавказа
Научно-практический журнал
Зарегистрирован в Федеральной службе
по надзору за соблюдением законодательства
в сфере массовых коммуникаций
и охране культурного наследия
ПИ №ФС77-26521 от 7 декабря 2006 года
ISSN 2073-8137
rus
русский
eng
english

Поиск по сайту




Адрес редакции
355017, Ставрополь, улица Мира, 310.

Телефоны
(8652) 35-25-11, 35-32-29.

E-mail
medvestnik@stgmu.ru

Рейтинг@Mail.ru

Эффективность применения экстракта Ruscus aculeatus у пациентов с хроническими заболеваниями вен: систематический обзор литературы и метаанализ

[Обзоры]
Хрыщанович Владимир Янович; Скобелева Наталья Яновна;

Представлена актуальная информация о терапевтической эффективности веноактивных препаратов, содержащих экстракт иглицы колючей, у пациентов с хроническими заболеваниями вен (ХЗВ). Метаанализ указал на высокую эффективность экстрактов Ruscus aculeatus в отношении ряда веноспецифических симптомов, уменьшения объема голени у пациентов с ХЗВ. Поиск доказательств в отношении других симптомов и признаков ХЗВ требует проведения дополнительных исследований.

Скачать

Список литературы:
1. Nicolaides A., Kakkos S., Eklof B., Perrin M., Nelzen O. [et al.]. Management of chronic venous disorders of the lower limbs – guidelines according to scientific evidence. Int. Angiol. 2014;33:87-208.
2. Perrin M., Eklof B., van Rij A., Labropoulos N., Vasquez M. [et al.]. Venous symptoms: the SYM Vein Consensus statement developed under the auspices of the European Venous Forum. Int. Angiol. 2016;35(4):374-398.
3. Kakkos S. K., Papageorgopoulou C. P., Nikolakopoulos K. M., Kalogeropoulou C., Tsolakis I. A. Validation of the 3D SYM VEIN symptom assessment tool. Eur. J. Vasc. Endovasc. Surg. 2020;60(4):587-593. https://doi.org/10.1016/j.ejvs.2020.06.028
4. Martinez-Zapata M. J., Vernooij R. W., Simancas-Racines D., Uriona Tuma S. M., Stein A. T. [et al.]. Phlebotonics for venous insufficiency. Cochrane Database Syst. Rev. 2020;3;11(11):CD003229. https://doi.org/10.1002/14651858.CD003229.pub4
5. Kakkos S. K., Nicolaides A. N. Efficacy of micronized purified flavonoid fraction (daflon(R)) on improving individual symptoms, signs and quality of life in patients with chronic venous disease: a systematic review and meta-analysis of randomized double-blind placebocontrolled trials. Int. Angiol. 2018;37(2):143-154. https://doi.org/10.23736/S0392-9590.18.03975-5
6. Nicolaides A., Kakkos S., Baekgaard N., Comerota A., de Maeseneer M. [et al.]. Management of chronic venous disorders of the lower limbs. Guidelines According to Scientific Evidence. Part I. Int. Angiol. 2018;37:181-254. https://doi.org/10.23736/S0392-9590.18.03999-8
7. Kakkos S. K., Allaert F. A. Efficacy of Ruscus extract, HMC and vitamin C, constituents of Cyclo 3 fort®, on improving individual venous symptoms and edema: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials. Int. Angiol. 2017;36(2):93-106. https://doi.org/10.23736/S0392-9590.17.03815-9
8. Van der Velden S. K., van den Bos R. R., Pichot O., Nijsten T., De Maeseneer M. Towards an individualized management strategy for patients with chronic venous disease: results of a Delphi consensus. Phlebology. 2018;33(7):492-499. https://doi.org/10.1177/0268355517719357
9. Salim S., Tan M., Geoghegan L., Belramman A., Onida S. [et al.]. A systematic review assessing the quality of clinical practice guidelines in chronic venous disease. J. Vasc. Surg. Venous Lymphat. Disord. 2021;9(3):787-791.e3. https://doi.org/10.1016/j.jvsv.2020.09.014
10. Hutton B., Salanti G., Caldwell D. M., Chaimani A., Schmid C. H. [et al.]. The PRISMA extension statement for reporting of systematic reviews incorporating network meta-analyses of health care interventions: checklist and explanations. Ann. Intern. Med. 2015;162(11):777-784. https://doi.org/10.7326/M14-2385
11. Launois R. A quality of life tool kit in chronic venous disorders. Phlebolymphology. 2014;21(3):152-160.
12. Beltramino R., Penenory A., Buceta A. M. An open-label, randomized multicenter study comparing the efficacy and safety of Cyclo 3 Fort versus hydroxyethyl rutoside in chronic venous lymphatic insufficiency. Angiology. 2000;51(7):535-544. https://doi.org/10.1177/000331970005100702
13. Vanscheidt W., Jost V., Wolna P., Lücker P. W., Müller A. [et al.]. Efficacy and safety of a Butcher’s broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency. Arzneimittelforschung. 2002;52(4):243-250. https://doi.org/10.1055/s-0031-1299887
14. Lurie F., Passman M., Meisner M., Dalsing M., Masuda E. [et al.]. The 2020 update of the CEAP classification system and reporting standards. J. Vasc. Surg. Venous Lymphat. Disord. 2020;8(3):342-352. https://doi.org/10.1016/j.jvsv.2019.12.075
15. Davies A. H. The seriousness of chronic venous disease: a review of real-world evidence. Adv. Ther. 2019;36(Suppl1):5-12. https://doi.org/10.1007/s12325-019-0881-7
16. Lee B. B., Nicolaides A. N., Myers K., Meissner M., Kalodiki E. [et al.]. Venous hemodynamic changes in lower limb venous disease: the UIP consensus according to scientific evidence. Int. Angiol. 2016;35(3):236-352.
17. Vuylsteke M. E., Thomis S., Guillaume G., Modliszewski M. L., Weides N. [et al.]. Epidemiological study on chronic venous disease in Belgium and Luxembourg: prevalence, risk factors, and symptomatology. Eur. J. Vasc. Endovasc. Surg. 2015;49(4):432-439. https://doi.org/10.1016/j.ejvs.2014.12.031
18. Escudero Rodríguez J. R., Fernández Quesada F., Bellmunt Montoya S. Prevalence and clinical characteristics of chronic venous disease in patients seen in primary care in Spain: results of the international study Vein Consult Program [Article in English, Spanish]. Cir. Esp. 2014;92(8):539-546.https://doi.org/10.1016/j.ciresp.2013.09.013
19. Raffetto J. D. Pathophysiology of chronic venous disease and venous ulcers. Surg. Clin. North. Am. 2018;98(2):337-347. https://doi.org/10.1016/j.suc.2017.11.002
20. Govind D., Thomas K. N., Hill B. G., van Rij A. M. Microvenous reflux in the skin of limbs with superficial venous incompetence. Ultrasound Med. Biol. 2018;44(4):756-761. https://doi.org/10.1016/j.ultrasmedbio.2017.11.014
21. O’Donnell T. F. Jr., Passman M. A., Marston W. A., Ennis W. J., Dalsing M. [et al.]. Society for Vascular Surgery; American Venous Forum. Management of venous leg ulcers: clinical practice guidelines of the Society for Vascular Surgery® and the American Venous Forum. J. Vasc. Surg. 2014;60(two Suppl):3S-59S. https://doi.org/10.1016/j.jvs.2014.04.049
22. Lal B. K. Venous ulcers of the lower extremity: definition, epidemiology, and economic and social burdens. Semin. Vasc. Surg. 2015;28(1):3-5. https://doi.org/10.1053/j.semvascsurg.2015.05.002
23. Frati-Munari A. C. Medical significance of endothelial glycocalyx. Arch. Cardiol. Mex. 2013;83(4):303-312. https://doi.org/10.1016/j.acmx.2013.04.015
24. Chen Y., Peng W., Raffetto J. D., Khalil R. A. Matrix metalloproteinases in remodeling of lower extremity veins and chronic venous disease. Prog. Mol. Biol. Transl. Sci. 2017;147:267-299. https://doi.org/10.1016/bs.pmbts.2017.02.003
25. MacColl E., Khalil R. A. Matrix metalloproteinases as regulators of vein structure and function: implications in chronic venous disease. J. Pharmacol. Exp. Ther. 2015;355(3):410-428. https://doi.org/10.1124/jpet.115.227330
26. Sansilvestri-Morel P., Fioretti F., Rupin A., Senni K., Fabiani J. N. [et al.]. Comparison of extracellular matrix in skin and saphenous veins from patients with varicose veins: does the skin reflect venous matrix changes? Clin. Sci. (Lond). 2007;112(4):229-239. https://doi.org/10.1042/CS20060170
27. Castro-Ferreira R., Cardoso R., Leite-Moreira A., Mansilha A. The role of endothelial dysfunction and inflammation in chronic venous disease. Ann. Vasc. Surg. 2018;46:380-393. https://doi.org/10.1016/j.avsg.2017.06.131
28. Kahn S. R. The post-thrombotic syndrome. Hematology Am. Soc. Hematol. Educ. Program. 2016;1:413-418. https://doi.org/10.1182/asheducation-2016.1.413
29. Radak D. J., Tanaskovic S. Z., Vlajinac H. D., Marinkovic J. M., Maksimovic M. Z. Relationship between pain and CEAP C categories of chronic venous disease. Angiology. 2016;67(7):670-675. https://doi.org/10.1177/0003319715613179
30. Tsoukanov T. Y., Tsoukanov A. Y., Nikolaychuk A. Great saphenous vein transitory reflux in patients with symptoms related to chronic venous disorders, but without visible signs (C0s), and its correction with MPFF treatment. Phlebolymphology. 2015;22:18-24.
31. Keo H. H., Husmann M., Groechenig E., Willenberg T., Gretener S. B. Diagnostic accuracy of fluorescence microlymphography for detecting limb lymphedema. Eur. J. Vasc. Endovasc. Surg. 2015;49(4):474-479. https://doi.org/10.1016/j.ejvs.2014.12.033
32. Masuda E., Ozsvath K., Vossler J., Woo K., Kistner R. [et al.]. The 2020 appropriate use criteria for chronic lower extremity venous disease of the American Venous Forum, the Society for Vascular Surgery, the American Vein and Lymphatic Society, and the Society of Interventional Radiology. J. Vasc. Surg. Venous Lymphat. Disord. 2020;8(4):505-525.e4. https://doi.org/10.1016/j.jvsv.2020.02.001
33. Bignamini A. A., Matuska J. Sulodexide for the symptoms and signs of chronic venous disease: a systematic review and metaanalysis. Adv. Ther. 2020;37(3):1013-1033. https://doi.org/10.1007/s12325-020-01232-1
34. Nicolaides A. The benefits of micronized purified flavonoid fraction (MPFF) throughout the progression of chronic venous disease. Adv. Ther. 2020;37(Suppl 1):1-5. https://doi.org/10.1007/s12325-019-01218-8
35. Wittens C., Davies A. H., Bækgaard N., Broholm R., Cavezzi A. [et al.]. Management of chronic venous disease: clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur. J. Vasc. Endovasc. Surg. 2015;49:678-737. https://doi.org/10.1016/j.ejvs.2015.02.007
36. Belczak S. Q., Sincos I. R., Campos W., Beserra J., Nering G. [et al.]. Veno-active drugs for chronic venous disease: a randomized, doubleblind, placebo-controlled parallel-design trial. Phlebology. 2014;29(7):454-460. https://doi.org/10.1177/0268355513489550
37. Rabe E., Agus G. B., Roztocil K. Analysis of the effects of micronized purified flavonoid fraction versus placebo on symptoms and quality of life in patients suffering from chronic venous disease: from a prospective randomized trial. Int. Angiol. 2015;34(5):428-436.
38. Aziz Z., Tang W. L., Chong N. J., Tho L. Y. A systematic review of the efficacy and tolerability of hydroxyethylrutosides for improvement of the signs and symptoms of chronic venous insufficiency. J. Clin. Pharm. Ther. 2015;40(2):177-185. https://doi.org/10.1111/jcpt.12247
39. Scallon C., Bell-Syer S. E., Aziz Z. Flavonoids for treating venous leg ulcers. Cochrane Database Syst. Rev. 2013;31(5):CD006477. https://doi.org/10.1002/14651858.CD006477.pub2
40. Kalodiki E., Azzam M., Schnatterbeck P., Geroulakos G., Lattimer C. R. The Discord Outcome Analysis (DOA) as a reporting standard at three months and five years in randomised varicose vein treatment trials. Eur. J. Vasc. Endovasc. Surg. 2019;57(2):267-274. https://doi.org/10.1016/j.ejvs.2018.09.013
41. Allaert F. A. Combination of Ruscus aculeatus extract, hesperidin methyl chalcone and ascorbic acid: a comprehensive review of their pharmacological and clinical effects and of the pathophysiology of chronic venous disease. Int. Angiol. 2016;35(2):111-116.
42. Allaert F. A. Meta-analysis of the impact of the principal venoactive drugs agents on malleolar venous edema. Int. Angiol. 2012;31:310-315.
43. Jawien A., Bouskela E., Allaert F. A., Nicolaides A. N. The place of Ruscus extract, hesperidin methyl chalcone, and vitamin C in the management of chronic venous disease. Int. Angiol. 2017;36(1):31-41. https://doi.org/10.23736/S0392-9590.16.03788-3
44. Kakkos S. K., Bouskela E., Jawien A., Nicolaides A. N. New data on chronic venous disease: a new place for Cyclo 3® Fort. Int. Angiol. 2018;37(1):85-92. https://doi.org/10.23736/S0392-9590.17.03935-9
45. Kakkos S. K., Guex J. J., Lugli M., Nicolaides A. N. CEAP clinical classes C0S-C4: differences, similarities and role of Ruscus + HMC + vitamin C in patients with chronic venous disease. Int. Angiol. 2020;39(2):118-124. https://doi.org/10.23736/S0392-9590.20.04341-2
46. De Almeida Cyrino F. Z. G., Balthazar D. S., Sicuro F. L., Bouskela E. Effects of venotonic drugs on the microcirculation: Comparison between Ruscus extract and micronized diosmine. Clin. Hemorheol. Microcirc. 2018;68(4):371-382. https://doi.org/10.3233/CH-170281
47. Todd M. Compression in older people. BJN. 2019;28(9):566. https://doi.org/10.12968/bjon.2019.28.9.566
48. Caggiati A., De Maeseneer M., Cavezzi A., Mosti G., Morrison N. Rehabilitation of patients with venous diseases of the lower limbs: state of the art. Phlebology. 2018;33(10):663-671. https://doi.org/10.1177/0268355518754463
49. Rabe E., Partsch H., Morrison N., Meissner M. H., Mosti G. [et al.]. Risks and contraindications of medical ESVS 2022 Clinical Practice Guidelines on the Management of CVD of the Lower Limbs 255 compression treatment – a critical reappraisal. An international consensus statement. Phlebology. 2020;35(7):447-460. https://doi.org/10.1177/0268355520909066
50. Carroll C., Hummel S., Leaviss J., Ren S., Stevens J. W. [et al.]. Systematic review, network meta-analysis and exploratory cost-effectiveness model of randomized trials of minimally invasive techniques versus surgery for varicose veins. Br. J. Surg. 2014;101(9):1040-1052. https://doi.org/10.1002/bjs.9566
51. Mansilha A., Sousa J. Benefits of venoactive drug therapy in surgical or endovenous treatment for varicose veins: a systematic review. Int. Angiol. 2019;38(4):291-298. https://doi.org/10.23736/S0392-9590
52. Khryshchanovich V. Y., Nebylitsin Y. S., Kosinets V. A. Efficacy of micronized purified flavonoid fraction-based venoactive therapy after endovenous mechanochemical obliteration: prospective comparative study. Drugs Real. World Outcomes. 2021;8(3):349-358. https://doi.org/10.1007/s40801-021-00249-4
53. Bogachev V. Y., Boldin B. V., Lobanov V. N. Benefits of micronized purified flavonoid fraction as adjuvant therapy on inflammatory response after sclerotherapy. Int. Angiol. 2018;37:71-78. https://doi.org/10.23736/S0392-9590.17.03868-8
54. Rauly-Lestienne I., Heusler P., Cussac D., LantoineAdam F., de Almeida Cyrino F. Z., Bouskela E. Contribution of muscarinic receptors to in vitro and in vivo effects of Ruscus extract. Microvasc. Res. 2017;114:1-11. https://doi.org/10.1016/j.mvr.2017.05.005
55. Urbanek T. The clinical efficacy of Ruscus Aesculatus extract: is there enough evidence to update the pharmacotherapy guidelines for chronic venous disease? Phlebological Review. 2017;25:75-80. https://doi.org/10.5114/pr.2017.70594

Ключевые слова: хронические заболевания вен, веноспецифические симптомы, флеботропная терапия, иглица колючая, геспередин, витамин C


Учредители:
Ставропольская государственная медицинская академия
Государственный научно-исследовательский институт курортологии
Пятигорская государственная фармацевтическая академия