Lymph outflow and dynamics of trophic changes in the lower extremities on the background of long-term use of a phlebotropic drug

Introduction. The mechanisms of the positive effect of phlebotonics on trophic changes and edema have not been fully studied.

Aim. To evaluate the lymph outflow and dynamics of trophic changes in the lower extremities on the background of long-term use of phlebotonics

Materials and methods. An open, direct, non-randomized study involved 62 patients with varicose veins of the lower extremities C4 according to CEAR. The patients were divided into 2 groups: the main group (n = 31) was treated with a phlebotropic drug of purified micronized flavonoid fraction (diosmin + flavonoids in terms of hesperidin) (MOFF) 1000 mg/ day for 1 year in combination with daily use of a combined action gel (sodium heparin, phospholipids, escin) in the morning and evening for 15 days (in courses with a break of 1 week for 3 months) on the inner surface of the thigh and lower leg in the projection of the large saphenous vein, as well as wearing second-class compression knitwear throughout the entire treatment period; The control group (n = 31) consisted of patients who underwent volume surgery using radiofrequency ablation (RF) of the large subcutaneous vein, followed by wearing second-class compression knitwear (2 months) and taking troxevazine 300 mg 2 times daily for 2 months. Patients underwent lymphography after 3, 6, 9, and 12 months. The area of trophic changes was determined using the “Analyzer” application.

Results. The rate of reduction of lower leg circumference in the study groups was comparable. However, from the 9th month of the study, there was a statistically significant difference between the groups in the area of hyperpigmentation, which became significantly smaller in the control group (p < 0.05). After 6 months of using the phlebotropic drug, the predominance of the area of contrasted lymphatic vessels in the main group was determined (p < 0.05).

Conclusion. The drug MPFF can be considered the drug of choice in the treatment of venous and lymphatic insufficiency. According to the results of the study, its effectiveness is not inferior to the RF of the large subcutaneous vein.

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