Добезилат кальция: возможности терапии хронической венозной патологии

Стойко Ю.М., Гудымович В.Г. Добезилат кальция: возможности терапии хронической венозной патологии. Consilium Medicum. 2017; 19 (7.1. Хирургия): 71–74.

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Stoiko Yu.M., Gudymovich V.G. Calcium dobesilate: possibility of therapy of chronic venous disease. Consilium Medicum. 2017; 19 (7.1. Surgery): 71–74.

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Аннотация

В обзорной статье, посвященной флеботропной терапии в лечении пациентов с хронической венозной недостаточностью нижних конечностей, рассмотрен один из препаратов данной группы – добезилат кальция. Анализ отечественной и зарубежной литературы свидетельствует об эффективности использования его у пациентов данной категории, что подтверждается рядом международных исследований и включением препарата в Российские клинические рекомендации по диагностике и лечению хронических заболеваний вен. Механизм действия, обеспечивающий противоотечный, противовоспалительный, антитромботический эффекты, позволяет использовать его не только во флебологии. Мультинаправленное действие добезилата кальция позволяет применять его как ангиопротектор у пациентов с диабетической ретинопатией и нефропатией.

Ключевые слова: хронические заболевания вен нижних конечностей, флеботропные препараты, добезилат кальция.

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In a review article devoted to phlebotropic therapy in the treatment of patients with chronic venous insufficiency of the lower extremities are considered one of the drugs of this group – calcium dobesilate. Analysis of domestic and foreign literature indicates the effectiveness of its use in patients of this category, as evidenced by a number of international studies and the inclusion of the drug in the Russian clinical practice guidelines for the diagnosis and treatment of chronic venous diseases. The mechanism of action, providing anti-edematous, anti-inflammatory, antithrombotic effects, allows to use it not only in phlebology. Multimedialne action of calcium dobesilate allows its use both as a vasoprotector in patients with diabetic retinopathy and nephropathy.

Key words: chronic venous disease of the lower extremities, phlebotropics, calcium dobesilate.

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Список литературы

1. Клиническая флебология. Под ред. Ю.Л.Шевченко, Ю.М.Стойко. М.: ДПК Пресс, 2016. / Klinicheskaia flebologiia. Pod red. Iu.L.Shevchenko, Iu.M.Stoiko. M.: DPK Press, 2016. [in Russian]
2. Совещание экспертов. Российские клинические рекомендации по диагностике и лечению хронических заболеваний вен, основанные на принципах доказательной медицины. Рабочие материалы. М., 2008. / Soveshchanie ekspertov. Rossiiskie klinicheskie rekomendatsii po diagnostike i lecheniiu khronicheskikh zabolevanii ven, osnovannye na printsipakh dokazatel'noi meditsiny. Rabochie materialy. M., 2008. [in Russian]
3. Rabe E, Guex JJ, Puskas A et al. Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol 2012; 31 (2): 105–15.
4. Nicolaides A, Kakkos S, Eklof B et al. Management of chronic venous disorders of the lower limbs. Guidelines according to scientific evidence. Int Angiol 2014; 33 (2): 126–39.
5. Garay RP, Hannaert P, Chiavaroli C. Calcium dobesilate in the treatment of diabetic retinopathy. Treat Endocrinol 2005; 4 (4): 221–32.
6. Mestres P, Rodriguez L, Erill S, Laport J. Modification by calcium dobesilate of histamine effects on capillary ultra-structure. Experientia 1975; 31: 826–9.
7. Zabel-Langhennig R, Kulle M. Capillary fragility in diabetics and its modification by calcium dobesilate. Z Gesamte Inn Med 1983; 38: 633–6.
8. Van Bijsterveld OP, Janssen PT. The effect of calcium dobe-silate on albumin leakage of the conjunctival vessels. Curr Eve Res 1981; 1: 425–30.
9. Allain H, Ramelet AA, Polard E, Bentué-Ferrer D. Safety of calcium dobesilate in chronic venous disease, diabetic retinopathy and haemorrhoids. Drug Saf 2004; 27: 649–60.
10. Demirtas S, Caliskan A, Guclu O et al. Can calcium dobesilate be used safely for peripheral microvasculopathies that require neoangiogenesis? Med Sci Monit Basic Res 2013; 19: 253–7.
11. Alda O, Valero MS, Pereboom D et al. In vitro calcium dobesilate on oxidative/inflammatory stress in hunan varicosae veins. Phlebology 2011; 26 (8): 332–7.
12. Angulo J, Peiró C, Romacho T et al. Inhibition of vascular endothelial growth factor (VEGF)-induced endothelial proliferation, arterial relaxation, vascular permeability and angiogenesis by dobesilate. Eur J Pharmacol 2011; 667: 153–9.
13. Brunet J, Farine JC, Garay RP, Hannaert P. In vitro antioxidant properties of calcium dobesilate. Fundam Clin Pharmacol 1998; 12: 205–12.
14. Piller NB. The lymphagogue action of calcium dobesilate on the flow of lymph from the thoracic duct of anesthetized and mobile guinea pigs. Lymphology 1988; 21: 124–7.
15. Flota-Cervera F, Flota-Ruiz C, Treviño C, Berber A. Randomized, double blind, placebo-controlled clinical trial to evaluate the lymphagogue effect and clinical efficacy of calcium dobesilate in chronic venous disease. Angiology 2008; 59 (3): 352–6.
16. Ciapponi A, Laffaire E, Roqué M. Calcium dobesilate for chronic venous insufficiency: a systematic review. Angiology 2004; 55 (2): 147–54.
17. Martinez-Zapata MJ, Vernooij RW, Uriona Tuma SM et al. Phlebotonics for venous insufficiency. Cochrane Database Syst Rev 2016; 4: CD003229.
18. Российские клинические рекомендации по диагностике и лечению хронических заболеваний вен. Флебология. 2013; 7 (2): 2–48. / Rossiiskie klinicheskie rekomendatsii po diagnostike i lecheniiu khronicheskikh zabolevanii ven. Flebologiia. 2013; 7 (2): 2–48. [in Russian]
19. Cai T, Wu XY, Zhang XQ et al. Calcium Dobesilate Prevents Diabetic Kidney Disease by Decreasing Bim and Inhibiting Apoptosis of Renal Proximal Tubular Epithelial Cells. DNA Cell Biol 2017; 36 (4): 249–55.
20. Rabe EL, Jaeger KA, Bulitta M, Pannier F. Calcium dobesilate in patients suffering from chronic venous insufficiency: a double-blind, placebo-controlled, clinical trial. Phlebology 2016; 26 (4): 162–8.

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1. Klinicheskaia flebologiia. Pod red. Iu.L.Shevchenko, Iu.M.Stoiko. M.: DPK Press, 2016. [in Russian]
2. Soveshchanie ekspertov. Rossiiskie klinicheskie rekomendatsii po diagnostike i lecheniiu khronicheskikh zabolevanii ven, osnovannye na printsipakh dokazatel'noi meditsiny. Rabochie materialy. M., 2008. [in Russian]
3. Rabe E, Guex JJ, Puskas A et al. Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol 2012; 31 (2): 105–15.
4. Nicolaides A, Kakkos S, Eklof B et al. Management of chronic venous disorders of the lower limbs. Guidelines according to scientific evidence. Int Angiol 2014; 33 (2): 126–39.
5. Garay RP, Hannaert P, Chiavaroli C. Calcium dobesilate in the treatment of diabetic retinopathy. Treat Endocrinol 2005; 4 (4): 221–32.
6. Mestres P, Rodriguez L, Erill S, Laport J. Modification by calcium dobesilate of histamine effects on capillary ultra-structure. Experientia 1975; 31: 826–9.
7. Zabel-Langhennig R, Kulle M. Capillary fragility in diabetics and its modification by calcium dobesilate. Z Gesamte Inn Med 1983; 38: 633–6.
8. Van Bijsterveld OP, Janssen PT. The effect of calcium dobe-silate on albumin leakage of the conjunctival vessels. Curr Eve Res 1981; 1: 425–30.
9. Allain H, Ramelet AA, Polard E, Bentué-Ferrer D. Safety of calcium dobesilate in chronic venous disease, diabetic retinopathy and haemorrhoids. Drug Saf 2004; 27: 649–60.
10. Demirtas S, Caliskan A, Guclu O et al. Can calcium dobesilate be used safely for peripheral microvasculopathies that require neoangiogenesis? Med Sci Monit Basic Res 2013; 19: 253–7.
11. Alda O, Valero MS, Pereboom D et al. In vitro calcium dobesilate on oxidative/inflammatory stress in hunan varicosae veins. Phlebology 2011; 26 (8): 332–7.
12. Angulo J, Peiró C, Romacho T et al. Inhibition of vascular endothelial growth factor (VEGF)-induced endothelial proliferation, arterial relaxation, vascular permeability and angiogenesis by dobesilate. Eur J Pharmacol 2011; 667: 153–9.
13. Brunet J, Farine JC, Garay RP, Hannaert P. In vitro antioxidant properties of calcium dobesilate. Fundam Clin Pharmacol 1998; 12: 205–12.
14. Piller NB. The lymphagogue action of calcium dobesilate on the flow of lymph from the thoracic duct of anesthetized and mobile guinea pigs. Lymphology 1988; 21: 124–7.
15. Flota-Cervera F, Flota-Ruiz C, Treviño C, Berber A. Randomized, double blind, placebo-controlled clinical trial to evaluate the lymphagogue effect and clinical efficacy of calcium dobesilate in chronic venous disease. Angiology 2008; 59 (3): 352–6.
16. Ciapponi A, Laffaire E, Roqué M. Calcium dobesilate for chronic venous insufficiency: a systematic review. Angiology 2004; 55 (2): 147–54.
17. Martinez-Zapata MJ, Vernooij RW, Uriona Tuma SM et al. Phlebotonics for venous insufficiency. Cochrane Database Syst Rev 2016; 4: CD003229.
18. Rossiiskie klinicheskie rekomendatsii po diagnostike i lecheniiu khronicheskikh zabolevanii ven. Flebologiia. 2013; 7 (2): 2–48. [in Russian]
19. Cai T, Wu XY, Zhang XQ et al. Calcium Dobesilate Prevents Diabetic Kidney Disease by Decreasing Bim and Inhibiting Apoptosis of Renal Proximal Tubular Epithelial Cells. DNA Cell Biol 2017; 36 (4): 249–55.
20. Rabe EL, Jaeger KA, Bulitta M, Pannier F. Calcium dobesilate in patients suffering from chronic venous insufficiency: a double-blind, placebo-controlled, clinical trial. Phlebology 2016; 26 (4): 162–8.

Авторы

Ю.М.Стойко, В.Г.Гудымович*

ФГБУ «Национальный медико-хирургический центр им. Н.И.Пирогова» Минздрава России. 105203, Россия, Москва, ул. Нижняя Первомайская, д. 70
*gudvic@mail.ru

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Yu.M.Stoiko, V.G.Gudymovich*

N.I.Pirogov National Medical and Surgical Center of the Ministry of Health of the Russian Federation. 105203, Russian Federation, Moscow, ul. Nizhniaia
Pervomaiskaia, d. 70
*gudvic@mail.ru

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