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Современное состояние проблемы хронических заболеваний вен нижних конечностей
Современное состояние проблемы хронических заболеваний вен нижних конечностей
Кудыкин М.Н. Современное состояние проблемы хронических заболеваний вен нижних конечностей. Consilium Medicum. 2017; 19 (7.1. Хирургия): 52–56.
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Аннотация
В статье рассмотрены актуальные данные об эпидемиологии, патогенезе и клинических проявлениях хронических заболеваний вен нижних конечностей. Проводится сравнительный анализ действия различных флеботропных препаратов для лечения проявлений хронических заболеваний вен и хронической венозной недостаточности, обсуждаются преимущества микронизированной очищенной флавоноидной фракции для терапии всех классов хронических заболеваний вен.
Ключевые слова: хронические заболевания вен, хроническая венозная недостаточность, варикозная болезнь, посттромботический синдром, диосмин, микронизированная очищенная флавоноидная фракция, флеботропная терапия, Флебавен.
Key words: chronic venous diseases, chronic venous insufficiency, varicose veins, post-thrombotic syndrome, diosmin, micronized purified flavonoid fraction, phlebotrophic therapy, Flebaven.
Ключевые слова: хронические заболевания вен, хроническая венозная недостаточность, варикозная болезнь, посттромботический синдром, диосмин, микронизированная очищенная флавоноидная фракция, флеботропная терапия, Флебавен.
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Key words: chronic venous diseases, chronic venous insufficiency, varicose veins, post-thrombotic syndrome, diosmin, micronized purified flavonoid fraction, phlebotrophic therapy, Flebaven.
Полный текст
Список литературы
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9. Jawien A, Grzela T, Ochwat A. Prevalence of chronic venous insufficiency in men and women in Poland: multicentre cross-sectional study in 40095 patients. Phlebology 2003; 81: 110–22.
10. Langer RD, Ho E, Deneberg JO et al. Relation-ship between symptoms and venous disease. Arch Int Med 2005; 165: 1420–4.
11. Labropoulos N, Stansby G. Venous and Lymphatic Diseases. Taylor & Francis 2006; 559.
12. Schmid-Schonbein GW, Granger DN. Molecular Basis for Microcirculatory Disorders. Springer 2003; 640.
13. Nicolaides AN, Allegra C, Bergan J et al. Management of Chronic Venous Disorders of the Lower Limbs Guidelines According to Scientific Evidence. Int Angiol 2008; 27: 1–59.
14. Ramelet A-A, Perrin M, Kern P, Bounameaux H. Phlebology, 5-th ed. Elsevier Masson 2008: 565.
15. Davies AH. Management of Chronic Venous Disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2015. pii: S1078-5884(15)00699-1. DOI: 10.1016/j.ejvs.2015.09.024
16. Varicose Veins in the Legs: The Diagnosis and Management of Varicose Veins. National Clinical Guideline Centre (UK). London: National Institute for Health and Care Excellence (UK), 2013.
17. Российские клинические рекомендации по диагностике и лечению хронических заболеваний вен. Флебология. 2013; 2: 6–47. / Rossiiskie klinicheskie rekomendatsii po diagnostike i lecheniiu khronicheskikh zabolevanii ven. Flebologiia. 2013; 2: 6–47. [in Russian]
18. Katsenis K. Micronized purified flavonoid fraction (MPFF): a review of its pharmacological effects, therapeutic efficacy and benefits in the management of chronic venous insufficiency. Curr Vasc Pharmacol 2005; 3 (1): 1–9.
19. Jantet G. RELIEF Study Group. Chronic Venous Insufficiency: Worlwide Results of the RELIEF Study. Angiology 2002; 53: 245–6.
20. Rabe E, Agus GB, 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): 428–36.
21. Pitsch F. Assessment of treatment efficacy on venous symptoms: the example of Detralex. Phlebo-lymphology 2008; 15: 137–42.
22. Belczak SQ, Sincos IR, Campos W et al. Veno-active drugs for chronic venous disease: A randomized, double-blind, placebo-controlled parallel-design trial. Phlebology 2014; 29 (7): 454–60. DOI: 10.1177/0268355513489550
23. Colerige-Smith P, Lok C, Ramelet AA. Venous leg ulcer: meta-analysis of adjunctive therapy with micronized purified flavonoid fraction. Eur J Vasc Endovasc Surg 2005; 30: 198–208.
24. Чеснокова Н.Н., Кононова С.В., Запорожская Л.И., Кудыкин М.Н. Исследование сегмента регионального рынка лекарственных препаратов для лечения и профилактики варикозной болезни нижних конечностей. Мед. альманах. 2015; 4 (39): 205–9. / Chesnokova N.N., Kononova S.V., Zaporozhskaia L.I., Kudykin M.N. Issledovanie segmenta regional'nogo rynka lekarstvennykh preparatov dlia lecheniia i profilaktiki varikoznoi bolezni nizhnikh konechnostei. Med. al'manakh. 2015; 4 (39): 205–9. [in Russian]
25. Colerige-Smith P. From Skin Disorders to Venous Leg Ulcers: Pathophysiology and Efficacy of Daflon 500 mg in Ulcer Healing. Angiology 2003; 54 (Suppl. 1): 45–50.
26. Handbook of venous disorders. 7-nd ed. Guidelines Am Venous Forum 2017; 557.
2. Bergan JJ, Schmid-Schonbein GW, Coleridge-Smith PD. Chronic venous disease. N Engl J Med 2006; 355 (3): 488–96.
3. 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): 87–208.
4. Allegra C, Antignani P-L, Bergan JJ et al. The “С” of CEAP: Suggested definitions and refinements: An international Union of Phlebology conference of experts. J Vasc Surg 2003; 37 (1): 129–31.
5. Rabe E, Guex J-J, Puskas A et al. The VCP Coordinators Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol 2012; 31 (2): 105–15.
6. Eklof B, Perrin M, Delis KT et al. Up-date terminology of chronic venous disorders: The VEIN-TERM transatlantic interdisciplinary consensus document. J Vasc Surg 2009; 49: 498–501.
7. Bogachev V.Iu. Sovremennaia farmakoterapiia khronicheskoi venoznoi nedostatochnosti nizhnikh konechnostei. Farmatsevticheskii vestn. 2006; 10 (2): 54–9 [in Russian]
8. Ruckley CV, Fowkes FGR, Bradbury AW. Venous Disease. Epidemiology, Management and Delivery of Care. Springer 1999; 278.
9. Jawien A, Grzela T, Ochwat A. Prevalence of chronic venous insufficiency in men and women in Poland: multicentre cross-sectional study in 40095 patients. Phlebology 2003; 81: 110–22.
10. Langer RD, Ho E, Deneberg JO et al. Relation-ship between symptoms and venous disease. Arch Int Med 2005; 165: 1420–4.
11. Labropoulos N, Stansby G. Venous and Lymphatic Diseases. Taylor & Francis 2006; 559.
12. Schmid-Schonbein GW, Granger DN. Molecular Basis for Microcirculatory Disorders. Springer 2003; 640.
13. Nicolaides AN, Allegra C, Bergan J et al. Management of Chronic Venous Disorders of the Lower Limbs Guidelines According to Scientific Evidence. Int Angiol 2008; 27: 1–59.
14. Ramelet A-A, Perrin M, Kern P, Bounameaux H. Phlebology, 5-th ed. Elsevier Masson 2008: 565.
15. Davies AH. Management of Chronic Venous Disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2015. pii: S1078-5884(15)00699-1. DOI: 10.1016/j.ejvs.2015.09.024
16. Varicose Veins in the Legs: The Diagnosis and Management of Varicose Veins. National Clinical Guideline Centre (UK). London: National Institute for Health and Care Excellence (UK), 2013.
17. Rossiiskie klinicheskie rekomendatsii po diagnostike i lecheniiu khronicheskikh zabolevanii ven. Flebologiia. 2013; 2: 6–47. [in Russian]
18. Katsenis K. Micronized purified flavonoid fraction (MPFF): a review of its pharmacological effects, therapeutic efficacy and benefits in the management of chronic venous insufficiency. Curr Vasc Pharmacol 2005; 3 (1): 1–9.
19. Jantet G. RELIEF Study Group. Chronic Venous Insufficiency: Worlwide Results of the RELIEF Study. Angiology 2002; 53: 245–6.
20. Rabe E, Agus GB, 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): 428–36.
21. Pitsch F. Assessment of treatment efficacy on venous symptoms: the example of Detralex. Phlebo-lymphology 2008; 15: 137–42.
22. Belczak SQ, Sincos IR, Campos W et al. Veno-active drugs for chronic venous disease: A randomized, double-blind, placebo-controlled parallel-design trial. Phlebology 2014; 29 (7): 454–60. DOI: 10.1177/0268355513489550
23. Colerige-Smith P, Lok C, Ramelet AA. Venous leg ulcer: meta-analysis of adjunctive therapy with micronized purified flavonoid fraction. Eur J Vasc Endovasc Surg 2005; 30: 198–208.
24. Chesnokova N.N., Kononova S.V., Zaporozhskaia L.I., Kudykin M.N. Issledovanie segmenta regional'nogo rynka lekarstvennykh preparatov dlia lecheniia i profilaktiki varikoznoi bolezni nizhnikh konechnostei. Med. al'manakh. 2015; 4 (39): 205–9. [in Russian]
25. Colerige-Smith P. From Skin Disorders to Venous Leg Ulcers: Pathophysiology and Efficacy of Daflon 500 mg in Ulcer Healing. Angiology 2003; 54 (Suppl. 1): 45–50.
26. Handbook of venous disorders. 7-nd ed. Guidelines Am Venous Forum 2017; 557.
2. Bergan JJ, Schmid-Schonbein GW, Coleridge-Smith PD. Chronic venous disease. N Engl J Med 2006; 355 (3): 488–96.
3. 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): 87–208.
4. Allegra C, Antignani P-L, Bergan JJ et al. The “С” of CEAP: Suggested definitions and refinements: An international Union of Phlebology conference of experts. J Vasc Surg 2003; 37 (1): 129–31.
5. Rabe E, Guex J-J, Puskas A et al. The VCP Coordinators Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol 2012; 31 (2): 105–15.
6. Eklof B, Perrin M, Delis KT et al. Up-date terminology of chronic venous disorders: The VEIN-TERM transatlantic interdisciplinary consensus document. J Vasc Surg 2009; 49: 498–501.
7. Богачев В.Ю. Современная фармакотерапия хронической венозной недостаточности нижних конечностей. Фармацевтический вестн. 2006; 10 (2): 54–9. / Bogachev V.Iu. Sovremennaia farmakoterapiia khronicheskoi venoznoi nedostatochnosti nizhnikh konechnostei. Farmatsevticheskii vestn. 2006; 10 (2): 54–9 [in Russian]
8. Ruckley CV, Fowkes FGR, Bradbury AW. Venous Disease. Epidemiology, Management and Delivery of Care. Springer 1999; 278.
9. Jawien A, Grzela T, Ochwat A. Prevalence of chronic venous insufficiency in men and women in Poland: multicentre cross-sectional study in 40095 patients. Phlebology 2003; 81: 110–22.
10. Langer RD, Ho E, Deneberg JO et al. Relation-ship between symptoms and venous disease. Arch Int Med 2005; 165: 1420–4.
11. Labropoulos N, Stansby G. Venous and Lymphatic Diseases. Taylor & Francis 2006; 559.
12. Schmid-Schonbein GW, Granger DN. Molecular Basis for Microcirculatory Disorders. Springer 2003; 640.
13. Nicolaides AN, Allegra C, Bergan J et al. Management of Chronic Venous Disorders of the Lower Limbs Guidelines According to Scientific Evidence. Int Angiol 2008; 27: 1–59.
14. Ramelet A-A, Perrin M, Kern P, Bounameaux H. Phlebology, 5-th ed. Elsevier Masson 2008: 565.
15. Davies AH. Management of Chronic Venous Disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2015. pii: S1078-5884(15)00699-1. DOI: 10.1016/j.ejvs.2015.09.024
16. Varicose Veins in the Legs: The Diagnosis and Management of Varicose Veins. National Clinical Guideline Centre (UK). London: National Institute for Health and Care Excellence (UK), 2013.
17. Российские клинические рекомендации по диагностике и лечению хронических заболеваний вен. Флебология. 2013; 2: 6–47. / Rossiiskie klinicheskie rekomendatsii po diagnostike i lecheniiu khronicheskikh zabolevanii ven. Flebologiia. 2013; 2: 6–47. [in Russian]
18. Katsenis K. Micronized purified flavonoid fraction (MPFF): a review of its pharmacological effects, therapeutic efficacy and benefits in the management of chronic venous insufficiency. Curr Vasc Pharmacol 2005; 3 (1): 1–9.
19. Jantet G. RELIEF Study Group. Chronic Venous Insufficiency: Worlwide Results of the RELIEF Study. Angiology 2002; 53: 245–6.
20. Rabe E, Agus GB, 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): 428–36.
21. Pitsch F. Assessment of treatment efficacy on venous symptoms: the example of Detralex. Phlebo-lymphology 2008; 15: 137–42.
22. Belczak SQ, Sincos IR, Campos W et al. Veno-active drugs for chronic venous disease: A randomized, double-blind, placebo-controlled parallel-design trial. Phlebology 2014; 29 (7): 454–60. DOI: 10.1177/0268355513489550
23. Colerige-Smith P, Lok C, Ramelet AA. Venous leg ulcer: meta-analysis of adjunctive therapy with micronized purified flavonoid fraction. Eur J Vasc Endovasc Surg 2005; 30: 198–208.
24. Чеснокова Н.Н., Кононова С.В., Запорожская Л.И., Кудыкин М.Н. Исследование сегмента регионального рынка лекарственных препаратов для лечения и профилактики варикозной болезни нижних конечностей. Мед. альманах. 2015; 4 (39): 205–9. / Chesnokova N.N., Kononova S.V., Zaporozhskaia L.I., Kudykin M.N. Issledovanie segmenta regional'nogo rynka lekarstvennykh preparatov dlia lecheniia i profilaktiki varikoznoi bolezni nizhnikh konechnostei. Med. al'manakh. 2015; 4 (39): 205–9. [in Russian]
25. Colerige-Smith P. From Skin Disorders to Venous Leg Ulcers: Pathophysiology and Efficacy of Daflon 500 mg in Ulcer Healing. Angiology 2003; 54 (Suppl. 1): 45–50.
26. Handbook of venous disorders. 7-nd ed. Guidelines Am Venous Forum 2017; 557.
________________________________________________
2. Bergan JJ, Schmid-Schonbein GW, Coleridge-Smith PD. Chronic venous disease. N Engl J Med 2006; 355 (3): 488–96.
3. 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): 87–208.
4. Allegra C, Antignani P-L, Bergan JJ et al. The “С” of CEAP: Suggested definitions and refinements: An international Union of Phlebology conference of experts. J Vasc Surg 2003; 37 (1): 129–31.
5. Rabe E, Guex J-J, Puskas A et al. The VCP Coordinators Epidemiology of chronic venous disorders in geographically diverse populations: results from the Vein Consult Program. Int Angiol 2012; 31 (2): 105–15.
6. Eklof B, Perrin M, Delis KT et al. Up-date terminology of chronic venous disorders: The VEIN-TERM transatlantic interdisciplinary consensus document. J Vasc Surg 2009; 49: 498–501.
7. Bogachev V.Iu. Sovremennaia farmakoterapiia khronicheskoi venoznoi nedostatochnosti nizhnikh konechnostei. Farmatsevticheskii vestn. 2006; 10 (2): 54–9 [in Russian]
8. Ruckley CV, Fowkes FGR, Bradbury AW. Venous Disease. Epidemiology, Management and Delivery of Care. Springer 1999; 278.
9. Jawien A, Grzela T, Ochwat A. Prevalence of chronic venous insufficiency in men and women in Poland: multicentre cross-sectional study in 40095 patients. Phlebology 2003; 81: 110–22.
10. Langer RD, Ho E, Deneberg JO et al. Relation-ship between symptoms and venous disease. Arch Int Med 2005; 165: 1420–4.
11. Labropoulos N, Stansby G. Venous and Lymphatic Diseases. Taylor & Francis 2006; 559.
12. Schmid-Schonbein GW, Granger DN. Molecular Basis for Microcirculatory Disorders. Springer 2003; 640.
13. Nicolaides AN, Allegra C, Bergan J et al. Management of Chronic Venous Disorders of the Lower Limbs Guidelines According to Scientific Evidence. Int Angiol 2008; 27: 1–59.
14. Ramelet A-A, Perrin M, Kern P, Bounameaux H. Phlebology, 5-th ed. Elsevier Masson 2008: 565.
15. Davies AH. Management of Chronic Venous Disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg 2015. pii: S1078-5884(15)00699-1. DOI: 10.1016/j.ejvs.2015.09.024
16. Varicose Veins in the Legs: The Diagnosis and Management of Varicose Veins. National Clinical Guideline Centre (UK). London: National Institute for Health and Care Excellence (UK), 2013.
17. Rossiiskie klinicheskie rekomendatsii po diagnostike i lecheniiu khronicheskikh zabolevanii ven. Flebologiia. 2013; 2: 6–47. [in Russian]
18. Katsenis K. Micronized purified flavonoid fraction (MPFF): a review of its pharmacological effects, therapeutic efficacy and benefits in the management of chronic venous insufficiency. Curr Vasc Pharmacol 2005; 3 (1): 1–9.
19. Jantet G. RELIEF Study Group. Chronic Venous Insufficiency: Worlwide Results of the RELIEF Study. Angiology 2002; 53: 245–6.
20. Rabe E, Agus GB, 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): 428–36.
21. Pitsch F. Assessment of treatment efficacy on venous symptoms: the example of Detralex. Phlebo-lymphology 2008; 15: 137–42.
22. Belczak SQ, Sincos IR, Campos W et al. Veno-active drugs for chronic venous disease: A randomized, double-blind, placebo-controlled parallel-design trial. Phlebology 2014; 29 (7): 454–60. DOI: 10.1177/0268355513489550
23. Colerige-Smith P, Lok C, Ramelet AA. Venous leg ulcer: meta-analysis of adjunctive therapy with micronized purified flavonoid fraction. Eur J Vasc Endovasc Surg 2005; 30: 198–208.
24. Chesnokova N.N., Kononova S.V., Zaporozhskaia L.I., Kudykin M.N. Issledovanie segmenta regional'nogo rynka lekarstvennykh preparatov dlia lecheniia i profilaktiki varikoznoi bolezni nizhnikh konechnostei. Med. al'manakh. 2015; 4 (39): 205–9. [in Russian]
25. Colerige-Smith P. From Skin Disorders to Venous Leg Ulcers: Pathophysiology and Efficacy of Daflon 500 mg in Ulcer Healing. Angiology 2003; 54 (Suppl. 1): 45–50.
26. Handbook of venous disorders. 7-nd ed. Guidelines Am Venous Forum 2017; 557.
Авторы
М.Н.Кудыкин
ФГБУ «Приволжский федеральный медицинский исследовательский центр» Минздрава России. 603155, Россия, Нижний Новгород,
Верхне-Волжская наб., д. 18
*mady5@yandex.ru
Volga Federal Medical Research Center. 603155, Russian Federation, Nizhny Novgorod, Verkhne-Volzhskaia nab., d. 18
*mady5@yandex.ru
ФГБУ «Приволжский федеральный медицинский исследовательский центр» Минздрава России. 603155, Россия, Нижний Новгород,
Верхне-Волжская наб., д. 18
*mady5@yandex.ru
________________________________________________
Volga Federal Medical Research Center. 603155, Russian Federation, Nizhny Novgorod, Verkhne-Volzhskaia nab., d. 18
*mady5@yandex.ru
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