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Natural treatment approaches for varicose veins: A brief review of the literature

Year 2024, , 121 - 132, 15.04.2024
https://doi.org/10.23902/trkjnat.1411314

Abstract

Chronic venous insufficiency (CVI) is a widespread condition affecting millions worldwide. Each year, approximately 150,000 new patients are diagnosed with CVI, and nearly $500 million is used in the care of these patients. The venous system has sturdy valves and muscle pumps that keep blood flowing back to the heart against gravity. The inadequacy of these systems leads to difficulties in blood circulation, blood pooling, and venous hypertension, all which have the potential to lead to the development of varicose veins, edema, discomfort, alterations in the skin, and potentially even the formation of ulcers. Conditions that induce CVI are genetic predisposition, obesity (body mass index greater than 30), continuous standing/sitting work, age, pregnancy, gender, and lifestyle. Conventional venous insufficiency treatments include compression therapy, surgical interventions like vein stripping, and sclerotherapy. Venoactive drugs used in conservative treatment have the potential to enhance both varicose veins and symptoms associated with chronic venous disorders throughout all stages of venous insufficiency. In addition to synthetic drugs, naturally derived coumarins, flavonoids, rutin derivatives, pycnogenol, micronized purified flavonoid fraction, and saponosides are essential in the treatment. Medicinal plants and natural compounds are highly preferred for treating CVI and varicose veins due to their biological activities, such as anti-inflammatory, antioxidant, and vascular tone improvement. The present review provides a concise overview of the utilization of natural compounds and plant extracts in treating varicose veins, both in medical practice and traditional folk medicine.

References

  • 1. Akan, H. & Sade, Y.B. 2015. Investigation of the etnobotanical aspects the town Kâhta and village of Narince. BEU Journal of Science, 4(2): 219-248. https://doi.org/10.17798/beufen.47724
  • 2. Aksoy, A., Çelik, J. & Tunay, H. 2016. Some plants which are used and sold by the folk in the Bazaar at Gazipaşa (Antalya) district and ıntended use of them. Research Journal of Biology Science, 9(2): 55-60.
  • 3. Alsaigh, T., Pocock, E. S., Bergan, J. J. & Schmid-Schonbein, G. W. 2011. Acute venous occlusion enhances matrix metalloprotease activity: implications on endothelial dysfunction. Microvascular Research, 81(1): 108-116. https://doi.org/10.1016/j.mvr.2010.09.010
  • 4. Arcangeli, P. 2000. Pycnogenol® in chronic venous insufficiency. Fitoterapia, 71(3): 236-244. https://doi.org/10.1016/S0944-7113(00)80059-8
  • 5. Arnould, T., Michiels, C., Janssens, D., Berna, N. & Remacle, J. 1998. Effect of Ginkor Fort on hypoxia-induced neutrophil adherence to human saphenous vein endothelium. Journal of Cardiovascular Pharmacology, 31(3): 456-463. https://doi.org/10.1016/S0944-7113(00)80059-8
  • 6. Arpaia, M.R., Ferrone, R., Amitrano, M., Nappo, C., Leonardo, G., & Del Guercio, R. (1990). Effects of Centella asiatica extract on mucopolysaccharide metabolism in subjects with varicose veins. International Journal of Clinical Pharmacology Research, 10(4): 229-233.
  • 7. Aslam, M.R., Muhammad Asif, H., Ahmad, K., Jabbar, S., Hayee, A., Sagheer, M.S., Rehman, J.U., Khalid, S., Hashmi, A.S. & Rajpoot, S.R. 2022. Global impact and contributing factors in varicose vein disease development. SAGE Open Medicine, 10: 1-13. https://doi.org/10.1177/20503121221118992
  • 8. Auteri, A., Pasqui, A., Bruni, F., Di Renzo, M., Bova, G., Chiarion, C. & Delchambre, J. 1994. Pharmacodynamics and pharmacokinetics of Veliten (rutine, alpha-tocopherol and ascorbic acid) in patients with chronic venous insufficiency. International Journal Of Clinical Pharmacology Research, 14(3): 95-100.
  • 9. Azhdari, M., Zilaee, M., Karandish, M., Hosseini, S.A., Mansoori, A., Zendehdel, M. & Khodarahpour, S. 2020. Red vine leaf extract (AS 195) can improve some signs and symptoms of chronic venous insufficiency, a systematic review. Phytotherapy Research, 34(10): 2577-2585. https://doi.org/10.1002/ptr.6705
  • 10. Beebe-Dimmer, J.L., Pfeifer, J.R., Engle, J.S. & Schottenfeld, D. 2005. The epidemiology of chronic venous insufficiency and varicose veins. Annals of Epidemiology, 15(3): 175-184. https://doi.org/10.1016/j.annepidem.2004.05.015
  • 11. Belcaro, G. 2015. A clinical comparison of Pycnogenol, Antistax, and stocking in chronic venous insufficiency. International Journal of Angiology, 24(4): 268-274. https://doi.org/10.1055/s-0035-1556060
  • 12. Belcaro, G., Cesarone, M., Bavera, P., Ricci, A., Renton, S., Leon, M., Ippolito, E., Dugall, M. & Acerbi, G. 2002. HR (Venoruton1000, Paroven, 0-[beta-hydroxyethyl]-rutosides) vs. Daflon 500 in chronic venous disease and microangiopathy: an independent prospective, controlled, randomized trial. Journal of Cardiovascular Pharmacology and Therapeutics, 7(3): 139-145. https://doi.org/10.1177/107424840200700303
  • 13. Benítez, G., González-Tejero, M. & Molero-Mesa, J. 2010. Pharmaceutical ethnobotany in the western part of Granada province (southern Spain): Ethnopharmacological synthesis. Journal of Ethnopharmacology, 129(1): 87-105. https://doi.org/10.1016/j.jep.2010.02.016
  • 14. Bogachev, V.I., Boldin, B. & Turkin, P.I. 2019. Perioperative administration of micronized purified flavonoid fraction in endovascular treatment of varicose disease. Angiologiia i Sosudistaia Khirurgiia= Angiology and Vascular Surgery, 25(2): 88-95. https://doi.org/10.33529/angio2019214
  • 15. Borghi, S.M., Casagrande, R. & Verri, W.A. 2023. Hesperidin methyl chalcone: an emerging compound for the treatment of inflammation and pain. Current Medicinal Chemistry, 30(5): 601-603. https://doi.org/10.2174/0929867329666220822113459
  • 16. Bradbury, A., Evans, C., Allan, P., Lee, A., Ruckley, C.V. & Fowkes, F. 1999. What are the symptoms of varicose veins? Edinburgh vein study cross sectional population survey. BMJ, 318(7180): 353-356. https://doi.org/10.1136/bmj.318.7180.353
  • 17. Callam, M. 1994. Epidemiology of varicose veins. Journal of British Surgery, 81(2): 167-173. https://doi.org/10.1002/bjs.1800810204
  • 18. Castro-Ferreira, R. Cardoso, R. Leite-Moreira, A. & Mansilha, A. 2018. The role of endothelial dysfunction and inflammation in chronic venous disease. Annals of Vascular Surgery, 46: 380-393. https://doi.org/10.1016/j.avsg.2017.06.131
  • 19. Cazaubon, M., Benigni, J.-P., Steinbruch, M., Jabbour, V. & Gouhier-Kodas, C. 2021. Is there a difference in the clinical efficacy of diosmin and micronized purified flavonoid fraction for the treatment of chronic venous disorders? Review of available evidence. Vascular Health and Risk Management, 17: 591-600. https://doi.org/10.2147/VHRM.S324112
  • 20. Cesarone, M., Belcaro, G., Pellegrini, L., Ledda, A., Vinciguerra, G., Ricci, A., Di Renzo, A., Ruffini, I., Gizzi, G. & Ippolito, E. 2006b. Venoruton® vs Daflon®: evaluation of effects on quality of life in chronic venous insufficiency. Angiology, 57(2): 131-138. https://doi.org/10.1177/000331970605700201
  • 21. Cesarone, M., Belcaro, G., Rohdewald, P., Pellegrini, L., Ledda, A., Vinciguerra, G., Ricci, A., Gizzi, G., Ippolito, E. & Fano, F. 2006a. Comparison of Pycnogenol® and Daflon® in treating chronic venous insufficiency: A prospective, controlled study. Clinical and Applied Thrombosis/Hemostasis, 12(2): 205-212. https://doi.org/10.1177/107602960601200209
  • 22. Cesarone, M., Laurora, G., De Sanctis, M., Incandela, L., Grimaldi, R., Marelli, C. & Belcaro, G. 1994. The microcirculatory activity of Centella asiatica in venous insufficiency. A double-blind study. Minerva Cardioangiologica, 42(6): 299-304.
  • 23. Chong, N. J. & Aziz, Z. 2013. A systematic review of the efficacy of Centella asiatica for improvement of the signs and symptoms of chronic venous insufficiency. Evidence-Based Complementary and Alternative Medicine, 2013: 1-11. https://doi.org/10.1155/2013/627182
  • 24. D’alessandro, A., Caroli, A., Mandolesi, D., Venosi, S., Orsini, A., Riva, A., Morazzoni, P., Balbo, A. & Mandolesi, S. 2015. Use of Ginkgo biloba phytosome in chronic venous disease: a pilot study. Acta Phlebologica, 16(2): 83-92.
  • 25. De Feo, V., Aquino, R., Menghini, A., Ramundo, E. & Senatore, F. 1992. Traditional phytotherapy in the Peninsula Sorrentina, Campania, southern Italy. Journal of Ethnopharmacology, 36(2): 113-125. https://doi.org/10.1016/0378-8741(92)90010-O
  • 26. De Maeseneer, M.G., Kakkos, S.K., Aherne, T., Baekgaard, N., Black, S., Blomgren, L., Giannoukas, A., Gohel, M., de Graaf, R. & Hamel-Desnos, C. 2022. Editor's choice–European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs. European Journal of Vascular and Endovascular Surgery, 63(2): 184-267. https://doi.org/10.1016/j.ejvs.2021.12.024
  • 27. Deniz, F.S.S., Orhan, İ.E. & Duman, H. 2021. Profiling cosmeceutical effects of various herbal extracts through elastase, collagenase, tyrosinase inhibitory and antioxidant assays. Phytochemistry Letters, 45: 171-183. https://doi.org/10.1016/j.phytol.2021.08.019
  • 28. Deniz, F.S.S., Salmas, R.E., Emerce, E., Cankaya, İ.E.T., Yusufoglu, H.S. & Orhan, İ.E. 2020. Evaluation of collagenase, elastase and tyrosinase inhibitory activities of Cotinus coggygria Scop. through in vitro and in silico approaches. South African Journal of Botany, 132: 277-288. https://doi.org/10.1016/j.sajb.2020.05.017
  • 29. Dickson, S., Gallagher, J., McIntyre, L., Suter, A. & Tan, J. 2004. An open study to assess the safety and efficacy of Aesculus hippocastanum tablets (Aesculaforce® 50 mg) in the treatment of chronic venous insufficiency. Journal of Herbal Pharmacotherapy, 4(2): 19-32. https://doi.org/10.1300/J157v04n02_03
  • 30. Diehm, C., Trampisch, H., Lange, S. & Schmidt, C. 1996. Comparison of leg compression stocking and oral horse-chestnut seed extract therapy in patients with chronic venous insufficiency. The Lancet, 347(8997): 292-294. https://doi.org/10.1016/S0140-6736(96)90467-5
  • 31. Domanski, D., Zegrocka-Stendel, O., Perzanowska, A., Dutkiewicz, M., Kowalewska, M., Grabowska, I., Maciejko, D., Fogtman, A., Dadlez, M. & Koziak, K. 2016. Molecular mechanism for cellular response to β-escin and its therapeutic implications. PLoS One, 11(10): e0164365. https://doi.org/10.1371/journal.pone.0164365
  • 32. Dudek-Makuch, M. & Studzińska-Sroka, E. 2015. Horse chestnut-efficacy and safety in chronic venous insufficiency: an overview. Revista Brasileira de Farmacognosia, 25(5): 533-541. https://doi.org/10.1016/j.bjp.2015.05.009
  • 33. Eberhardt, R.T. & Raffetto, J.D. 2014. Chronic venous insufficiency. Circulation, 130(4): 333-346. https://doi.org/10.1161/CIRCULATIONAHA.113.006898
  • 34. El-Mokasabi, F.M., Al-Sanousi, M.F. & El-Mabrouk, R.M. 2018. Taxonomy and ethnobotany of medicinal plants in eastern region of Libya. Journal of Environmental Science, Toxicology and Food Technology, 12: 14-23. https://doi.org/10.9790/2402-1208011423
  • 35. Erler, M. & Welt, M. 1991. Roßkastaniensamenextrakt bei der Therapie peripherer venöser Ödeme–ein klinischer Therapievergleich. Med Welt, 42: 593-596
  • 36. Facino, R.M., Carini, M., Stefani, R., Aldini, G. & Saibene, L. 1995. Anti‐elastase and anti‐hyaluronidase activities of saponins and sapogenins from Hedera helix, Aesculus hippocastanum, and Ruscus aculeatus: factors contributing to their efficacy in the treatment of venous insufficiency. Archiv der Pharmazie, 328(10): 720-724. https://doi.org/10.1002/ardp.19953281006
  • 37. Feldo, M., Woźniak, M., Wójciak-Kosior, M., Sowa, I., Kot-Waśik, A., Aszyk, J., Bogucki, J., Zubilewicz, T. & Bogucka-Kocka, A. 2018. Influence of diosmin treatment on the level of oxidative stress markers in patients with chronic venous insufficiency. Oxidative Medicine and Cellular Longevity, 2018: 1-5. https://doi.org/10.1155/2018/2561705
  • 38. Frick, R.W. & Frick, R.W. 2000. Three treatments for chronic venous insufficiency: escin, hydroxyethylrutoside, and Daflon. Angiology, 51(3): 197-205. https://doi.org/10.1177/000331970005100303
  • 39. Gallelli, L. 2019. Escin: a review of its anti-edematous, anti-inflammatory, and venotonic properties. Drug Design, Development and Therapy: 13: 3425-3437. https://doi.org/10.2147/DDDT.S207720
  • 40. Gao, R.D., Qian, S.Y., Wang, H.H., Liu, Y.S. & Ren, S.Y. 2022. Strategies and challenges in treatment of varicose veins and venous insufficiency. World Journal of Clinical Cases, 10(18): 5946-5956. https://doi.org/10.12998/wjcc.v10.i18.5946
  • 41. Gawas, M., Bains, A., Janghu, S., Kamat, P. & Chawla, P. 2022. A comprehensive review on varicose veins: Preventive measures and different treatments. Journal of the American Nutrition Association, 41(5): 499-510. https://doi.org/10.1080/07315724.2021.1909510
  • 42. Grau, M., Bölck, B., Bizjak, D.A., Stabenow, C.J.A., & Bloch, W. 2016. The red‐vine‐leaf extract AS195 increases nitric oxide synthase–dependent nitric oxide generation and decreases oxidative stress in endothelial and red blood cells. Pharmacology Research & Perspectives, 4(1): 1-13.
  • 43. Gulati, O.P. 2014. Pycnogenol® in chronic venous insufficiency and related venous disorders. Phytotherapy Research, 28(3): 348-362. https://doi.org/10.1002/ptr.5019
  • 44. Guzik, B., Chwała, M., Matusik, P., Ludew, D., Skiba, D., Wilk, G., Mrowiecki, W., Batko, B., Cencora, A., Kapelak, B., Sadowski, J., Korbut, R. & Guzik, T. J. 2011. Mechanisms of increased vascular superoxide production in human varicose veins. Polish Archives of Internal Medicine, 121: 279-286.
  • 45. Han, M.İ. & Bulut, G. 2015. The folk-medicinal plants of Kadisehri (Yozgat-Turkey). Acta Societatis Botanicorum Poloniae, 84(2): 237-248. https://doi.org/10.5586/asbp.2015.021
  • 46. Haviarova, Z., Weismann, P., Stvrtinova, V. & Benuska, J. 1999. The determination of the collagen and elastin amount in the human varicose vein by the computer morphometric method. General Physiology and Biophysics, 18: 30-33.
  • 47. Huang, Y.L., Kou, J.P., Ma, L., Song, J.X. & Yu, B.Y. 2008. Possible mechanism of the anti-inflammatory activity of ruscogenin: role of intercellular adhesion molecule-1 and nuclear factor-κB. Journal of Pharmacological Sciences, 108(2): 198-205. https://doi.org/10.1254/jphs.08083FP
  • 48. Huwait, E. & Mobashir, M. 2022. Potential and therapeutic roles of diosmin in human diseases. Biomedicines, 10(5): 1076. https://doi.org/10.3390/biomedicines10051076
  • 49. Ionescu, N., Neagu, A. M. & Popescu, M. 2021. Preparation and characterization of vegetable oils and plant extracts with effect in the treatment of varicose veins. UPB Scientific Bulletin, Series B, 83(3): 185-192.
  • 50. Incandela, L., Cesarone, M.R., Cacchio, M., De Sanctis, M.T., Santavenere, C., D'Auro, M.G. & Belcaro, G. 2001. Total triterpenic fraction of Centella asiatica in chronic venous insufficiency and in high-perfusion microangiopathy. Angiology, 52(2): 1-13.
  • 51. Janaćković, P., Gavrilović, M., Savić, J., Marin, P.D. & Stevanović, Z.D. 2019. Traditional knowledge on plant use from Negotin Krajina (Eastern Serbia): An ethnobotanical study. Indian Journal of Traditional Knowledge, 18(1): 25-33.
  • 52. Kakkos, S.K. & Nicolaides, A.N. 2018. Efficacy of micronized purified flavonoid fraction (Daflon®) 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 placebo-controlled trials. International Angiology: a Journal of the International Union of Angiology, 37(2): 143-154. https://doi.org/10.23736/s0392-9590.18.03975-5
  • 53. Kalankan, G., Özkan, Z.C. & Akbulut, S. 2015. Medicinal and aromatic wild plants and traditional usage of them in Mount Ida (Balıkesir/Turkey). Journal of Applied Biological Sciences, 9(3): 25-33.
  • 54. Karaköse, M. 2022. An ethnobotanical study of medicinal plants in Güce district, north-eastern Turkey. Plant Diversity, 44(6): 577-597. https://doi.org/10.1016/j.pld.2022.03.005
  • 55. Karcı, E., Gürbüz, İ., Akaydın, G. & Günbatan, T. 2017. Folk medicines of Bafra (Samsun-Turkey). Turkish Journal of Biochemistry, 42(4): 381-399. https://doi.org/10.1515/tjb-2017-0172
  • 56. Keszeg, V. 1981. A Mezőségi Detrehemtelep Népi Gyógyászata (Folk Medicine of the Detrehemtelep in the Field). Népismereti Dolgozatok, 97-117.
  • 57. Krasiński, Z. & Krasińska, B. 2023. Treatment of early-stage chronic venous disease-management standards for 2023. Polish Journal of Surgery, 95(1): 64-69.
  • 58. Kekilli, E.B., Orhan, İ.E., Deniz, F.S.Ş., Eren, G., Emerce, E., Kahraman, A. I. & Ayhan, A. 2021. Erodium birandianum Ilarslan & Yurdak. shows anti-gout effect through xanthine oxidase inhibition: Combination of in vitro and in silico techniques and profiling of main components by LC-Q-ToF-MS. Phytochemistry Letters, 43: 80-87. https://doi.org/10.1016/j.phytol.2021.03.010
  • 59. Khatib, C., Nattouf, A. & Agha, M.I.H. 2021. Ethnobotanical survey of medicinal herbs in the Western region in Syria (Latakia and Tartus). Research Square [Preprint], 1-75. (cited: 31.03.2021) https://doi.org/10.21203/rs.3.rs-355008/v1
  • 60. Koch, R. 2002. Comparative study of Venostasin® and Pycnogenol® in chronic venous insufficiency. Phytotherapy Research, 16(S1): 1-5. https://doi.org/10.1002/ptr.1010
  • 61. Korkmaz, M. & Karakurt, E. 2015. An ethnobotanical ınvestigation to determine plants used as folk medicine in Kelkit Gümüşhane/Turkey district. Biological Diversity and Conservation, 8(3): 290-303.
  • 62. Korkmaz, M., Karakuş, S. & Selvi, S. 2016. An ethnobotanical study on medicinal plants in Erzincan, Turkey. Indian Journal of Traditional Knowledge, 15(2): 192-202.
  • 63. Kozachok, S., Pecio, Ł., Orhan, I.E, Deniz, F.S.S, Marchyshyn, S. & Oleszek W. 2020. Reinvestigation of Herniaria glabra L. saponins and their biological activity. Phytochemistry, 169: 112162. https://doi.org/10.1016/j.phytochem.2019.112162
  • 64. Kucukguven, A. & Khalil, R.A. 2013. Matrix metalloproteinases as potential targets in the venous dilation associated with varicose veins, Current Drug Targets, 14(3): 287-324. https://doi.org/10.2174/138945013804998972
  • 65. Köksal, C., Alsalehi, S., Kocamaz, Ö. & Sunar, H. 2010. Treatment of chronic venous insufficiency. Koşuyolu Heart Journal, 13(2): 28-33.
  • 66. Kültür, Ş. 2007. Medicinal plants used in Kırklareli province (Turkey). Journal of Ethnopharmacology, 111(2): 341-364. https://doi.org/10.1016/j.jep.2006.11.035
  • 67. Las Heras Etayo, N., Llamas, F. & Acedo, C. 2021. Ethnobotanical research and compilation of the medicinal uses in Spain and the active principles of Chiliadenus glutinosus (L.) Fourr. for the scientific validation of its therapeutic properties. Plants, 10(3): 584. https://doi.org/10.3390/plants10030584
  • 68. Lichota, A., Gwozdzinski, L. & Gwozdzinski, K. 2019. Therapeutic potential of natural compounds in inflammation and chronic venous insufficiency. European Journal of Medicinal Chemistry, 176: 68-91. https://doi.org/10.1016/j.ejmech.2019.04.075
  • 69. Lim, C. & Davies, A. 2009. Pathogenesis of primary varicose veins. Journal of British Surgery, 96(11): 1231-1242. https://doi.org/10.1002/bjs.6798
  • 70. Lurie, F. & Branisteanu, D.E. 2023. Improving chronic venous disease management with micronised purified flavonoid fraction: new evidence from clinical trials to real life. Clinical Drug Investigation, 43(1): 9-13. https://doi.org/10.1007/s40261-023-01261-y
  • 71. Mansilha, A. & Sousa, J. 2018. Pathophysiological mechanisms of chronic venous disease and implications for venoactive drug therapy. International Journal of Molecular Sciences, 19(6): 1669. https://doi.org/10.3390/ijms19061669
  • 72. Mansilha, A. & Sousa, J. 2019. Benefits of venoactive drug therapy in surgical or endovenous treatment for varicose veins: a systematic review. International Angiology: a Journal of the International Union of Angiology, 38(4): 291-298. https://doi.org/10.23736/s0392-9590.19.04216-0
  • 73. Martinez, R.M., Pinho-Ribeiro, F.A., Steffen, V.S., Caviglione, C.V., Pala, D., Baracat, M.M., Georgetti, S.R., Verri, W.A. & Casagrande, R. 2016. Topical formulation containing hesperidin methyl chalcone inhibits skin oxidative stress and inflammation induced by ultraviolet B irradiation. Photochemical & Photobiological Sciences, 15: 554-563. https://doi.org/10.1039/c5pp00467e
  • 74. Masullo, M., Pizza, C. & Piacente, S. 2016. Ruscus genus: a rich source of bioactive steroidal saponins. Planta Medica, 82(18): 1513-1524. https://doi.org/10.1055/s-0042-119728
  • 75. Murad, M.H., Coto-Yglesias, F., Zumaeta-Garcia, M., Elamin, M.B., Duggirala, M.K., Erwin, P.J., Montori, V.M. & Gloviczki, P. 2011. A systematic review and meta-analysis of the treatments of varicose veins. Journal of Vascular Surgery, 53(5): 49-65. https://doi.org/10.1016/j.jvs.2011.02.031
  • 76. Michiels, C., Arnould, T., Knott, I., Dieu, M. & Remacle, J. 1993. Stimulation of prostaglandin synthesis by human endothelial cells exposed to hypoxia. American Journal of Physiology, 264: 866-874. https://doi.org/10.1152/ajpcell.1993.264.4.C866.
  • 77. Monjotin, N. & Tenca, G. 2022. Lymphotonic activity of Ruscus extract, hesperidin methyl chalcone and vitamin C in human lymphatic smooth muscle cells. Microvascular Research, 139: 104274. https://doi.org/10.1016/j.mvr.2021.104274
  • 78. Novais, M., Santos, I., Mendes, S. & Pinto-Gomes, C. 2004. Studies on pharmaceutical ethnobotany in Arrábida natural park (Portugal). Journal of Ethnopharmacology, 93(2-3): 183-195. https://doi.org/10.1016/j.jep.2004.02.015
  • 79. Oklu, R., Habito, R., Mayr, M., Deipolyi, A.R., Albadawi, H., Hesketh, R., Walker, T.G., Linskey, K.R., Long, C.A. & Wicky, S. 2012. Pathogenesis of varicose veins. Journal of Vascular and Interventional Radiology, 23(1): 33-39. https://doi.org/10.1016/j.jvir.2011.09.010
  • 80. Orhan, I.E. & Deniz, F.S.S. 2020. Natural products and extracts as xantine oxidase ınhibitors-a hope for gout. Current Pharmaceutical Design, 26: 1-16. https://doi.org/10.2174/1381612826666200728144605
  • 81. Papp, N., Purger, D., Czigle, S., Czégényi, D., Stranczinger, S., Tóth, M., Dénes, T., Kocsis, M., Takácsi-Nagy, A. & Filep, R. 2022. The importance of pine species in the ethnomedicine of Transylvania (Romania). Plants, 11(18): 2331. https://doi.org/10.3390/plants11182331
  • 82. Partsch, H. 2009. Varicose veins and chronic venous insufficiency. Vasa, 38(4): 293-301. https://doi.org/10.1024/0301-1526.38.4.293
  • 83. Phan, S.H., Gannon, D.E., Ward, P.A. & Karmiol, S. 1992. Mechanism of neutrophil ınduced xanthine dehydrogenase to xanthine oxidase conversion in endothelial cells: evidence of a role for elastase. American Journal of Respiratory Cell and Molecular Biology, 6: 270-278. https://doi.org/10.1165/ajrcmb/6.3.270
  • 84. Pittler, M.H. & Ernst, E. 1998. Horse-chestnut seed extract for chronic venous insufficiency: a criteria-based systematic review. Archives of Dermatology, 134(11): 1356-1360. https://doi.org/10.1001/archderm.134.11.1356
  • 85. Pizzorno, J.E., Murray, M.T. & Joiner-Bey, H. 2016. Varicose veins, The Clinician's Handbook of Natural Medicine, 3rd Edition, Churchill Livingstone, Edinburgh, 1008 pp.
  • 86. Rabe, E., Agus, G. & Roztocil, K. 2015. 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. International Angiology: a Journal of the International Union of Angiology, 34(5): 428-436.
  • 87. Raetz, J., Wilson, M. & Collins, K. 2019. Varicose veins: diagnosis and treatment. American Family Physician, 99(11): 682-688.
  • 88. Raffetto, J.D. & Khalil, R.A. 2021. Mechanisms of lower extremity vein dysfunction in chronic venous disease and implications in management of varicose veins. Vessel Plus, 5: 1-43. https://doi.org/10.20517/2574-1209.2021.16
  • 89. Rehn, D., Unkauf, M., Klein, P., Jost, V. & Lücker, P. 1996. Comparative clinical efficacy and tolerability of oxerutins and horse chestnut extract in patients with chronic venous insufficiency. Arzneimittel-forschung, 46(5): 483-487.
  • 90. Sargin, S.A. & Büyükcengiz, M. 2019. Plants used in ethnomedicinal practices in Gulnar district of Mersin, Turkey. Journal of Herbal Medicine, 15: 1-18. https://doi.org/10.1016/j.hermed.2018.06.003
  • 91. Sarı, A.O., Bilgin, O., Bilgic, A., Nedret, T., Güvensen, A. & Şenol, S.G. 2010. The plants used as folk remedies in Aegean and South marmara regions. Journal of Aegean Agricultural Research Institute, 20(2): 1-21.
  • 92. Schaefer, E., Peil, H., Ambrosetti, L. & Petrini, O. 2003. Oedema protective properties of the red vine leaf extract AS 195 (Folia Vitis viniferae) in the treatment of chronic venous insufficiency. Arzneimittelforschung, 53(4): 243-246. https://doi.org/10.1055/s-0031-1297103
  • 93. Schuller‐Petrovic, S., Siedler, S., Kern, T., Meinhart, J., Schmidt, K. & Brunner, F. 1997. Imbalance between the endothelial cell‐derived contracting factors prostacyclin and angiotensin II and nitric oxide/cyclic GMP in human primary varicosis. British Journal of Pharmacology, 122(4): 772-778. https://doi.org/10.1038/sj.bjp.0701437
  • 94. Seo, M.G., Jo, M.J., Hong, N.I., Kim, M.J., Shim, K.S., Shin, E., Lee, J.J. & Park, S.J. 2021. Anti-inflammatory and anti-vascular leakage effects by combination of Centella asiatica and Vitis vinifera L. leaf extracts. Evidence-Based Complementary and Alternative Medicine, 14: 1-18. https://doi.org/10.1155/2021/7381620
  • 95. Somers, P. & Knaapen, M. 2006. The histopathology of varicose vein disease. Angiology, 57(5): 546-555. https://doi.org/10.1177/0003319706293115
  • 96. Stücker, M., Rabe, E., Meyer, K., Ottillinger, B. & Schütt, T. 2019. Therapeutic approach to chronic venous insufficiency–clinical benefits of red-vine-leaf-extract AS 195 (Antistax®). Die Pharmazie-An International Journal of Pharmaceutical Sciences, 74(4): 193-200. https://doi.org/10.1691/ph.2019.9326
  • 97. Süntar, I. 2020. Importance of ethnopharmacological studies in drug discovery: role of medicinal plants. Phytochemistry Reviews, 19(5): 1199-1209. https://doi.org/10.1007/s11101-019-09629-9
  • 98. Unal, E., Topcu, A., Yuksekdag, S. & Ozkan F. 2018. Mechanisms of Action that Contribute to Efficacy of Aesculus hippocastanum (Aescin, Horse Chestnut) in Hemorrhoidal Disease: Pharmacokinetics and Therapeutic Profile. Pharmacology and Toxicology, 6: 902-904.
  • 99. Urbanek, T. 2017. The clinical efficacy of Ruscus aesculatus extract: is there enough evidence to update the pharmacotherapy guidelines for chronic venous disease? Phlebological Review, 25(1): 75-80. https://doi.org/10.5114/pr.2017.70594
  • 100. Vanscheidt, W., Jost, V., Wolna, P., Lücker, P.W., Müller, A., Theurer, C., Patz, B. & Grützner, K.I. 2002a. Efficacy and safety of a Butcher’s broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency. Arzneimittelforschung, 52(04): 243-250. https://doi.org/10.1055/s-0031-1299887
  • 101. Vanscheidt, W., Rabe, E., Naser-Hijazi, B., Ramelet, A., Partsch, H., Diehm, C., Schulz-Ehrenburg, U., Spengel, F., Wirsching, M. & Gotz, V. 2002b. The efficacy and safety of a coumarin-/troxerutin combination (SB-LOT) in patients with chronic venous insufficiency: A double blind placebo controlled randomised study. Vasa, 31(3): 185-190. https://doi.org/10.1024/0301-1526.31.3.185
  • 102. Youn, Y.J. & Lee, J. 2019. Chronic venous insufficiency and varicose veins of the lower extremities. The Korean Journal of Internal Medicine, 34(2): 269. https://doi.org/10.3904/kjim.2018.230
  • 103. Yun, S. 2021. Venoactive drugs, summary of the clinical trials and guidelines. Annals of Phlebology, 19(2): 21-26. https://doi.org/10.37923/phle.2021.19.2.21
  • 104. Yun, S. 2022. Practical use of venoactive drugs for chronic venous disease in Korea. Annals of Phlebology, 20(1): 1-5. https://doi.org/10.37923/phle.2022.20.1.1
  • 105. Zhang, L., Xie, Q. & Li, X. 2022. Esculetin: A review of its pharmacology and pharmacokinetics. Phytotherapy Research, 36(1): 279-298. https://doi.org/10.1002/ptr.7311
  • 106. Zweier, J.L., Kuppusamy, P., Gorman-Thomson, S., Klunk, D. & Lutty, G.A. 1994. Measurement and characterization of free radical generation in reoxygenated human endothelial cells. American Journal of Physiology, 266: 700-708. https://doi.org/10.1152/ajpcell.1994.266.3.C700
  • 107. Woroń, J. 2022. Drugs containing extracts from Ruscus in chronic venal disease therapy–what's new about their effects? Polish Journal of Surgery, 94(1): 75-78. https://doi.org/10.5604/01.3001.0015.7954
Year 2024, , 121 - 132, 15.04.2024
https://doi.org/10.23902/trkjnat.1411314

Abstract

Kronik venöz yetmezlik (KVY), dünya çapında milyonlarca kişiyi etkileyen yaygın bir durumdur. Her yıl yaklaşık 150.000 yeni hastaya KVY tanısı konulur ve bu hastaların bakımına yaklaşık 500 milyon dolar harcanmaktadır. Venöz sistemde, kanın yer çekimine karşı kalbe geri akmasını sağlayacak sağlam kapakçıklar ve kas pompaları vardır. Bu sistemlerin yetersizliği kan dolaşımında zorluklara yol açarak kanın birikmesine ve venöz hipertansiyona neden olur. Yukarıda belirtilen durum varisli damarların gelişmesine, ödeme, ciltte değişikliklere ve hatta potansiyel olarak ülser oluşumuna yol açabilir. KVY genetik yatkınlığını tetikleyen koşullar arasında, obezite (vücut kitle indeksi 30'dan büyük), sürekli ayakta/oturup çalışma, yaş, hamilelik, cinsiyet ve yaşam tarzı yer almaktadır. Geleneksel venöz yetmezlik tedavileri arasında kompresyon tedavisi, damar soyulması gibi cerrahi müdahaleler ve skleroterapi yer alır. Konservatif tedavide kullanılan venoaktif ilaçlar, hem varisli damarları hem de venöz yetmezliğin tüm aşamalarında kronik venöz bozukluklarla ilişkili semptomları iyileştirme potansiyeline sahiptir. Tedavide sentetik ilaçların yanı sıra doğal olarak elde edilen kumarinler, flavonoitler, rutin türevleri, piknogenol, mikronize saflaştırılmış flavonoit fraksiyonu ve saponozitler önemlidir. Tıbbi bitkiler ve doğal bileşikler, anti-enflamatuvar, antioksidan ve damar tonusunu iyileştirme gibi biyolojik aktivitelerinden dolayı KVY ve varisli damarların tedavisinde oldukça tercih edilmektedir. Bu derleme, hem tıbbi uygulamada hem de geleneksel halk hekimliğinde varisli damarların tedavisinde doğal bileşiklerin ve bitki esktrelerinin kullanımına kısa bir genel bakış sunmaktadır.

References

  • 1. Akan, H. & Sade, Y.B. 2015. Investigation of the etnobotanical aspects the town Kâhta and village of Narince. BEU Journal of Science, 4(2): 219-248. https://doi.org/10.17798/beufen.47724
  • 2. Aksoy, A., Çelik, J. & Tunay, H. 2016. Some plants which are used and sold by the folk in the Bazaar at Gazipaşa (Antalya) district and ıntended use of them. Research Journal of Biology Science, 9(2): 55-60.
  • 3. Alsaigh, T., Pocock, E. S., Bergan, J. J. & Schmid-Schonbein, G. W. 2011. Acute venous occlusion enhances matrix metalloprotease activity: implications on endothelial dysfunction. Microvascular Research, 81(1): 108-116. https://doi.org/10.1016/j.mvr.2010.09.010
  • 4. Arcangeli, P. 2000. Pycnogenol® in chronic venous insufficiency. Fitoterapia, 71(3): 236-244. https://doi.org/10.1016/S0944-7113(00)80059-8
  • 5. Arnould, T., Michiels, C., Janssens, D., Berna, N. & Remacle, J. 1998. Effect of Ginkor Fort on hypoxia-induced neutrophil adherence to human saphenous vein endothelium. Journal of Cardiovascular Pharmacology, 31(3): 456-463. https://doi.org/10.1016/S0944-7113(00)80059-8
  • 6. Arpaia, M.R., Ferrone, R., Amitrano, M., Nappo, C., Leonardo, G., & Del Guercio, R. (1990). Effects of Centella asiatica extract on mucopolysaccharide metabolism in subjects with varicose veins. International Journal of Clinical Pharmacology Research, 10(4): 229-233.
  • 7. Aslam, M.R., Muhammad Asif, H., Ahmad, K., Jabbar, S., Hayee, A., Sagheer, M.S., Rehman, J.U., Khalid, S., Hashmi, A.S. & Rajpoot, S.R. 2022. Global impact and contributing factors in varicose vein disease development. SAGE Open Medicine, 10: 1-13. https://doi.org/10.1177/20503121221118992
  • 8. Auteri, A., Pasqui, A., Bruni, F., Di Renzo, M., Bova, G., Chiarion, C. & Delchambre, J. 1994. Pharmacodynamics and pharmacokinetics of Veliten (rutine, alpha-tocopherol and ascorbic acid) in patients with chronic venous insufficiency. International Journal Of Clinical Pharmacology Research, 14(3): 95-100.
  • 9. Azhdari, M., Zilaee, M., Karandish, M., Hosseini, S.A., Mansoori, A., Zendehdel, M. & Khodarahpour, S. 2020. Red vine leaf extract (AS 195) can improve some signs and symptoms of chronic venous insufficiency, a systematic review. Phytotherapy Research, 34(10): 2577-2585. https://doi.org/10.1002/ptr.6705
  • 10. Beebe-Dimmer, J.L., Pfeifer, J.R., Engle, J.S. & Schottenfeld, D. 2005. The epidemiology of chronic venous insufficiency and varicose veins. Annals of Epidemiology, 15(3): 175-184. https://doi.org/10.1016/j.annepidem.2004.05.015
  • 11. Belcaro, G. 2015. A clinical comparison of Pycnogenol, Antistax, and stocking in chronic venous insufficiency. International Journal of Angiology, 24(4): 268-274. https://doi.org/10.1055/s-0035-1556060
  • 12. Belcaro, G., Cesarone, M., Bavera, P., Ricci, A., Renton, S., Leon, M., Ippolito, E., Dugall, M. & Acerbi, G. 2002. HR (Venoruton1000, Paroven, 0-[beta-hydroxyethyl]-rutosides) vs. Daflon 500 in chronic venous disease and microangiopathy: an independent prospective, controlled, randomized trial. Journal of Cardiovascular Pharmacology and Therapeutics, 7(3): 139-145. https://doi.org/10.1177/107424840200700303
  • 13. Benítez, G., González-Tejero, M. & Molero-Mesa, J. 2010. Pharmaceutical ethnobotany in the western part of Granada province (southern Spain): Ethnopharmacological synthesis. Journal of Ethnopharmacology, 129(1): 87-105. https://doi.org/10.1016/j.jep.2010.02.016
  • 14. Bogachev, V.I., Boldin, B. & Turkin, P.I. 2019. Perioperative administration of micronized purified flavonoid fraction in endovascular treatment of varicose disease. Angiologiia i Sosudistaia Khirurgiia= Angiology and Vascular Surgery, 25(2): 88-95. https://doi.org/10.33529/angio2019214
  • 15. Borghi, S.M., Casagrande, R. & Verri, W.A. 2023. Hesperidin methyl chalcone: an emerging compound for the treatment of inflammation and pain. Current Medicinal Chemistry, 30(5): 601-603. https://doi.org/10.2174/0929867329666220822113459
  • 16. Bradbury, A., Evans, C., Allan, P., Lee, A., Ruckley, C.V. & Fowkes, F. 1999. What are the symptoms of varicose veins? Edinburgh vein study cross sectional population survey. BMJ, 318(7180): 353-356. https://doi.org/10.1136/bmj.318.7180.353
  • 17. Callam, M. 1994. Epidemiology of varicose veins. Journal of British Surgery, 81(2): 167-173. https://doi.org/10.1002/bjs.1800810204
  • 18. Castro-Ferreira, R. Cardoso, R. Leite-Moreira, A. & Mansilha, A. 2018. The role of endothelial dysfunction and inflammation in chronic venous disease. Annals of Vascular Surgery, 46: 380-393. https://doi.org/10.1016/j.avsg.2017.06.131
  • 19. Cazaubon, M., Benigni, J.-P., Steinbruch, M., Jabbour, V. & Gouhier-Kodas, C. 2021. Is there a difference in the clinical efficacy of diosmin and micronized purified flavonoid fraction for the treatment of chronic venous disorders? Review of available evidence. Vascular Health and Risk Management, 17: 591-600. https://doi.org/10.2147/VHRM.S324112
  • 20. Cesarone, M., Belcaro, G., Pellegrini, L., Ledda, A., Vinciguerra, G., Ricci, A., Di Renzo, A., Ruffini, I., Gizzi, G. & Ippolito, E. 2006b. Venoruton® vs Daflon®: evaluation of effects on quality of life in chronic venous insufficiency. Angiology, 57(2): 131-138. https://doi.org/10.1177/000331970605700201
  • 21. Cesarone, M., Belcaro, G., Rohdewald, P., Pellegrini, L., Ledda, A., Vinciguerra, G., Ricci, A., Gizzi, G., Ippolito, E. & Fano, F. 2006a. Comparison of Pycnogenol® and Daflon® in treating chronic venous insufficiency: A prospective, controlled study. Clinical and Applied Thrombosis/Hemostasis, 12(2): 205-212. https://doi.org/10.1177/107602960601200209
  • 22. Cesarone, M., Laurora, G., De Sanctis, M., Incandela, L., Grimaldi, R., Marelli, C. & Belcaro, G. 1994. The microcirculatory activity of Centella asiatica in venous insufficiency. A double-blind study. Minerva Cardioangiologica, 42(6): 299-304.
  • 23. Chong, N. J. & Aziz, Z. 2013. A systematic review of the efficacy of Centella asiatica for improvement of the signs and symptoms of chronic venous insufficiency. Evidence-Based Complementary and Alternative Medicine, 2013: 1-11. https://doi.org/10.1155/2013/627182
  • 24. D’alessandro, A., Caroli, A., Mandolesi, D., Venosi, S., Orsini, A., Riva, A., Morazzoni, P., Balbo, A. & Mandolesi, S. 2015. Use of Ginkgo biloba phytosome in chronic venous disease: a pilot study. Acta Phlebologica, 16(2): 83-92.
  • 25. De Feo, V., Aquino, R., Menghini, A., Ramundo, E. & Senatore, F. 1992. Traditional phytotherapy in the Peninsula Sorrentina, Campania, southern Italy. Journal of Ethnopharmacology, 36(2): 113-125. https://doi.org/10.1016/0378-8741(92)90010-O
  • 26. De Maeseneer, M.G., Kakkos, S.K., Aherne, T., Baekgaard, N., Black, S., Blomgren, L., Giannoukas, A., Gohel, M., de Graaf, R. & Hamel-Desnos, C. 2022. Editor's choice–European Society for Vascular Surgery (ESVS) 2022 clinical practice guidelines on the management of chronic venous disease of the lower limbs. European Journal of Vascular and Endovascular Surgery, 63(2): 184-267. https://doi.org/10.1016/j.ejvs.2021.12.024
  • 27. Deniz, F.S.S., Orhan, İ.E. & Duman, H. 2021. Profiling cosmeceutical effects of various herbal extracts through elastase, collagenase, tyrosinase inhibitory and antioxidant assays. Phytochemistry Letters, 45: 171-183. https://doi.org/10.1016/j.phytol.2021.08.019
  • 28. Deniz, F.S.S., Salmas, R.E., Emerce, E., Cankaya, İ.E.T., Yusufoglu, H.S. & Orhan, İ.E. 2020. Evaluation of collagenase, elastase and tyrosinase inhibitory activities of Cotinus coggygria Scop. through in vitro and in silico approaches. South African Journal of Botany, 132: 277-288. https://doi.org/10.1016/j.sajb.2020.05.017
  • 29. Dickson, S., Gallagher, J., McIntyre, L., Suter, A. & Tan, J. 2004. An open study to assess the safety and efficacy of Aesculus hippocastanum tablets (Aesculaforce® 50 mg) in the treatment of chronic venous insufficiency. Journal of Herbal Pharmacotherapy, 4(2): 19-32. https://doi.org/10.1300/J157v04n02_03
  • 30. Diehm, C., Trampisch, H., Lange, S. & Schmidt, C. 1996. Comparison of leg compression stocking and oral horse-chestnut seed extract therapy in patients with chronic venous insufficiency. The Lancet, 347(8997): 292-294. https://doi.org/10.1016/S0140-6736(96)90467-5
  • 31. Domanski, D., Zegrocka-Stendel, O., Perzanowska, A., Dutkiewicz, M., Kowalewska, M., Grabowska, I., Maciejko, D., Fogtman, A., Dadlez, M. & Koziak, K. 2016. Molecular mechanism for cellular response to β-escin and its therapeutic implications. PLoS One, 11(10): e0164365. https://doi.org/10.1371/journal.pone.0164365
  • 32. Dudek-Makuch, M. & Studzińska-Sroka, E. 2015. Horse chestnut-efficacy and safety in chronic venous insufficiency: an overview. Revista Brasileira de Farmacognosia, 25(5): 533-541. https://doi.org/10.1016/j.bjp.2015.05.009
  • 33. Eberhardt, R.T. & Raffetto, J.D. 2014. Chronic venous insufficiency. Circulation, 130(4): 333-346. https://doi.org/10.1161/CIRCULATIONAHA.113.006898
  • 34. El-Mokasabi, F.M., Al-Sanousi, M.F. & El-Mabrouk, R.M. 2018. Taxonomy and ethnobotany of medicinal plants in eastern region of Libya. Journal of Environmental Science, Toxicology and Food Technology, 12: 14-23. https://doi.org/10.9790/2402-1208011423
  • 35. Erler, M. & Welt, M. 1991. Roßkastaniensamenextrakt bei der Therapie peripherer venöser Ödeme–ein klinischer Therapievergleich. Med Welt, 42: 593-596
  • 36. Facino, R.M., Carini, M., Stefani, R., Aldini, G. & Saibene, L. 1995. Anti‐elastase and anti‐hyaluronidase activities of saponins and sapogenins from Hedera helix, Aesculus hippocastanum, and Ruscus aculeatus: factors contributing to their efficacy in the treatment of venous insufficiency. Archiv der Pharmazie, 328(10): 720-724. https://doi.org/10.1002/ardp.19953281006
  • 37. Feldo, M., Woźniak, M., Wójciak-Kosior, M., Sowa, I., Kot-Waśik, A., Aszyk, J., Bogucki, J., Zubilewicz, T. & Bogucka-Kocka, A. 2018. Influence of diosmin treatment on the level of oxidative stress markers in patients with chronic venous insufficiency. Oxidative Medicine and Cellular Longevity, 2018: 1-5. https://doi.org/10.1155/2018/2561705
  • 38. Frick, R.W. & Frick, R.W. 2000. Three treatments for chronic venous insufficiency: escin, hydroxyethylrutoside, and Daflon. Angiology, 51(3): 197-205. https://doi.org/10.1177/000331970005100303
  • 39. Gallelli, L. 2019. Escin: a review of its anti-edematous, anti-inflammatory, and venotonic properties. Drug Design, Development and Therapy: 13: 3425-3437. https://doi.org/10.2147/DDDT.S207720
  • 40. Gao, R.D., Qian, S.Y., Wang, H.H., Liu, Y.S. & Ren, S.Y. 2022. Strategies and challenges in treatment of varicose veins and venous insufficiency. World Journal of Clinical Cases, 10(18): 5946-5956. https://doi.org/10.12998/wjcc.v10.i18.5946
  • 41. Gawas, M., Bains, A., Janghu, S., Kamat, P. & Chawla, P. 2022. A comprehensive review on varicose veins: Preventive measures and different treatments. Journal of the American Nutrition Association, 41(5): 499-510. https://doi.org/10.1080/07315724.2021.1909510
  • 42. Grau, M., Bölck, B., Bizjak, D.A., Stabenow, C.J.A., & Bloch, W. 2016. The red‐vine‐leaf extract AS195 increases nitric oxide synthase–dependent nitric oxide generation and decreases oxidative stress in endothelial and red blood cells. Pharmacology Research & Perspectives, 4(1): 1-13.
  • 43. Gulati, O.P. 2014. Pycnogenol® in chronic venous insufficiency and related venous disorders. Phytotherapy Research, 28(3): 348-362. https://doi.org/10.1002/ptr.5019
  • 44. Guzik, B., Chwała, M., Matusik, P., Ludew, D., Skiba, D., Wilk, G., Mrowiecki, W., Batko, B., Cencora, A., Kapelak, B., Sadowski, J., Korbut, R. & Guzik, T. J. 2011. Mechanisms of increased vascular superoxide production in human varicose veins. Polish Archives of Internal Medicine, 121: 279-286.
  • 45. Han, M.İ. & Bulut, G. 2015. The folk-medicinal plants of Kadisehri (Yozgat-Turkey). Acta Societatis Botanicorum Poloniae, 84(2): 237-248. https://doi.org/10.5586/asbp.2015.021
  • 46. Haviarova, Z., Weismann, P., Stvrtinova, V. & Benuska, J. 1999. The determination of the collagen and elastin amount in the human varicose vein by the computer morphometric method. General Physiology and Biophysics, 18: 30-33.
  • 47. Huang, Y.L., Kou, J.P., Ma, L., Song, J.X. & Yu, B.Y. 2008. Possible mechanism of the anti-inflammatory activity of ruscogenin: role of intercellular adhesion molecule-1 and nuclear factor-κB. Journal of Pharmacological Sciences, 108(2): 198-205. https://doi.org/10.1254/jphs.08083FP
  • 48. Huwait, E. & Mobashir, M. 2022. Potential and therapeutic roles of diosmin in human diseases. Biomedicines, 10(5): 1076. https://doi.org/10.3390/biomedicines10051076
  • 49. Ionescu, N., Neagu, A. M. & Popescu, M. 2021. Preparation and characterization of vegetable oils and plant extracts with effect in the treatment of varicose veins. UPB Scientific Bulletin, Series B, 83(3): 185-192.
  • 50. Incandela, L., Cesarone, M.R., Cacchio, M., De Sanctis, M.T., Santavenere, C., D'Auro, M.G. & Belcaro, G. 2001. Total triterpenic fraction of Centella asiatica in chronic venous insufficiency and in high-perfusion microangiopathy. Angiology, 52(2): 1-13.
  • 51. Janaćković, P., Gavrilović, M., Savić, J., Marin, P.D. & Stevanović, Z.D. 2019. Traditional knowledge on plant use from Negotin Krajina (Eastern Serbia): An ethnobotanical study. Indian Journal of Traditional Knowledge, 18(1): 25-33.
  • 52. Kakkos, S.K. & Nicolaides, A.N. 2018. Efficacy of micronized purified flavonoid fraction (Daflon®) 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 placebo-controlled trials. International Angiology: a Journal of the International Union of Angiology, 37(2): 143-154. https://doi.org/10.23736/s0392-9590.18.03975-5
  • 53. Kalankan, G., Özkan, Z.C. & Akbulut, S. 2015. Medicinal and aromatic wild plants and traditional usage of them in Mount Ida (Balıkesir/Turkey). Journal of Applied Biological Sciences, 9(3): 25-33.
  • 54. Karaköse, M. 2022. An ethnobotanical study of medicinal plants in Güce district, north-eastern Turkey. Plant Diversity, 44(6): 577-597. https://doi.org/10.1016/j.pld.2022.03.005
  • 55. Karcı, E., Gürbüz, İ., Akaydın, G. & Günbatan, T. 2017. Folk medicines of Bafra (Samsun-Turkey). Turkish Journal of Biochemistry, 42(4): 381-399. https://doi.org/10.1515/tjb-2017-0172
  • 56. Keszeg, V. 1981. A Mezőségi Detrehemtelep Népi Gyógyászata (Folk Medicine of the Detrehemtelep in the Field). Népismereti Dolgozatok, 97-117.
  • 57. Krasiński, Z. & Krasińska, B. 2023. Treatment of early-stage chronic venous disease-management standards for 2023. Polish Journal of Surgery, 95(1): 64-69.
  • 58. Kekilli, E.B., Orhan, İ.E., Deniz, F.S.Ş., Eren, G., Emerce, E., Kahraman, A. I. & Ayhan, A. 2021. Erodium birandianum Ilarslan & Yurdak. shows anti-gout effect through xanthine oxidase inhibition: Combination of in vitro and in silico techniques and profiling of main components by LC-Q-ToF-MS. Phytochemistry Letters, 43: 80-87. https://doi.org/10.1016/j.phytol.2021.03.010
  • 59. Khatib, C., Nattouf, A. & Agha, M.I.H. 2021. Ethnobotanical survey of medicinal herbs in the Western region in Syria (Latakia and Tartus). Research Square [Preprint], 1-75. (cited: 31.03.2021) https://doi.org/10.21203/rs.3.rs-355008/v1
  • 60. Koch, R. 2002. Comparative study of Venostasin® and Pycnogenol® in chronic venous insufficiency. Phytotherapy Research, 16(S1): 1-5. https://doi.org/10.1002/ptr.1010
  • 61. Korkmaz, M. & Karakurt, E. 2015. An ethnobotanical ınvestigation to determine plants used as folk medicine in Kelkit Gümüşhane/Turkey district. Biological Diversity and Conservation, 8(3): 290-303.
  • 62. Korkmaz, M., Karakuş, S. & Selvi, S. 2016. An ethnobotanical study on medicinal plants in Erzincan, Turkey. Indian Journal of Traditional Knowledge, 15(2): 192-202.
  • 63. Kozachok, S., Pecio, Ł., Orhan, I.E, Deniz, F.S.S, Marchyshyn, S. & Oleszek W. 2020. Reinvestigation of Herniaria glabra L. saponins and their biological activity. Phytochemistry, 169: 112162. https://doi.org/10.1016/j.phytochem.2019.112162
  • 64. Kucukguven, A. & Khalil, R.A. 2013. Matrix metalloproteinases as potential targets in the venous dilation associated with varicose veins, Current Drug Targets, 14(3): 287-324. https://doi.org/10.2174/138945013804998972
  • 65. Köksal, C., Alsalehi, S., Kocamaz, Ö. & Sunar, H. 2010. Treatment of chronic venous insufficiency. Koşuyolu Heart Journal, 13(2): 28-33.
  • 66. Kültür, Ş. 2007. Medicinal plants used in Kırklareli province (Turkey). Journal of Ethnopharmacology, 111(2): 341-364. https://doi.org/10.1016/j.jep.2006.11.035
  • 67. Las Heras Etayo, N., Llamas, F. & Acedo, C. 2021. Ethnobotanical research and compilation of the medicinal uses in Spain and the active principles of Chiliadenus glutinosus (L.) Fourr. for the scientific validation of its therapeutic properties. Plants, 10(3): 584. https://doi.org/10.3390/plants10030584
  • 68. Lichota, A., Gwozdzinski, L. & Gwozdzinski, K. 2019. Therapeutic potential of natural compounds in inflammation and chronic venous insufficiency. European Journal of Medicinal Chemistry, 176: 68-91. https://doi.org/10.1016/j.ejmech.2019.04.075
  • 69. Lim, C. & Davies, A. 2009. Pathogenesis of primary varicose veins. Journal of British Surgery, 96(11): 1231-1242. https://doi.org/10.1002/bjs.6798
  • 70. Lurie, F. & Branisteanu, D.E. 2023. Improving chronic venous disease management with micronised purified flavonoid fraction: new evidence from clinical trials to real life. Clinical Drug Investigation, 43(1): 9-13. https://doi.org/10.1007/s40261-023-01261-y
  • 71. Mansilha, A. & Sousa, J. 2018. Pathophysiological mechanisms of chronic venous disease and implications for venoactive drug therapy. International Journal of Molecular Sciences, 19(6): 1669. https://doi.org/10.3390/ijms19061669
  • 72. Mansilha, A. & Sousa, J. 2019. Benefits of venoactive drug therapy in surgical or endovenous treatment for varicose veins: a systematic review. International Angiology: a Journal of the International Union of Angiology, 38(4): 291-298. https://doi.org/10.23736/s0392-9590.19.04216-0
  • 73. Martinez, R.M., Pinho-Ribeiro, F.A., Steffen, V.S., Caviglione, C.V., Pala, D., Baracat, M.M., Georgetti, S.R., Verri, W.A. & Casagrande, R. 2016. Topical formulation containing hesperidin methyl chalcone inhibits skin oxidative stress and inflammation induced by ultraviolet B irradiation. Photochemical & Photobiological Sciences, 15: 554-563. https://doi.org/10.1039/c5pp00467e
  • 74. Masullo, M., Pizza, C. & Piacente, S. 2016. Ruscus genus: a rich source of bioactive steroidal saponins. Planta Medica, 82(18): 1513-1524. https://doi.org/10.1055/s-0042-119728
  • 75. Murad, M.H., Coto-Yglesias, F., Zumaeta-Garcia, M., Elamin, M.B., Duggirala, M.K., Erwin, P.J., Montori, V.M. & Gloviczki, P. 2011. A systematic review and meta-analysis of the treatments of varicose veins. Journal of Vascular Surgery, 53(5): 49-65. https://doi.org/10.1016/j.jvs.2011.02.031
  • 76. Michiels, C., Arnould, T., Knott, I., Dieu, M. & Remacle, J. 1993. Stimulation of prostaglandin synthesis by human endothelial cells exposed to hypoxia. American Journal of Physiology, 264: 866-874. https://doi.org/10.1152/ajpcell.1993.264.4.C866.
  • 77. Monjotin, N. & Tenca, G. 2022. Lymphotonic activity of Ruscus extract, hesperidin methyl chalcone and vitamin C in human lymphatic smooth muscle cells. Microvascular Research, 139: 104274. https://doi.org/10.1016/j.mvr.2021.104274
  • 78. Novais, M., Santos, I., Mendes, S. & Pinto-Gomes, C. 2004. Studies on pharmaceutical ethnobotany in Arrábida natural park (Portugal). Journal of Ethnopharmacology, 93(2-3): 183-195. https://doi.org/10.1016/j.jep.2004.02.015
  • 79. Oklu, R., Habito, R., Mayr, M., Deipolyi, A.R., Albadawi, H., Hesketh, R., Walker, T.G., Linskey, K.R., Long, C.A. & Wicky, S. 2012. Pathogenesis of varicose veins. Journal of Vascular and Interventional Radiology, 23(1): 33-39. https://doi.org/10.1016/j.jvir.2011.09.010
  • 80. Orhan, I.E. & Deniz, F.S.S. 2020. Natural products and extracts as xantine oxidase ınhibitors-a hope for gout. Current Pharmaceutical Design, 26: 1-16. https://doi.org/10.2174/1381612826666200728144605
  • 81. Papp, N., Purger, D., Czigle, S., Czégényi, D., Stranczinger, S., Tóth, M., Dénes, T., Kocsis, M., Takácsi-Nagy, A. & Filep, R. 2022. The importance of pine species in the ethnomedicine of Transylvania (Romania). Plants, 11(18): 2331. https://doi.org/10.3390/plants11182331
  • 82. Partsch, H. 2009. Varicose veins and chronic venous insufficiency. Vasa, 38(4): 293-301. https://doi.org/10.1024/0301-1526.38.4.293
  • 83. Phan, S.H., Gannon, D.E., Ward, P.A. & Karmiol, S. 1992. Mechanism of neutrophil ınduced xanthine dehydrogenase to xanthine oxidase conversion in endothelial cells: evidence of a role for elastase. American Journal of Respiratory Cell and Molecular Biology, 6: 270-278. https://doi.org/10.1165/ajrcmb/6.3.270
  • 84. Pittler, M.H. & Ernst, E. 1998. Horse-chestnut seed extract for chronic venous insufficiency: a criteria-based systematic review. Archives of Dermatology, 134(11): 1356-1360. https://doi.org/10.1001/archderm.134.11.1356
  • 85. Pizzorno, J.E., Murray, M.T. & Joiner-Bey, H. 2016. Varicose veins, The Clinician's Handbook of Natural Medicine, 3rd Edition, Churchill Livingstone, Edinburgh, 1008 pp.
  • 86. Rabe, E., Agus, G. & Roztocil, K. 2015. 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. International Angiology: a Journal of the International Union of Angiology, 34(5): 428-436.
  • 87. Raetz, J., Wilson, M. & Collins, K. 2019. Varicose veins: diagnosis and treatment. American Family Physician, 99(11): 682-688.
  • 88. Raffetto, J.D. & Khalil, R.A. 2021. Mechanisms of lower extremity vein dysfunction in chronic venous disease and implications in management of varicose veins. Vessel Plus, 5: 1-43. https://doi.org/10.20517/2574-1209.2021.16
  • 89. Rehn, D., Unkauf, M., Klein, P., Jost, V. & Lücker, P. 1996. Comparative clinical efficacy and tolerability of oxerutins and horse chestnut extract in patients with chronic venous insufficiency. Arzneimittel-forschung, 46(5): 483-487.
  • 90. Sargin, S.A. & Büyükcengiz, M. 2019. Plants used in ethnomedicinal practices in Gulnar district of Mersin, Turkey. Journal of Herbal Medicine, 15: 1-18. https://doi.org/10.1016/j.hermed.2018.06.003
  • 91. Sarı, A.O., Bilgin, O., Bilgic, A., Nedret, T., Güvensen, A. & Şenol, S.G. 2010. The plants used as folk remedies in Aegean and South marmara regions. Journal of Aegean Agricultural Research Institute, 20(2): 1-21.
  • 92. Schaefer, E., Peil, H., Ambrosetti, L. & Petrini, O. 2003. Oedema protective properties of the red vine leaf extract AS 195 (Folia Vitis viniferae) in the treatment of chronic venous insufficiency. Arzneimittelforschung, 53(4): 243-246. https://doi.org/10.1055/s-0031-1297103
  • 93. Schuller‐Petrovic, S., Siedler, S., Kern, T., Meinhart, J., Schmidt, K. & Brunner, F. 1997. Imbalance between the endothelial cell‐derived contracting factors prostacyclin and angiotensin II and nitric oxide/cyclic GMP in human primary varicosis. British Journal of Pharmacology, 122(4): 772-778. https://doi.org/10.1038/sj.bjp.0701437
  • 94. Seo, M.G., Jo, M.J., Hong, N.I., Kim, M.J., Shim, K.S., Shin, E., Lee, J.J. & Park, S.J. 2021. Anti-inflammatory and anti-vascular leakage effects by combination of Centella asiatica and Vitis vinifera L. leaf extracts. Evidence-Based Complementary and Alternative Medicine, 14: 1-18. https://doi.org/10.1155/2021/7381620
  • 95. Somers, P. & Knaapen, M. 2006. The histopathology of varicose vein disease. Angiology, 57(5): 546-555. https://doi.org/10.1177/0003319706293115
  • 96. Stücker, M., Rabe, E., Meyer, K., Ottillinger, B. & Schütt, T. 2019. Therapeutic approach to chronic venous insufficiency–clinical benefits of red-vine-leaf-extract AS 195 (Antistax®). Die Pharmazie-An International Journal of Pharmaceutical Sciences, 74(4): 193-200. https://doi.org/10.1691/ph.2019.9326
  • 97. Süntar, I. 2020. Importance of ethnopharmacological studies in drug discovery: role of medicinal plants. Phytochemistry Reviews, 19(5): 1199-1209. https://doi.org/10.1007/s11101-019-09629-9
  • 98. Unal, E., Topcu, A., Yuksekdag, S. & Ozkan F. 2018. Mechanisms of Action that Contribute to Efficacy of Aesculus hippocastanum (Aescin, Horse Chestnut) in Hemorrhoidal Disease: Pharmacokinetics and Therapeutic Profile. Pharmacology and Toxicology, 6: 902-904.
  • 99. Urbanek, T. 2017. The clinical efficacy of Ruscus aesculatus extract: is there enough evidence to update the pharmacotherapy guidelines for chronic venous disease? Phlebological Review, 25(1): 75-80. https://doi.org/10.5114/pr.2017.70594
  • 100. Vanscheidt, W., Jost, V., Wolna, P., Lücker, P.W., Müller, A., Theurer, C., Patz, B. & Grützner, K.I. 2002a. Efficacy and safety of a Butcher’s broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency. Arzneimittelforschung, 52(04): 243-250. https://doi.org/10.1055/s-0031-1299887
  • 101. Vanscheidt, W., Rabe, E., Naser-Hijazi, B., Ramelet, A., Partsch, H., Diehm, C., Schulz-Ehrenburg, U., Spengel, F., Wirsching, M. & Gotz, V. 2002b. The efficacy and safety of a coumarin-/troxerutin combination (SB-LOT) in patients with chronic venous insufficiency: A double blind placebo controlled randomised study. Vasa, 31(3): 185-190. https://doi.org/10.1024/0301-1526.31.3.185
  • 102. Youn, Y.J. & Lee, J. 2019. Chronic venous insufficiency and varicose veins of the lower extremities. The Korean Journal of Internal Medicine, 34(2): 269. https://doi.org/10.3904/kjim.2018.230
  • 103. Yun, S. 2021. Venoactive drugs, summary of the clinical trials and guidelines. Annals of Phlebology, 19(2): 21-26. https://doi.org/10.37923/phle.2021.19.2.21
  • 104. Yun, S. 2022. Practical use of venoactive drugs for chronic venous disease in Korea. Annals of Phlebology, 20(1): 1-5. https://doi.org/10.37923/phle.2022.20.1.1
  • 105. Zhang, L., Xie, Q. & Li, X. 2022. Esculetin: A review of its pharmacology and pharmacokinetics. Phytotherapy Research, 36(1): 279-298. https://doi.org/10.1002/ptr.7311
  • 106. Zweier, J.L., Kuppusamy, P., Gorman-Thomson, S., Klunk, D. & Lutty, G.A. 1994. Measurement and characterization of free radical generation in reoxygenated human endothelial cells. American Journal of Physiology, 266: 700-708. https://doi.org/10.1152/ajpcell.1994.266.3.C700
  • 107. Woroń, J. 2022. Drugs containing extracts from Ruscus in chronic venal disease therapy–what's new about their effects? Polish Journal of Surgery, 94(1): 75-78. https://doi.org/10.5604/01.3001.0015.7954
There are 107 citations in total.

Details

Primary Language English
Subjects Pharmacognosy
Journal Section Review/Derleme
Authors

Tuğsen Büyükyıldırım 0000-0003-0101-9742

Fatma Sezer Şenol Deniz 0000-0002-5850-9841

Early Pub Date April 4, 2024
Publication Date April 15, 2024
Submission Date December 28, 2023
Acceptance Date March 30, 2024
Published in Issue Year 2024

Cite

APA Büyükyıldırım, T., & Şenol Deniz, F. S. (2024). Natural treatment approaches for varicose veins: A brief review of the literature. Trakya University Journal of Natural Sciences, 25(1), 121-132. https://doi.org/10.23902/trkjnat.1411314
AMA Büyükyıldırım T, Şenol Deniz FS. Natural treatment approaches for varicose veins: A brief review of the literature. Trakya Univ J Nat Sci. April 2024;25(1):121-132. doi:10.23902/trkjnat.1411314
Chicago Büyükyıldırım, Tuğsen, and Fatma Sezer Şenol Deniz. “Natural Treatment Approaches for Varicose Veins: A Brief Review of the Literature”. Trakya University Journal of Natural Sciences 25, no. 1 (April 2024): 121-32. https://doi.org/10.23902/trkjnat.1411314.
EndNote Büyükyıldırım T, Şenol Deniz FS (April 1, 2024) Natural treatment approaches for varicose veins: A brief review of the literature. Trakya University Journal of Natural Sciences 25 1 121–132.
IEEE T. Büyükyıldırım and F. S. Şenol Deniz, “Natural treatment approaches for varicose veins: A brief review of the literature”, Trakya Univ J Nat Sci, vol. 25, no. 1, pp. 121–132, 2024, doi: 10.23902/trkjnat.1411314.
ISNAD Büyükyıldırım, Tuğsen - Şenol Deniz, Fatma Sezer. “Natural Treatment Approaches for Varicose Veins: A Brief Review of the Literature”. Trakya University Journal of Natural Sciences 25/1 (April 2024), 121-132. https://doi.org/10.23902/trkjnat.1411314.
JAMA Büyükyıldırım T, Şenol Deniz FS. Natural treatment approaches for varicose veins: A brief review of the literature. Trakya Univ J Nat Sci. 2024;25:121–132.
MLA Büyükyıldırım, Tuğsen and Fatma Sezer Şenol Deniz. “Natural Treatment Approaches for Varicose Veins: A Brief Review of the Literature”. Trakya University Journal of Natural Sciences, vol. 25, no. 1, 2024, pp. 121-32, doi:10.23902/trkjnat.1411314.
Vancouver Büyükyıldırım T, Şenol Deniz FS. Natural treatment approaches for varicose veins: A brief review of the literature. Trakya Univ J Nat Sci. 2024;25(1):121-32.

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