{"id":18957,"date":"2022-05-10T11:01:08","date_gmt":"2022-05-10T09:01:08","guid":{"rendered":"https:\/\/wikenfarma.com\/scientific-evaluation-study-of-a-nutraceutical-composed-of-phytotherapeutic-active-ingredients-in-female-patients-with-grade-moderate-venous-insufficiency-evaluation-of-efficacy-and-tolerability\/"},"modified":"2025-03-25T09:31:35","modified_gmt":"2025-03-25T08:31:35","slug":"scientific-evaluation-study-of-a-nutraceutical-composed-of-phytotherapeutic-active-ingredients-in-female-patients-with-grade-moderate-venous-insufficiency-evaluation-of-efficacy-and-tolerability","status":"publish","type":"post","link":"https:\/\/wikenfarma.com\/en\/scientific-evaluation-study-of-a-nutraceutical-composed-of-phytotherapeutic-active-ingredients-in-female-patients-with-grade-moderate-venous-insufficiency-evaluation-of-efficacy-and-tolerability\/","title":{"rendered":"SCIENTIFIC EVALUATION STUDY OF A NUTRACEUTICAL COMPOSED OF PHYTOTHERAPEUTIC ACTIVE INGREDIENTS IN FEMALE PATIENTS WITH GRADE -MODERATE VENOUS INSUFFICIENCY. EVALUATION OF EFFICACY AND TOLERABILITY"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"18957\" class=\"elementor elementor-18957 elementor-4638\" data-elementor-post-type=\"post\">\n\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-bef7a2c elementor-section-content-middle elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"bef7a2c\" data-element_type=\"section\" data-settings=\"{&quot;shape_divider_top&quot;:&quot;triangle&quot;,&quot;shape_divider_top_negative&quot;:&quot;yes&quot;,&quot;animation&quot;:&quot;none&quot;}\">\n\t\t\t\t\t<div class=\"elementor-shape elementor-shape-top\" data-negative=\"true\">\n\t\t\t<svg xmlns=\"http:\/\/www.w3.org\/2000\/svg\" viewBox=\"0 0 1000 100\" preserveAspectRatio=\"none\">\n\t<path class=\"elementor-shape-fill\" d=\"M500.2,94.7L0,0v100h1000V0L500.2,94.7z\"\/>\n<\/svg>\t\t<\/div>\n\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-5aba534\" data-id=\"5aba534\" data-element_type=\"column\" data-settings=\"{&quot;animation&quot;:&quot;none&quot;}\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-2dab6f0 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"2dab6f0\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><strong>Keywords<\/strong>: venous stasis, heavy legs, thrombophilia, varicose veins, progesterone, venous insufficiency<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-a6dc548 elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"a6dc548\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInDown&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">SCIENTIFIC EVALUATION STUDY OF A NUTRACEUTICAL\nCOMPOSED OF ACTIVE INGREDIENTS\nPHYTOTHERAPY IN FEMALE PATIENTS WITH MILD-TO-MODERATE VENOUS INSUFFICIENCY\n.\nEVALUATION OF EFFICACY AND TOLERABILITY\n<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-06bf5bf elementor-invisible elementor-widget elementor-widget-heading\" data-id=\"06bf5bf\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInDown&quot;}\" data-widget_type=\"heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<h1 class=\"elementor-heading-title elementor-size-default\">Alessia Pini, Anna Salmieri, Simone Cencetti, Luisa Bartalini, Rosa Maria Cordova,\nLuigi Ranieri, Lucia Villa, Alfredo Sabato\n<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-2919b81 elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"2919b81\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-31f3a47\" data-id=\"31f3a47\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-82b0093 elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"82b0093\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><br><b><br><\/b><\/p>\n<p><b>OBJECTIVE OF THE STUDY<\/b><\/p>\n<p><span style=\"font-weight: 400;\">The primary end point was to evaluate the efficacy of a tablet nutraceutical, composed of phytotherapeutic active ingredients, in reducing symptomatology and CEAP class in female patients with mild-to-moderate venous insufficiency symptoms. The second end point was to evaluate the tolerability and therapeutic sustainability of treatment with such a nutraceutical for 3 months. <\/span><\/p>\n<p><b>FOREWORD<\/b><\/p>\n<p><span style=\"font-weight: 400;\">In the hottest summer months, a feeling of deep leg fatigue occurs in a great many individuals due to poor blood return from the peripheral districts to the heart. During the summer period all these compensatory mechanisms are made less efficient: in fact, the heat, by causing an increase in vasodilation, leads to the appearance of heavy legs, itching and swelling of the ankles, which are the main symptoms of venous insufficiency. An unhealthy lifestyle can also contribute to an aggravation of this symptomatology: overweight, obesity, water retention, use of oral contraceptives, constipation, cigarette smoking, and carrying out a profession, which forces one to stand and be immobile for many hours, are among the main predisposing causes of venous insufficiency. The     <\/span><b>Dr. Alfredo Sabato<\/b><span style=\"font-weight: 400;\">, planned to monitor, with the support of territorial doctors.<\/span><b>, <\/b><span style=\"font-weight: 400;\">patients<\/span> <span style=\"font-weight: 400;\">with mild-to-moderate venous insufficiency symptoms in the lower limbs: swelling, heaviness, pain, itching, burning, hyperpigmentation, stasis dermatitis.<\/span><\/p>\n<p><b><i>Introduction by Dr. ALFREDO SABATO<\/i><\/b><\/p>\n<p><span style=\"font-weight: 400;\">We can say that <\/span><b>venous insufficiency<\/b><span style=\"font-weight: 400;\">  is a condition in which the venous system has difficulty returning blood from the periphery back to the heart. We have a load of fluid that is contained in vessels that do NOT have a muscular wall like arteries which are able to give active propulsion, but are vessels with a wall without muscle fibers and which have some   <\/span><b>valves<\/b><span style=\"font-weight: 400;\">: the ascent of the blood back to the heart must take place on the one hand by the muscle pump, and for this it is necessary to walk, and on the other hand by the tightness of the valves that the veins possess. So if there is a problem to the ascent back to the heart, a stasis of the blood column is formed, which causes transudation of the finest capillaries and edema of the tissue. Failure to take action can result in progressive worsening of the situation. Venous insufficiency is a chronic and progressive disease.     <\/span><\/p>\n<p><span style=\"font-weight: 400;\">As for causes, first of all there is a family predisposition and it is more prevalent in the female sex: there are girls even young girls who have the same problems as mothers and grandmothers; there are also causes due to behaviors or <\/span><b>wrong lifestyle<\/b><span style=\"font-weight: 400;\">  or even physical problems such as excess weight or sedentary lifestyle, working in static orthostatism. Excessive environmental temperature, excessive exposure to the sun causing vasodilation, taking oral estroprogestinics, hormonal imbalances. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">In particular, the <\/span><b>pregnancy<\/b><span style=\"font-weight: 400;\">  is a temporary cause but is important for those who already have a family predisposition and for those who gain a lot of weight, because in addition to a physical obstruction of venous return there is the weight of the fetus pressing on the veins that are most important for venous return and there is also a physiological increase in progesterone. The   <\/span><b>progesterone<\/b><span style=\"font-weight: 400;\">  Is a powerful vasodilator. Other causes may be unbalanced diets or even alterations in plantar support. There may also be footwear that affects optimal venous return, such as shoes that are too high or too low. Incongruous sports activities can also have a negative effect on venous return.   <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The most frequent symptoms<\/span><span style=\"font-weight: 400;\"> are <\/span><b>very common<\/b><span style=\"font-weight: 400;\">  and the first is edema of the lower limbs with a feeling of tired and heavy legs, paresthesias, tingling, diffuse and localized heat in the limbs, night cramps, restlessness of the limbs (so-called restless legs syndrome) may present. Orthostatic phlebodynia may also present. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Other symptoms may be visual, considered more as &#8220;conditions,&#8221; which may be asymptomatic with or without pain: these are <\/span><b>truncular varices<\/b><span style=\"font-weight: 400;\">, of <\/span><b>telangiectasias<\/b><span style=\"font-weight: 400;\">  to phlebostatically based skin ulcers in more advanced states. Clinical classification is made through the   <\/span><b>CEAP classification<\/b><span style=\"font-weight: 400;\"> which has been used for 25 years now and is based on four parameters: clinical, etiological, anatomical and pathophysiological and is used to describe the different relative clinical patterns of onset and evolution of chronic venous disease.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Venous insufficiency is a chronic aggravating condition for which complications arise as the condition progresses but are treatable and containable through proper management of the patient taking into account his or her general clinical picture and social and family status.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Among the milder complications we highlight the following <\/span><b>edema in the lower limbs<\/b><span style=\"font-weight: 400;\">, the <\/span><b>varicophlebitis<\/b><span style=\"font-weight: 400;\"> but more <\/span><b>serious<\/b><span style=\"font-weight: 400;\"> that affect not the quality of life but life itself: <\/span><b>deep vein thrombosis<\/b><span style=\"font-weight: 400;\"> of the popliteal vein, femoral vein where it is necessary to do therapy with low molecular weight heparins, wear a curative elastic brace, and study the patient from the point of view of potential genetic abnormalities that may predispose to <\/span><b>thrombophilia<\/b><span style=\"font-weight: 400;\">. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">Then there are also deep vein thromboses of <\/span><b>paraneoplastic origin<\/b><span style=\"font-weight: 400;\">, tumors with necrosis factors that can trigger the process of coagulation within the vessel. Deep vein thrombosis is a pathological condition   <\/span><b>severe <\/b><span style=\"font-weight: 400;\">which must be managed carefully as it can cause pulmonary embolism.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are other complications due to the chronicity of this condition and they are the <\/span><b>varices ingravescence<\/b><span style=\"font-weight: 400;\">, i.e., the inordinate increase of varices in the lower limbs due to which pigment leaks out with dystrophies and skin discolorations that can lead to phlebostatic-based skin ulceration that prefers the inner malleolar area of the leg and ankle. <\/span> <\/p>\n<p><b>SCIENTIFIC RATIONALE<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Wikenfarma found that a nutraceutical, composed of active phytotherapeutic ingredients such as micronized Diosmin, Hesperidin, Melilot, Horse Chestnut, and Rutin, is particularly effective in reducing symptoms related to venous insufficiency and improving the CEAP membership class commonly used to classify chronic venous disorders.<\/span><\/p>\n<p><b>DESCRIPTION OF THE ACTIVE INGREDIENTS OF THE NUTRACEUTICAL<\/b><\/p>\n<p><span style=\"font-weight: 400;\">La <\/span><b>DIOSMINE<\/b><span style=\"font-weight: 400;\"> is a phytotherapeutic that can be found in drug or supplement form in a micronized form that ensures maximum bioavailability and thus optimal efficacy.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The properties of Diosmin are innumerable:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Increases vessel tone by inhibition of COMTs and reduction of norepinephrine metabolism<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">decreases capillary permeability<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">neutralizes pro-inflammatory molecules such as thromboxane A2 by reducing leukocyte activation and expression of adhesion molecules by vascular endothelium with reduction of inflammatory process and edema<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Improves the dynamic balance between coagulation and fibrinolysis<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Optimizes lymphatic drainage by preventing extravascular fluid accumulation<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Reduces the compression of edema on nerve structures and thus the pain symptoms.<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Using a combination with other phytotherapeutics creates a synergy to intervene more effectively on mediators of inflammation, to reduce vascular permeability, to increase venous tone, and to achieve good control of the hemostatic balance by stimulating tissue fibrinolysis by reducing edema.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The substances that go best in association with Diosmin are the<\/span><b>Hesperidine<\/b><span style=\"font-weight: 400;\"> which improves the permeability and fragility of capillary walls by increasing their resistance, and the <\/span><b>Rutin<\/b><span style=\"font-weight: 400;\"> which acts directly on the permeability and trophism of capillaries and has antihemorrhagic and antiedemigenous action.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">L&#8217;<\/span><b>Horse Chestnut<\/b><span style=\"font-weight: 400;\"> is characterized by its high content of l&#8217;<\/span><b>Escin<\/b><span style=\"font-weight: 400;\"> which increases tone, reduces capillary permeability, exerts anti-inflammatory action and has fibrinolytic action so it reduces the risk of edema becoming chronic and is also very useful in lymphatic edema. <\/span> <\/p>\n<p><span style=\"font-weight: 400;\">The <\/span><b>Melilotus<\/b><span style=\"font-weight: 400;\"> has anti-inflammatory, anti-edemigenous action and has a high titer of <\/span><b>Coumarins<\/b><span style=\"font-weight: 400;\">, which are anticoagulant substances. Coumarol is the most representative molecule in this category. These substances decrease prothrombin synthesis and have a great anticoagulant effect.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Therefore, the synergy of the different phytotherapeutic active ingredients, shortens the therapy time and improves the symptomatology quickly.<\/span><\/p>\n<p> <\/p>\n<p><b>INCLUSION AND EXCLUSION CRITERIA<\/b><\/p>\n<p><span style=\"font-weight: 400;\">Female patients aged 18 to 79 years with a diagnosis of mild to moderate venous insufficiency were recruited into the study. Symptomatic patients with clinical and instrumental signs of venous insufficiency <\/span><\/p>\n<p><span style=\"font-weight: 400;\">Patients with <\/span><span style=\"font-weight: 400;\">severe cardiovascular or renal function comorbidities and patients on antihypertensive therapy with calcium antagonists<\/span><\/p>\n<p><b>PROCEDURE<\/b><\/p>\n<p><span style=\"font-weight: 400;\">The experimental study was carried out through a controlled clinical trial. At the first visit, the volunteer was evaluated by the researcher. Having met the inclusion criteria, the volunteer was enrolled in the study. After signing the informed consent, therapy was prescribed and the patient returned for follow-up visit after 3 months: clinical examination was performed and self-assessment questionnaire was completed.     <\/span><\/p>\n<p> <\/p>\n<p><b>MATERIALS AND METHODS<\/b><\/p>\n<p><span style=\"font-weight: 400;\">The nutraceutical FLEBOKEN 30cpr\u00ae was used in the study for 3 months, with the following dosage: 2 tablets daily for the first 15 days and then 1 tablet daily.  <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The multicenter study involved 147 patients. Court enrollment of patients lasted 30 days from June 1, 2021, the study lasted 3 months and ended on September 30, 2021. <\/span><\/p>\n<p><span style=\"font-weight: 400;\">The composition of the nutraceutical FLEBOKEN 30cpr\u00ae with which the study was done is as follows:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Micronized diosmin 300mg<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Hesperidine 70mg<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Rutin 50mg<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Sweet Clover 50mg<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Horse chestnut 150mg<\/span><\/li>\n<\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-f3aad5a elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"f3aad5a\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column elementor-col-100 elementor-top-column elementor-element elementor-element-066b32a\" data-id=\"066b32a\" data-element_type=\"column\">\n\t\t\t<div class=\"elementor-widget-wrap elementor-element-populated\">\n\t\t\t\t\t\t<div class=\"elementor-element elementor-element-4b2c41f elementor-widget elementor-widget-image\" data-id=\"4b2c41f\" data-element_type=\"widget\" data-widget_type=\"image.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t\t\t\t<figure class=\"wp-caption\">\n\t\t\t\t\t\t\t\t\t\t<img fetchpriority=\"high\" decoding=\"async\" width=\"764\" height=\"1080\" src=\"https:\/\/wikenfarma.com\/wp-content\/uploads\/2022\/05\/fleboken-studio-dr.sabato-grafico1.webp\" class=\"attachment-full size-full wp-image-4640\" alt=\"\" srcset=\"https:\/\/wikenfarma.com\/wp-content\/uploads\/2022\/05\/fleboken-studio-dr.sabato-grafico1.webp 764w, https:\/\/wikenfarma.com\/wp-content\/uploads\/2022\/05\/fleboken-studio-dr.sabato-grafico1-212x300.webp 212w, https:\/\/wikenfarma.com\/wp-content\/uploads\/2022\/05\/fleboken-studio-dr.sabato-grafico1-724x1024.webp 724w, https:\/\/wikenfarma.com\/wp-content\/uploads\/2022\/05\/fleboken-studio-dr.sabato-grafico1-600x848.webp 600w\" sizes=\"(max-width: 764px) 100vw, 764px\" \/>\t\t\t\t\t\t\t\t\t\t\t<figcaption class=\"widget-image-caption wp-caption-text\">Fig.1<\/figcaption>\n\t\t\t\t\t\t\t\t\t\t<\/figure>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-36ca72c elementor-invisible elementor-widget elementor-widget-text-editor\" data-id=\"36ca72c\" data-element_type=\"widget\" data-settings=\"{&quot;_animation&quot;:&quot;fadeInLeft&quot;}\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p><b>ADVERSE EVENTS.<\/b><\/p>\n<p><span style=\"font-weight: 400;\">No adverse events were noted except for a single case of gastrointestinal intolerance probably due to individual hypersensitivity to one of the excipients, a symptomatology that quickly regressed with discontinuation of the nutraceutical.<\/span><\/p>\n<p> <\/p>\n<p><b>CONCLUSIONS<\/b><\/p>\n<p><span style=\"font-weight: 400;\">The studied nutraceutical has been shown to be effective in reducing the symptomatology reported by patients through the self-assessment questionnaire and, from the clinical medical examination, to be a valuable therapeutic support to improve the starting CEAP class.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Scientific study on mild to moderate venous insufficiency in women treated with Fleboken 30 Cps<\/p>\n","protected":false},"author":1,"featured_media":18013,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[265,270,271],"tags":[],"class_list":["post-18957","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-en","category-medical-blog","category-medical-blog-clinical-cases"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.7 - 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