THE USE OF 5,6-BENZO-[ALPHA]-PYRONE (COUMARIN) AND HEATING BY MICROWAVES IN THE TREATMENT OF CHRONIC LYMPHEDEMA OF THE LEGS

Sixty patients with leg lymphedema from a variety of etiologies were d ivided into randomized two groups, matched by Grade, duration, age, se x, and cause of lymphedema. Using a double-blind format, one group rec eived 5,6 benzo-[alpha]-pyrone (coumarin 1,2 benzopyrone, 400 mg/day) for six months; the other received a placebo. For the next six months, both groups received a standardized regimen of heat (using microwaves ) coupled with compression garments. Benzopyrone produced approximatel y 20% reduction in the volume (p=10(-4)) and improvement in circumfere nces and tonometry (p=10(-5) and 10(-7)). Symptoms (feelings of swelli ng, pain, heaviness and loss of mobility) were also significantly impr oved (p=0.03 to 10(-7)). During the second six months, when microwave heat therapy was added to drug therapy, the patients who had previousl y received the placebo showed significant improvement (p=0.03 to 10(-9 )) in signs and symptoms of lymphedema. Some, but not all, of the grou p that was receiving benzopyrones were also significantly improved by heat therapy (p=0.8 to 0.002). Taking benzopyrones for 12 months plus heat treatment for six months was significantly better, for some crite ria, than the placebo plus heat therapy (p=0.7 to 0.04). On the other hand, heat plus either placebo or benzopyrone was often significantly better than either the active or inactive drug without heat (p=0.8 to 10(-9)).