Evaluation of treatment of diabetic microangiopathy with total triterpenicfraction of Centella asiatica: A clinical prospective randomized trial with a microcirculatory model

Fifty patients with diabetic microangiopathy were studied by laser Doppler flowmetry (measuring skin blood flow at rest) (RF) and the venoarteriolar r esponse (VAR), by transcutaneous PO2 and PCO2 measurements, and by capillar y permeability evaluation (rate of ankle swelling [RAS]). Thirty of these p atients were treated for 6 months with total triterpenic fraction of Centel la asiatica (TTFCA) (60 mg twice daily), a drug active on microcirculation and capillary permeability. A control group of ten patients was treated wit h placebo and another group of ten patients was left without treatment thus acting as a second control group. After six months there were no significa nt changes in the two control groups. There was a significant improvement o f microcirculatory parameter in patients treated with TTFCA. RF (abnormally increased at the beginning of the treatment) decreased, and the VAR (impai red at the beginning of the study) improved. PO2 Increased and PCO2 decreas ed the abnormally increased capillary permeability was also improved (decre ased). According to these data, TTFCA is useful in diabetic microangiopathy by improving microcirculation and decreasing capillary permeability. Also TTFCA protects against the deterioration of microcirculation due to diabeti c microangiopathy.