Total triterpenic fraction of Centella asiatica in the treatment of venoushypertension: A clinical, prospective, randomized trial using a combined microcirculatory model

A single-blind, placebo-controlled, randomized study was performed on the e ffects of different doses of the total triterpenic fraction of Centella asi atica (TTFCA) in patients with venous hypertensive microangiopathy. A combi ned microcirculatory model that considers laser Doppler flowmetry (LDF) and transcutaneous oxygen (PO2), transcutaneous carbon dioxide tension (PCO2) measurements was combined with the symptom evaluation. LDF tests included t he baseline resting flow, the venoarteriolar reflex, and the variation of f low related to the temperature increase. All tests provided a significant d ifference between drug-treated groups and the placebo group, thereby allowi ng a distinction to be made between the higher (120 mg daily) and the lower (60 mg daily) dose of TTFCA. Transcutaneous PO2-PCO2 measurements were sig nificantly modified by drug treatments, while no variation could be detecte d in the placebo group. Important symptomatologic effects (evaluated by sub jective scores) followed TTFCA administration, especially at the higher dos e level, while no effect was obtained with placebo. The trend of symptom ev aluation paralleled the results of objective tests of our microcirculatory model, providing evidence that this model can reveal effects of venoactive drugs on venous hypertensive microangiopathy. TTFCA displays a significant activity. Doses as high as 120 mg daily may be safely used in venous hypert ension.