Evaluation of the effectiveness of the pharmacotherapy scheme “TRIO” in patients with chronic arterial insufficiency of IIb-III degree

Abstract

Background. Occlusive peripheral arterial disease (OPAD) of the lower extremities is a pathological condition; its pathogenetic substrate is an obstruction or narrowing of the lumen of peripheral vessels of various calibres. About 200 million people worldwide suffer from OPAD. The incidence and severity of the disease increase with age. Patients with diabetes are 2-4 times more likely to develop OPAD than those without diabetes. Smoking increases the risk of OPAD by 2.5 times.
 Objective. To evaluate the effectiveness of the pharmacotherapy regimen “TRIO” in patients with chronic arterial insufficiency of IIb-III degree.
 Materials and methods. The study included 45 people with confirmed OPAD of the lower extremities and chronic arterial insufficiency of IIb-III degree (62.2 % males, 37.8 % females, mean age – 61 years). Patients in the experimental group (n=20) were prescribed a “TRIO” scheme, which included: 1) a multicomponent isoosmolar solution containing Ringer’s lactate and pentoxifylline (200 ml per day); 2) multicomponent hyperosmolar solution containing sorbitol and sodium lactate (400 ml per day); 3) a solution of L-arginine hydrochloride (100 ml per day). Comparison group was treated by the solution 2 (200 ml per day) and solution 3 (100 ml per day) only. The effectiveness criteria included the distance of painless walking, the intensity of pain according to the visual-analogue scale (VAS), ankle brachial index, and peripheral oxygen saturation.
 Results and discussion. In the experimental group there was a shorter length of hospital stay (7.9±0.97 days vs. 9.8±1.63 days in the comparison group) and better dynamics of painless walking distance (1st day – 47.50±30.54 m, 7th day – 126.25±72.16 m, in the comparison group: 1st day – 49.00±27.73 m, 7th day – 54.20±33.59 m). Pain syndrome according to VAS also decreased more markedly in the experimental group: from 5.35±1.81 points on day 1 to 3.25±1.68 points on day 7 (in the comparison group – from 5.32±1.63 points on day 1 to 4.80±1.53 points on day 7). There was no significant difference in the ankle brachial index. Peripheral oxygen saturation increased more markedly in the experimental group (from 75.50±7.10 % on day 1 to 90.65±5.07 % on day 7) than in the control group (from 75.72±6.55 % on day 1 to 79.48±6.91 % on day 7).
 Conclusions. 1. Administration of the pharmacotherapy scheme “TRIO” allows to improve the indicators of the functional state of the vascular bed in patients with chronic arterial insufficiency of IIb-III degree. 2. Manifestations of improvement included lengthening of the distance of painless walking, increase of peripheral blood oxygen saturation, and reduction of the pain severity.