THERAPEUTICAL NOTES   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 1999 August;158(4):133-6

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: Italian

Post-mastectomy lymphedema of the upper limbs. Treatment with extract of melilotus officinalis

Muraca M. G., Baroncelli T. A.

Azienda Ospedaliera Careggi - CSPO Firenze

Background. The study aimed to evaluate the efficacy of melilotus officinalis in the treatment of post-mastectomy lymphedema. There are extensive reports in the literature of this plant’s specific antiedemigenic properties linked to its direct action on the smooth muscle contractility of lymphatic vessels (prolymphokinetic action) and stimulation of the tissular proteolytic function by macrophages (promacrophagic action).
Methods. A group of 25 women were enrolled in the study with lymphedema of the upper limbs consequent to axillary lymphadenectomy for breast heteroplasia. All patients underwent a preliminary angiological examination in basal conditions (T0), body weight was measured and the circumference of the diseased and contralateral arm was measured at the level of the armpit, arm, elbow, forearm, wrist and hand. All patients were negative for arterial and venous disease, and were free from recurrent disease. After a 7-day pharmacological washout period, all patients commenced medical treatment consisting of 20-mg tablet/day of melilotus officinalis extract 20% in coumarin (equivalent to 4 mg of coumarin) for a total of 12 weeks. Clinical controls and measurements of the upper limb at the different levels were performed at the end of week 6 (T1) and week 12 (T2).
Results. There was a marked reduction in limb volume at all levels with a good response at week 6, becoming even more marked at the end of treatment. These reductions were highly significant in statistical terms. The measurements of the contralateral arm also showed a significant reduction in limb volume. No noteworthy changes were reported in body weight measured at the various times. It is also worth noting that the treatment was well accepted by patients, both in terms of tolerability (no undesirable effects were reported) and efficacy. All patients expressed a positive subjective opinion regarding the reduction of limb volume.
Conclusions. The results showed: excellent clinical response to treatment, optimal tolerability and compliance.