Варикозное расширение вен – серьезное хроническое заболевание, основными признаками которого являются растягивание тканей сосудистой стенки с образованием венозных узлов. При этом наблюдается значительное нарушение оттока крови и ее застоя в сосудистой системе.
Медикаментозная терапия при этом заболевании является важной составляющей в комплексном лечении варикоза. На практике всего 9–10% больным, страдающим этим заболеванием, проводится оперативное вмешательство. Большинство историй болезни подтверждают результативность лечения варикоза именно с помощью лекарственных средств.
Общая стратегия лечения
Лечение варикоза лекарственными препаратами следует начинать как можно раньше. В этом случае она останавливает процесс и не дает ему прогрессировать. Средства обычно принимаются продолжительными курсами, иногда до 6 месяцев как в качестве самостоятельной терапии и профилактической меры, так и в виде дополнительной составляющей на этапах до и после операции.
Медикаментозная терапия не устранит венозные узлы и полностью не сможет удалить сосудистые звездочки. Но при грамотной схеме лечения медикаменты действуют, как серьезный барьер для развития и прогрессирования заболевания.
Чтобы тромбофлебит, трофические язвы и тромбоз не стали вашими постоянными спутниками, начните прием лекарств от варикоза вен на ногах при первых симптомах заболевания. Даже оперативное вмешательство поможет только с помощью медикаментозной терапии.
Группы препаратов и их действие
При венозном варикозе лекарственные вещества классифицируют по типу действия на три основные группы:
- венотонизирующие или флеботропные средства;
- кроверазжижающие средства (антикоагулянты) и медикаменты, угнетающие слипание тромбоцитов (антиагреганты);
- противовоспалительные средства.
Исследования и медицинская практика доказали результативность флеботоников, разработанных на основе природных флавоноидов – диосмина и гесперида. Эти вещества не просто защищают клетки вен, но стимулируют отток лимфы и стабилизируют работу капилляров. Особенно эффективен одновременный прием комбинированных лекарств, в которых имеются оба флавоноида.
Чаще всего флеботропные средства принимают от 2 до 3 месяцев курсами. Важно, чтобы прием совпадал с жарким временем года, когда нагрузка на сосуды увеличивается в связи с высокой температурой воздуха и употреблением больших объемов воды. Если варикоз сопровождается хронической венозной недостаточностью, флеботоники принимают постоянно в половинной дозе.
Больной с диагнозом варикозное расширение вен с самого начала должен получать систематическое лечение, чтобы предотвратить развитие заболевания и снизить вероятность осложнений.
Вторую задачу решают лекарственные препараты, разжижающие кровь (антикоагулянты) и улучшающие ее текучие свойства, предотвращая формирование тромботических сгустков (антиагреганты).
Образование тромбов, их отрыв от сосудистой стенки и движение по венозному руслу приводит к перекрытию сосудов сердца, легких и мозга человека. В результате этого очень высока вероятность развития инфаркта, легочной эмболии и ишемического инсульта.
Антиагретаты не являются лекарством от варикоза, а применяются как средство для профилактики его серьезных осложнений – тромбоза и тромбофлебита. Можно сказать, что эти лекарства спасают больному жизнь и до минимума снижают угрозу инвалидности.
Перечень наиболее эффективных средств
Флеботоники
Важно: в форме таблеток флеботропные препараты при варикозе противопоказаны для применения в первом триместре беременности, при грудном кормлении и особой чувствительности к компонентам.
Дозировку и длительность терапии препаратами при варикозном расширении вен нижних конечностей рассчитывает врач в зависимости от тяжести варикозного процесса и анамнеза.
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Детралекс. Содержит диосмин. Существенно повышает сопротивляемость стенки сосуда к растяжению, снимает отеки и застой крови, повышает тонус вен. Таблетки, покрытые оболочкой, принимают по 2 штуки в день – утром и днем. Курс от 2 до 6 месяцев. Примерная стоимость Детралекса – 700 рублей за упаковку с 30 таблетками.
Флебодиа 600. Может продаваться под названием Диовенор 600. Этот венотонизирующий препарат при варикозе содержит диосмин, обладающий свойством повышать тонус сосудов, снижать их ломкость и уменьшать отеки. Обладает антиоксидантным действием. Принимают по 1 таблетке, утром до завтрака. Курс лечения аналогичен Детралекс. Стоимость Флебодиа 420 – 1300 руб. за 15 и 60 таблеток соответственно.
Антистакс. Содержит сухой экстракт листьев красного винограда и производится в форме капсул, крема, геля и спрея. Особенно эффективен на ранних этапах варикоза. Улучшает микроциркуляцию крови, снимает отечность. Обычно рекомендуется прием 2 капсул до завтрака. Результат проявляется в максимальной степени через 5–6 недель. Крем наносят на кожу 2 раза в день. Ориентировочная стоимость Антистакс – капсулы от 570, гель до 710 руб. (в зависимости от лекарственной формы).
Венорутон. Изготавливается на основе рутина, снижает проницаемость стенок капилляров, повышает венозный тонус. Увеличивает плотность и эластичность сосудов, снижает экссудативное воспаление. Лекарственная форма: капсулы и гель. Средняя стоимость: капсулы (50 шт.) около 730, гель – 380 руб. соответственно.
Троксевазин. Сочетает в себе свойства ангиопротектора, антиоксиданта, флеботропного и противовоспалительного препарата. Выпускается в форме геля и капсул, которые желательно комбинировать для получения наилучшего результата. Примерная стоимость: гель 180–240, упаковка с 100 капсулами – 600 руб.
Эсцин (Венитан). Производится с использованием экстракта плодов конского каштана. Укрепляет венозную стенку, тонизирует, снимает воспаление. Крем наносят до 3–4 раз в сутки. Цена 210–270 руб.
Медикаменты для разжижения крови при варикозном расширении вен
Назначением антиагрегантов в форме инъекций и таблеток, улучшающих текучесть крови и предотвращающих тромбообразование, занимается только лечащий врач. Дозировка и схема лечения больных назначается только индивидуально.
- Лиотон 1000. Гель, изготовленный на основе гепарина – вещества, которое увеличивает текучие свойства крови, препятствуя формированию сгустков. Наносится на пораженное место 1–3 раза в день. Стоимость около 340 руб. за 30 г.
Венолайф. Кроме гепарина венолайф содержит дополнительные лекарственные вещества, улучшающие сосудистую микроцикруляцию, ускоряющие регенерацию пораженных тканей на клеточном уровне. Гель используют до 3 раз в день, стандартная продолжительность курса до 20 – 30 дней. Цена 310 руб. за тубу 40 г.
Курантил обладает свойством стимулировать кровоток и циркуляцию в мелких сосудах, уменьшать застой венозной крови. Доза рассчитывается флебологом, продолжительность курса также определяет врач. Стоимость от 540 до 650 руб. за 100 капсул по 25 мг и 40 капсул по 75 мг соответственно.
Трентал (пентоксифиллин). Ангиопротектор, улучшает текучие свойства крови, снижает вязкость, препятствует агрегации эритроцитов и тромбоцитов в кровяные сгустки, улучшает клеточный метаболизм. 480 руб. за 60 таблеток. Пентоксифиллин – от 90 до 130 руб. (60 таблеток).
Противовоспалительные нестероидные вещества
Такого рода лекарства необходимы при сильных болях, распространяющихся по ходу русла сосуда, при росте температуры, для уменьшения отеков и других симптомов воспалительного процесса. Они помогут приостановить процесс развития варикоза в тромбофлебит и тромбоз, которые опасны для жизни.
Дозировка и продолжительность курса определяется только врачом, поскольку эти медикаменты имеют серьезные противопоказания и побочное действие.
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Диклофенак. Активно влияет на процесс угнетения слипания тромбоцитов и воспалений, прекрасно купирует болевые ощущения особенно при внутримышечных инъекциях. В таблетках и инъекциях применяют при остро выраженном воспалении и болях, в форме геля – для местного использования на поверхности кожи.
Противопоказания относятся в первую очередь к возрастной категории до 16 лет, беременным и кормящим матерям. Кроме того, к противопоказаниям относятся:
- изменение состава крови неясного генеза;
- язвенные заболевания желудочно-кишечного тракта;
- системная волчанка, порфирия;
- гипертензия, острая сердечная недостаточность;
- почечная недостаточность, пиелонефрит, холецистит;
- заболевания дыхательных путей, бронхиальная астма – возможен бронхоспазм;
- аллергические реакции.
Ориентировочная цена: от 20 до 80 рублей в зависимости от лекарственной формы.
Что делать нельзя
При диагнозе варикозное расширение вен приходится с внимание относиться к образу жизни, питанию и занятием спортом. Не разрешаются:
- активные физические нагрузки, бег, прыжки (разрешаются занятия йогой);
- длительное стояние или продолжительное положение сидя;
- применение всех лекарственных средств без консультации с врачом-флебологом;
- долгие перелеты с вынужденным неподвижным положением ног. Кроме того, на больших высотах происходит резкое сгущение крови, что приводит к формированию тромбов;
- принятие горячих ванн, посещение сауны;
- категорически запрещен баночный и медовый массаж, разрешается только ручной вид медицинского массажа.
Возможные осложнения
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Трофические язвы – форма осложнения при варикозе, которое проявляется в развитии и углублении длительно незаживающей язвочки. Обычно на голени возникает отдельная болезненная язва, внутри которой часто наблюдают «мокнутие» в виде выделения серозной кровянистой жидкости, покрывающей пораженные ткани.
Срочное обращение за медицинской помощью
Немедленное обращение к врачу требуется при появлении следующих симптомов:
- Усиление болей в пораженной конечности, невозможность подняться с кровати или сделать несколько шагов;
- Кожа на ноге горячая, отечная и плотная на ощупь.
- Цвет кожи меняется от бледного до синюшного или синюшно-красного;
- Внезапная одышка, нехватка воздуха, потливость и резкая слабость;
- Кровотечение из участка пораженной кожи или варикозного узла.
Необходимые лекарства при варикозном расширении вен нижних конечностей обязательно должны присутствовать в схеме комплексного лечения. Даже после проведения оперативного вмешательства потребуется несколько курсов приема флеботонических и антиагрегантных средств в целях предупреждения возможных трофических расстройств, воспалений и осложнений на фоне заболевания.
Многие многокомпонентные препараты против варикоза действуют комбинированно, имеют несколько функций. Эффективность таких препаратов более выражена. Оптимально применять лечение курсами в правильной дозировке, рассчитанной флебологом, в сочетании с компрессионной терапией, занятиями йогой, плаванием в бассейне, фитотерапией.
Врачи-флебологи все чаще практикуют лечение варикоза вен на ногах мед. препаратами. Варикоз встречается и у молодых людей, вне зависимости от их образа жизни. Во время болезни возникают дистрофические изменения в стенке сосудов, которые ведут к хроническим застоям крови. Медикаментозное лечение назначается для влияния на этиологию развития и на осложнения, которые могут возникнуть. 
Варикоз встречается и у молодых людей, вне зависимости от их образа жизни
Лечение препаратами очень удобно как для врача, так и для пациента. Наиболее благоприятным периодом для лечения являются первые стадии варикозного расширения вен на ногах и незначительные сосудистые звёздочки.
Если начинать лечение на ранних стадиях, есть возможность добиться регресса заболевания без инвазивных методов.
Чтобы лечение имело большую эффективность, оно должно быть комплексным и включать одновременное применение препаратов из разных фармакологических групп.
Когда применяются мед препараты?
Медикаментозные препараты при варикозном расширении вен нижних конечностей назначают на всех стадиях заболевания, но цель их назначения разная. Например, приём венотоников при первых проявлениях заболевания может значительно уменьшить дефект варикозного расширения или восстановить исходную структуру сосуда. 
Медикаментозные препараты при варикозе назначают на всех стадиях заболевания
Согласно данным медицинской литературы, наилучшим вариантом лечения варикозно расширенных вен ног является малоинвазивная склеротерапия или радиочастотная абляция. На поздних стадиях лечение производят только хирургическим путём.
Следует отметить, что независимо от выбора метода лечения, дополнительно назначают медикаментозные препараты в качестве терапии и профилактики рецидива. В случаях, когда болезнь только началась и её проявления незначительны, в качестве основной терапии назначают курс медикаментозного лечения.
Перед назначением медикаментов при варикозе врач должен оценить состояние пациента, выяснить причину заболевания и определить наличие противопоказаний для начала консервативной терапии.
В лечении варикоза нижних конечностей играет роль много факторов, поэтому назначается комбинация из трех или четырёх препаратов. 
На поздних стадиях лечение производят только хирургическим путём.
Чаще всего используют такие группы препаратов:
- Флеботоники — лекарственные препараты против варикоза, предназначенные для увеличения тонуса венозных стенок и предотвращения их деформации. Препараты данной группы также влияют и на клапанный аппарат сосудов.
- Антикоагулянты. Назначают с целью разжижения крови и предотвращения тромбозов.
- НПВС (нестероидные противовоспалительные средства) снимают болевой синдром и воспалительные проявления на ногах.
- Дезагреганты имеют тот же эффект, что и антикоагулянты, но их можно принимать дольше и чаще.
- Фибринолитики – средства, способные растворить тромб на ранних стадиях его развития.
- Антиоксиданты. Во время отёка страдает метаболизм, выделяются токсические вещества, и антиоксиданты способны их инактивировать.
Флеботоники — лекарственные препараты против варикоза
При варикозе приём нескольких препаратов из разных групп может вызывать эффект потенцирования. Такое явление обусловлено тем, что тонус венозных стенок и клапанов зависит не только от самой вены, но и от крови, мышц и общего состояния организма.
Львиная доля препаратов, которые врачи назначают при варикозе, направлена на профилактику осложнений в виде тромбофлебитов, тромбоза глубоких вен, тромбоэмболии лёгочной артерии и появления трофических язв на ногах.
Важно понимать, что неконтролируемый приём препаратов без точной оценки вашего состояния может сильно навредить вашему здоровью! Лечение варикоза вен на ногах мед. препаратами — длительное и затратное, и исходя из этого, перед началом терапии проконсультируйтесь с флебологом или хирургом. 
Перед назначением медикаментов при варикозе врач должен оценить состояние пациента
Терапию варикоза нижних конечностей лекарственными препаратами нередко дополняют применением наружных мазей, гелей и кремов.
Флеботоники или венотоники
В основном венотоники влияют на эластичность венозной стенки и её мышечных волокон. Венотонические препараты можно условно разделить на две группы:
- Препараты, в состав которых входят вещества, влияющие на способность сокращения венозной стенки.
- Препараты, действие которых направлено на снижение проницаемости венозных сосудов.
В любом случае, венотоники влияют как на стенку сосуда, так и на его клапанный аппарат и являются хорошими противоварикозными препаратами. 
Детралекс
Детралекс – это очень активный препарат, который увеличивает тонус венозных сосудов и отток венозной крови за счёт их окклюзии. Данное лекарство выпускают в таблетках по 500 мг. Существует множество проводимых исследований, которые подтвердили его эффективность во время лечения варикозной болезни. Принимать препарат стоит только после консультации с доктором. Дело в том, что дозировка Детралекса зависит от объёма крови в деформированном сосуде и скорости её оттока. Такие показатели может узнать только доктор.
В среднем препарат принимают по 4 таблетки 2-3 раза в день, преимущественно во время еды. 
Препарат выпускают в таблетках по 600 мг.
Флебоида
Препарат Флебоида относится к группе ангиопротекторов с выраженным капилляростабилизирующим эффектом. Основу таблеток составляет вещество диосмин. Механизм действия Флебоиды заключается в том, что он улучшает связь между норадреналином и венозной стенкой, в результате такого взаимодействия возникает венозный спазм, улучшается венозный отток крови и налаживается дренаж лимфы.
Препарат выпускают в таблетках по 600 мг. Принимать следует по 3-5 таблеток 2 раза в день. Дозу и кратность приёма определяет лечащий врач.
Троксевазин
Как и предыдущий препарат, Троксевазин относится к группе лекарств, обладающих капилляростабилизирующим эффектом. Основу Троксевазина составляет рутин и рутиноподобные вещества. Рутин очень хорошо накапливается в стенках сосудов и инактивирует опасные метаболиты тканевого дыхания. Препарат рекомендуют принимать людям не только для лечения варикозного расширения вен на ногах, но и для борьбы с гипоксией. 
Основу Троксевазина составляет рутин и рутиноподобные вещества.
Дозировка препарата подбирается индивидуально, в среднем по 1 капсуле раз в день. Длительность лечения — около четырёх недель.
Антикоагулянты
Антикоагулянты – это лекарства, влияющие на факторы свертывания крови, что находятся в плазме. Выделяют две большие группы антикоагулянтов:
- Антикоагулянты прямого действия (Гепарин, Фраксипарин);
- Антикоагулянты непрямого действия (Варфарин).
Препараты, относящиеся к первой группе, ингибируют плазменные факторы свертывания крови. Они связываются с третьим, пятым, восьмым и двенадцатым факторами непосредственно в крови.
Гепарин улучшает реологию крови, венозный отток головного мозга и профилактирует образование тромбов. Применяют при ДВС-синдроме и тромбофлебитах разного генеза. Дозировка зависит от болезни, которую лечат, и от клинической картины. Гепарин вводят на физиологическом растворе, максимальная суточная доза — двадцать тысяч МО. Максимальная разовая доза — пять тысяч МО (МО — международная единица). 
Варфарин — препарат, относящийся к непрямым антикоагулянтам
Во время применения гепарина врач должен следить за лабораторными показателями крови. В случае наличия кровотечений или ран, препарат не назначают.
Препараты второй группы имеют похожее действие с прямыми антикоагулянтами, но ингибируют факторы свертывания непосредственно в самой печени, а не в крови.
Варфарин — препарат, относящийся к непрямым антикоагулянтам и являющийся антагонистом витамина К. При блокировании синтеза витамина К снижается синтез факторов свёртывания крови. Варфарин выпускают в таблетках от варикоза вен на ногах, дозировка может быть от 5 до 10 мг. Суточная доза постоянно меняется. Начинать терапию необходимо с 10 мг первые 4 дня и потом по 5 мг. Эффект от лечения наступает не раньше, чем через 3 дня. 
Варикозное расширение вен
Перед началом терапии от варикоза вен на ногах, следует проконсультироваться с вашим лечащим врачом с целью выяснения необходимости данной терапии.
Нестероидные противовоспалительные
НПВС, или нестероидные противовоспалительные средства, — очень эффективные препараты при тромбофлебитах, возникших на фоне варикозного расширения вен на ногах. Основной эффект данных лекарств возникает из-за их способности блокировать распад арахидоновой кислоты с последующим выделением большого количества медиаторов воспаления.
При воспалении внутренней стенки вен во время варикозной болезни увеличивается риск образования тромбов, нарушается венозный отток головного мозга, нарастают явления отёков с последующим развитием болевого синдрома. 
Нестероидные противовоспалительные средства
НПВС прекрасно справляются с воспалительными процессами и снижают их проявления. При варикозе назначают такие НПВС:
- Ибупрофен;
- Индометацин;
- Диклофенак.
Дозировка подбирается индивидуально, в зависимости от препарата и формы течения варикозной болезни. При приёме НПВС следует знать об их негативном влиянии на ЖКТ. Людям, страдающим от язвенной болезни, нестероидные противовоспалительные средства противопоказаны.
Дезагреганты
Дезагреганты – это препараты для лечения варикоза, которые, так же как и антикоагулянты, воздействуют на свёртывание крови. В отличие от антикоагулянтов, дезагреганты влияют не на факторы свёртывания крови, а на тромбоциты, угнетая их способность к слипанию. 
Диагностика и лечение варикоза
Наиболее распространённым и бюджетным является аспирин, или ацетилсалициловая кислота. Принимать препарат следует по 75-150 мг в день, запивая большим количеством воды. Аспирин улучшает текучесть крови, стимулирует венозный отток головного мозга.
Существует и множество других препаратов, в основе которых лежит все тот же аспирин. Фармацевтические компании модулируют и немного изменяют свойства аспирина. Добавляют к нему разные добавки и уменьшают токсичность.
В целом, при необходимости разжижения крови и отсутствии противопоказаний, можно применять ацетилсалициловую кислоту вместо дорогих аналогов.
Фибринолитики
Фибринолитики — это очень мощные препараты для улучшения циркуляции при образовании свежих тромбов. Основной задачей фибринолитиков является разрушение нитей фибрина, связывающих форменные элементы крови. Как и антикоагулянты, фибринолитики делятся на две группы:
Перед лечение варикоза нужно обязательно проконсультироваться с врачом
- прямого действия;
- непрямого действия.
Фибринолитики первой группы разрушают тромб при контакте действующего вещества препарата и нитей тромбина. Таким эффектом обладают Плазмин и Фибринолизин.
Ко второй группе фибринолитиков относятся препараты, которые способные вызывать активацию физиологических соединений, способных растворить тромб.
Данные лекарства эффективны только в первое время, позже растворить тромб практически невозможно.
К непрямым фибринолитикам относят:
- Алтеплаза;
- Стрептокиназа.
Непрямые фибринолитикам
Препараты от варикоза на ногах очень дорогие, поэтому применять их без врачебного контроля не рекомендуется.
Антиоксиданты
Эффективность антиоксидантов до сих пор полностью не доказана. Исходя из практического опыта, можно сказать, что во время приёма антиоксидантов улучшается не только метаболизм кожи над варикозно расширенными сосудами, но и общее состояние организма.
Действие антиоксидантов довольно разное, но в целом оно сводится к выведению недоокисленных продуктов из клеток или межклеточной жидкости.
Основными представителями антиоксидантов для лечения варикоза вен является L-аргинин и витамин Е. Дозировку необходимо подбирать под каждого пациента. Эффект наступает в среднем через 4-5 дней. Антиоксиданты хорошо использовать в качестве дополнительной терапии или для профилактики метаболических изменений в клетках.
Организм человека – совершенная система, в которой все продумано до мелочей, однако, и тут могут случаться сбои, приводящие к разным неприятным последствиям. Например, в норме кровь по венам течет строго в одном направлении – от периферии к сердцу, обратному току препятствуют специальные клапаны, расположенные внутри венозных сосудов. У здоровых людей стенки вен довольно упругие и сильно не растягиваются. В силу разных причин, например, при поражении клапанного аппарата, происходит стойкое расширение вены на определенном участке, формируется узел или варикоз. Это хроническая патология, лечить которую надо обязательно во избежание развития опасных последствий для здоровья (тромбофлебит, кровотечение, эмболия легочной артерии). Одним из составляющих целого комплекса лечебных мероприятий при варикозе является назначение специальных таблеток для вен. Что это за препараты – давайте разбираться.
Принципы лечения
По данным статистики около 30% женщин и более 10% мужчин имеют симптомы хронической венозной недостаточности, в частности, варикозное расширение вен. Чаще всего эта проблема заметна на ногах, но может затрагивать и внутренние органы (венозные сплетения пищевода, прямой кишки, матки и т.д.). Болезнь опасна своими осложнениями и может закончиться трагически, если не уделять ей должного внимания. Своевременное лечение позволяет восстановить нормальный венозный кровоток и избежать неприятных последствий. Лечебные мероприятия при варикозе делятся на два вида:
- Консервативные методы – уменьшение негативных факторов риска для вен, рекомендации по диете и физическим упражнениям, эластическая компрессия измененных сосудов, лекарственные препараты и физиотерапевтическое лечение. Для лучшего эффекта эти меры должны применяться в комплексе.
- Хирургические методы (удаление измененных вен) – применяются при неэффективности вышеперечисленных мероприятий или наличии осложнений.
При нулевой и первой стадии заболевания лекарства от варикоза назначаются с целью профилактики дальнейшего прогрессирования заболевания. При 2 и 3 стадии лечение таблетками проводится длительно для повышения тонуса вен и улучшения питания окружающих тканей. Как правило, на этих стадиях пациенту предлагается радикальное решение проблемы одним из способов малоинвазивной или традиционной хирургии. Лекарства при варикозе в запущенной стадии назначаются в качестве поддерживающей терапии в дополнение к оперативным методам лечения. При наличии противопоказаний для операции они являются основным способом помощи больному. Применение народных средств может быть оправдано только в общем комплексе мероприятий.
Классификация препаратов
Медикаментозная терапия варикоза делится на несколько групп в зависимости от механизмов воздействия:
- Венотонизирующие средства (флеботоники) – целенаправленно воздействуют на тонус венозных сосудов и защищают их от повреждений. В результате приема этих препаратов происходит улучшение кровообращения, нормализация оттока лимфы, устранение застоя, уменьшение отеков и укрепление сосудистых стенок. Самыми популярными медикаментами этой группы являются Детралекс и его отечественный аналог Венарус, Флебодиа, Троксевазин, Гинкор форте, Венорутон, Антистакс, Эскузан. Любое лекарство из этой группы можно применять при разных стадиях варикозной болезни.
- Антикоагулянты и дезагреганты – их действие связано со снижением свертываемости крови и устранением риска образования сгустков (тромбов). Разжижать кровь при варикозе необходимо для уменьшения угрозы тромбозов и других опасных состояний, которые могут возникнуть при этой патологии. Представители данной группы – Аспирин и препараты на основе ацетилсалициловой кислоты (Тромбо-Асс, Кардиомагнил, Аспирин Кардио и другие), а также Курантил, Трентал, Плавикс, Клексан, Варфарин. Эти лекарства должны назначаться врачом, их принимают долго под контролем анализа крови на факторы свертываемости.
- Нестероидные противовоспалительные препараты (НПВП) – обычно необходимы для лечения варикоза глубоких вен, сопровождающегося болевым синдромом. Они эффективно купируют боль, отек, местную гиперемию и другие симптомы воспаления, что значительно улучшает самочувствие пациента. Популярные препараты — Найз, Кеторол, Диклофенак ретард, Индометацин, Ибупрофен. Таблетки имеют противопоказания, принимать их рекомендуется по назначению врача во время острой стадии заболевания.
- Энзимы (ферменты) в таблетках – находят применение при осложнении варикоза (тромбофлебите). Они оказывают противовоспалительное и противотромботическое действие, снимают отек и боль, устраняют недостаточность в венозной и лимфатической системе, стимулируют иммунитет. Самый известный представитель этой группы — Вобэнзим.
По показаниям могут назначаться витамины, особенно группы C, Е, гомеопатические средства на растительной основе (например, Аэсцин) и другие препараты на усмотрение лечащего врача.
Флеботоники
Это основная группа лекарственных средств, которые применяются при хронической венозной недостаточности. Важно понимать, что эти препараты не избавят пациента от вздутых вен и узлов на ногах, но они предотвращают дальнейшее прогрессирование заболевания и облегчают качество жизни пациента за счет купирования таких симптомов, как боль, жжение по ходу вен, судорожные подергивания и тяжесть в ногах. Флеботоники нельзя принимать беременным и кормящим женщинам, лицам с повышенной чувствительностью к препарату. Выбор лекарства, длительность лечения, дозировка – все это назначения врача-флеболога или сосудистого хирурга.
Это комбинированный препарат с ангиопротекторным (защищающим сосудистую стенку) и венотонизирующим воздействием на организм. Лечебные свойства обусловлены компонентами, входящими в состав Детралекса:
- диосмин – вещество, уплотняющее капиллярную стенку, благодаря которому уменьшается сосудистая проницаемость, купируются основные признаки воспаления (покраснение, отечность, боль) и восстанавливается кровообращение в поврежденных тканях;
- гесперидин – дополняет действие диосмина за счет укрепления сосудистой стенки и повышения тонуса вен.
Оригинальный препарат Детралекс производится по специальной технологии – действующее вещество в нем находится в виде микрочастиц, это позволяет лекарству быстрее всасываться и достигать максимального терапевтического эффекта. Применение Детралекса при венозной недостаточности позволяет уменьшить проницаемость и ломкость капилляров, устранить явления застоя в венозной системе, улучшить микроциркуляцию крови. Детралекс выпускается только в форме таблеток по 500 мг в упаковке по 30 и 60 таблеток для приема дважды в день в обед и вечером. Длительность применения определяется врачом, обычно курс не менее 3 месяцев подряд. Отечественным аналогом является препарат Венарус, выгодно отличающийся по цене, но не уступающий по действию.
Современное медикаментозное средство на основе диосмина, в каждой таблетке которого по 600 мг действующего вещества. Препарат обладает рядом лечебных свойств, а именно:
- уменьшает степень растяжимости вен;
- повышает эластичные свойства сосудистой стенки;
- защищает капилляры от повреждения;
- устраняет явления венозного застоя;
- повышает сопротивляемость системы микроциркуляции;
- снижает проницаемость стенок капилляров;
- повышает сократительную способность лимфатических сосудов;
- уменьшает давление и улучшает дренажную функцию в системе лимфооттока.
После приема внутрь препарат равномерно распределяется во всей системе венозных сосудов нижних конечностей и других тканей. Доза устанавливается врачом, обычно в сутки это 1 таблетка.
Препараты для разжижения крови
Поддержание нормальных показателей текучести крови при расширении вен имеет большое значение в связи с высоким риском образования тромбов. Это осложнение чаще всего возникает там, где есть сгущение крови и повреждение стенок сосудов, как при варикозе. Какие препараты используются чаще всего:
- Курантил – обладает вазодилатирующими (расширяет сосуды) и ангиопротекторными свойствами, восстанавливает нормальную циркуляцию крови за счет уменьшения ее вязкости. Основное действующее вещество у Курантила – это дипиридамол, он оказывает антиагрегатное и иммустимулирующее действие, препятствует образованию тромбов при варикозе. Препарат назначается строго по показаниям в дозе на усмотрение врача.
- Трентал – оказывает сосудорасширяющее влияние, укрепляет сосудистую стенку, положительно влияет на состояние больного – снимает усталость, уменьшает количество судорог в мышцах.
- Аспирин – относится к первым средствам, применявшимся для регулярного понижения вязкости крови. Из-за многочисленных побочных эффектов в настоящее время для долговременного лечения назначаются аналогичные медикаменты на основе ацетилсалициловой кислоты (АСК-Кардио, Кардиомагнил), но содержащие минимальную терапевтическую дозу этого вещества. Такие аналоги безвредны для ЖКТ и других органов.
Предостережения
Практически все лекарства для лечения варикоза обладают побочными эффектами, прежде всего они оказывают токсическое влияние на желудочно-кишечный тракт. Положение ухудшается необходимостью проведения длительных курсов терапии.
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Что касается антиагрегантов и антикоагулянтов, влияющих на свертывание крови, то бесконтрольный прием подобных средств может привести к нежелательным реакциям со стороны органов кроветворения. Эти лекарства пьют под регулярным контролем анализов крови на свертывание. Все препараты от варикоза принимаются курсами с обязательными перерывами между ними, чтобы не развивалось привыкание. Прием таблеток при этой патологии следует сочетать с применением местных лекарственных препаратов, использованием эластичного компрессионного трикотажа, лечебной физической культурой. Только комплексными мероприятиями можно добиться устойчивых положительных результатов и не допустить дальнейшего развития патологии.
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