A Systematic Review of the Efficacy ofCentella asiaticafor Improvement of the Signs and Symptoms of Chronic Venous Insufficiency

Abstract

We aimed to assess the efficacy of Centella asiatica for improvement of the signs and symptoms of chronic venous insufficiency (CVI). We searched 13 electronic databases including the Cochrane Central Register of Controlled Trials for randomised controlled trials assessing the efficacy of Centella asiatica for CVI. Two review authors independently selected studies, assessed the risks of bias of included studies and extracted data. The treatment effects of similar studies were pooled whenever appropriate. Eight studies met the inclusion criteria. The pooling of data of similar studies showed that Centella asiatica significantly improved microcirculatory parameters such as transcutaneous partial pressure of CO2 and O2, rate of ankle swelling and venoarteriolar response. Three out of the eight studies did not provide quantitative data. However, these studies reported that patients treated with Centella asiatica showed significant improvement in CVI signs such as leg heaviness, pain and oedema. Our results show that Centella asiatica may be beneficial for improving signs and symptoms of CVI but this conclusion needs to be interpreted with caution as most of the studies were characterised by inadequate reporting and thus had unclear risks of bias, which may threaten the validity of the conclusions.

Medicinal Property of Gotu kola (Centella asiatica) from the Selection of Traditional Applications to the Novel Phytotherapy

“…C. asiatica is a candidate for reducing signs and symptoms of CVI and microangiopathy in the lower extremities because of its triterpenes contents. Triterpenes assist with anti-inflammation, as seen in various animal studies [14].…”

“…CVI can be caused from abnormalities of the venous wall and valves [14]. Aminaftone and calcium dobesilate drugs have been used as part of treatment therapies for CVI but little evidence is provided to determine the degree of effectiveness.…”

“…Aminaftone and calcium dobesilate drugs have been used as part of treatment therapies for CVI but little evidence is provided to determine the degree of effectiveness. Flavonoids, saponosides and diosmin are compounds in C. asiatica that have been assessed for treating onset symptoms of CVI and venous microangiopathy [14]. C. asiatica is a candidate for reducing signs and symptoms of CVI and microangiopathy in the lower extremities because of its triterpenes contents.…”

“…The comprehensive scientific literature review included studies that recruited patients with venous insufficiency or venous hypertension, because many of the randomized controlled trials did not use specific diagnostic classification of CVI [14]. Short-term effects of the plant compounds have been found effective, but long-term effects are inconclusive.…”

The Development of Centellaasiatica Extract-Loaded BSA Nanoparticles Production to Improve Bioavailability

“…The major biologically active compounds of C. asiatica extract are monoterpenes, sesquiterpene, triterpenoids 2 , polyphenols 20 and triterpenes 21. In addition to terpenoids, it also contains high total phenolic contents which contributed by the flavonoids such as quercetin, kaempherol, catechin, rutin, apigenin and naringin and volatile oils such as caryophyllene, farnesol and elemene 20,22 . The antioxidant activity of C.asiatica may be due to the reduction of hydroperoxides, inactivation of free radicals, chelation of metal ions or combinations 20 .…”