THE USE OF 5,6 BENZO-[α]-PYRONE (COUMARIN) AND HEATING BY MICROWAVES IN THE TREATMENT OF CHRONIC LYMPHEDEMA OF THE LEGS

Abstract

Sixty patients with leg lymphedema from a variety of etiologies were divided intorandomized two groups, matched by Grade, duration, age, sex, and cause of lymphedema. Usinga double-blind format, one group received 5,6 benzo-[ ]-pyrone (coumarin 1,2 benzopyrone,400 mg/day) for six months; the other received a placebo. For the next six months, both groupsreceived a standardized regimen of heat (using microwaves) coupled with compression garments.Benzopyrone produced approximately 20% reduction in the volume (p=104) andimprovement in circumferences and tonometry (p=10-5 and 10-7). Symptoms (feelings of swelling,pain, heaviness and loss of mobility) were also significantly improved (p=0.03 to 10-7).During the second six months, when microwave heat therapy was added to drug therapy,the patients who had previously received the placebo showed significant improvement (p=0.03 to10-9) in signs and symptoms of lymphedema. Some, but not all, of the group that was receivingbenzopyrones were also significantly improved by heat therapy (p=0.8 to 0.002). Takingbenzopyrones for 12 months plus heat treatment for six months was significantly better, for somecriteria, than the placebo plus heat therapy (p=0.7 to 0.04). On the other hand, heat plus eitherplacebo or benzopyrone was often significantly better than either the active or inactive drugwithout heat (p=0.8 to 10-9).