Proteolytic enzymes in
lymphedema therapy
Dzupina A., Morvay P., Dzupina M.
Proteolytic enzymes in lymphedema therapy. 41st Annual World
Congress - ICA'99, International College of Angiology, Sapporo,
Japan, July 3-10, 1999, Scientific Posters pp. 76 601 KA
Department of Internal Medicine,City Hospital, Bardejov,
Slovak Republic. Department of Immunoallergology, City Hospital,
Bardejov, Slovak Republic
Purpose: The goal of this study was to establish the effect of
Wobenzym in lymphedema therapy.
Material and Methods: Clinical examination, duplex sonography,
radionuclide lymphoscintigraphy, CT and MRI
established the diagnosis of lymphedema in 50 patients (12
primary, 38 secondary). After 4 weeks of standard treatment
consisting of manual lymph drainage, bandaging, sequential gradient
pneumatic therapy (Pneuven Bevuk), and special exercise therapy
including aqua therapy, 25 randomly selected patients continued in
standard therapy and 25 received 9 Wobenzym tablets daily for 6
weeks. A Wobenzym tablet contains pancreatin 100 mg, bromelain 45
mg, papain 60 mg, triacylglycerol lipase 10 mg, amylase 10 mg,
trypsin 24 mg, chymotrypsin 1 mg and rutoside 50 mg. Patients had
monitoring for common symptoms of pain, feelings of heaviness and
decreased mobility; extremity volume changes; and, serum levels of
liver enzymes, creatinine and minerals. Duplex sonography was used
to determine the centripetal fraction of venous flow.
Results: Wobenzym-treated patients noted significant beneficial
effects in subjective symptoms (56%, p < 0.005), reduction of
extremity volume (55%, p <0.005), duplex sonography measurements
(43%, p < 0.005) compared with the non-Wobenzym group.
Conclusion: Adding
Wobenzym to complete standard therapy significantly improves
subjective and objective parameters of lymphedema. No adverse
effects or significant changes in laboratory data were observed.