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Systemic enzyme therapy and complex decongestive therapy in the patients with primary and secondary lymphedema of lower extremity

Dzupina A., Morvay P., Dzupinova M. Systemic enzyme therapy and complex decongestive therapy in the patients with primary and secondary lymphedema of lower extremity. Lymfo 2000, Praha 13. - 14. 10. 2000. Praktická flebologie - supplement 2000, Roè. IX, str. 23-27. (17-13-2)-(17-12-1). Czech abstract

Summary: The goal of this trial is the evaluation of Wobenzym efficiency as an additional therapy to the standard treatment of lymphedema. Two groups of patients were observed: 12 women with primary lymphedema of lower extremity (group I.) and 20 women suffering by secondary lymphedema following erysipelas. The diagnosis of lymphedema was confirmed by clinical examination, duplex sonography, radionuclide lymphoscintigraphy, and by CT and MRI eventually. Complex decongestive therapy (CDT) was used as a standard treatment including manual lymph drainage, sequential gradient pneumatic therapy, a bandaging and special exercises with aquatherapy. After 4 weeks of CDT both groups were randomly divided in two halves. The subgroups I. A, II. A continue the treatment by CDT only. Subgroups I. B and II. B received Wobenzym 3x3 tablets daily additionally to CDT. The treatment of all groups continued following 6 weeks.
 During the observation subjective symptoms were estimated by questionnaire method, extremity volume differences and centripetal fraction of venous flow were measured. Serum levels of liver enzymes, creatinine and minerals were checked.
 In the groups receiving Wobenzym a statistically significant amelioration of all objectives were evident comparing to groups treated by CDT only. The comparison of control visit results after 4 and 10 weeks of treatment - subjective symptoms I. B p < 0,0004, II. B p < 0,0002, extremity volumes I. B p < 0,005, II. B p < 0,003, centripetal fraction of venous flow I. B p < 0,005, II. B p < 0,003.
 The treatment results in the patients with secondary lymphedema were better then the results in the patients with primary lymphedema. Nevertheless the results of the primary lymphedema patients showed statistical significance what is remarkable in this type of lymphedema with a generally known worse curability.
 Key words: lymphedema - complex decongestive therapy - Wobenzym