Experimental Comparative Study of the Efficacy and Side Effects of Cissus quadrangularis L. (Vitaceae) to Daflon (Servier) and Placebo in the Treatment of Acute Hemorrhoids
Sukij Panpimanmas MD*, Surath Sithipongsri MD**, Chairath Sukdanon MD***, Charuwan Manmee MSc****
Affiliation : * Department of Surgery, College of Medicine, Rangsit University, Rajavithi Hospital, Bangkok, Thailand ** Somdej Sriracha Hospital, Cholburi, Thailand *** Cholburi Hospital, Cholburi, Thailand **** Department of Academic Support, Rajavithi Hospital, Bangkok, Thailand
Objective : To investigate efficacy and side effects of Cissus quadrangularis L. and micronised purified flavanoid fraction
(MPFF) in treatment of hemorrhoids.
Material and Method: A prospective double blind randomized study was designed in acute hemorrhoidal patients from three
hospitals. In each hospital, eighty patients received the flavanoid mixture, C. quadrangularis, or placebo (3 x 2 p.c. for 4 days
and then 2 x 2 p.c. for 3 days). Patients were evaluated on bleeding, pain, discharge, pruritis, erythema, and direct patient
interviews. Each symptom was scored on a graded severity scale from 0 to 3 on the first day and the seventh day. Blood tests
and monitoring of treatment-related side effects were conducted.
Results : Five hundred seventy patients (299 females, 271 males) were enrolled. No significant difference regarding age,
gender, occupation, and history of disease was recorded. Mostly acute bleeding ceased at the second day in all groups.
Analysis on all groups revealed improvement in all symptoms with non-significant difference. No adverse events, no blood
chemistry changes were reported.
Conclusion : The therapeutic efficacy of flavanoid mixture, C. quadrangularis L. and placebo are not different indicating that
they play no role in improving early hemorrhoidal symptoms. Long-term studies should be conducted for effects in preventive
and curative action.
Keywords : Cissus quadrangularis L., Flavanoid mixture, Hemorrhoids references
