{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T17:25:15Z","timestamp":1788715515283,"version":"build-2803163510"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T00:00:00Z","timestamp":1639440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p><jats:bold>Background and Aim:<\/jats:bold> Several evidences have shown how, in hemorrhoidal disease, phlebotonic flavonoid agents such as quercetin reduce capillary permeability by increasing vascular walls resistance, how rutin and vitamin C have antioxidant properties, and that <jats:italic>Centella asiatica<\/jats:italic> has reparative properties towards the connective tissue. A retrospective study was designed in order to evaluate the efficacy and safety of a compound consisting of micronized flavonoids in combination with vitamin C and extracts of <jats:italic>C. asiatica<\/jats:italic>, <jats:italic>Vaccinium myrtillus<\/jats:italic>, and <jats:italic>Vitis vinifera<\/jats:italic> for grade II and III hemorrhoidal disease.<\/jats:p><jats:p><jats:bold>Patients and Methods:<\/jats:bold> Data of 49 patients, over 18, who were following a free diet regimen, not on therapy with other anti-hemorrhoid agents, treated with a compound consisting of 450\u00a0mg of micronized diosmin, 300\u00a0mg of <jats:italic>C. asiatica<\/jats:italic>, 270\u00a0mg of micronized hesperidin, 200\u00a0mg of <jats:italic>V. vinifera<\/jats:italic>, 160\u00a0mg of vitamin C, 160\u00a0mg of <jats:italic>V. myrtillus<\/jats:italic>, 140\u00a0mg of micronized quercetin, and 130\u00a0mg of micronized rutin (1 sachet or 2 tablets a day) for 7 days were collected. Hemorrhoid grade according to Goligher\u2019s scale together with anorectal symptoms (edema, prolapse, itching, thrombosis, burning, pain, tenesmus, and bleeding) both before treatment (T0) and after 7 days of therapy (T7) were collected. Primary outcomes were the reduction of at least one degree of hemorrhoids according to Goligher\u2019s scale assessed by proctological examination and compound safety. The secondary outcome was the reduction of anorectal symptoms assessed by questionnaires administered to patients.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> Forty-four patients (89.8%) presented a reduction in hemorrhoidal grade of at least one grade (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). No adverse events with the use of the compound were noted. A significant reduction was observed in all anorectal symptoms evaluated (<jats:italic>p<\/jats:italic> &amp;lt; 0.05). No predictors of response to the compound were identified among the clinical and demographic variables collected.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> The compound analyzed was effective and safe for patients with grade II and III hemorrhoidal disease according to Goligher\u2019s scale.<\/jats:p>","DOI":"10.3389\/fphar.2021.773320","type":"journal-article","created":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T10:11:35Z","timestamp":1639476695000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Evaluation of the Efficacy and Safety of a Compound of Micronized Flavonoids in Combination With Vitamin C and Extracts of Centella asiatica, Vaccinium myrtillus, and Vitis vinifera for the Reduction of Hemorrhoidal Symptoms in Patients With Grade II and III Hemorrhoidal Disease: A Retrospective Real-Life Study"],"prefix":"10.3389","volume":"12","author":[{"given":"Antonietta G.","family":"Gravina","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Pellegrino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Facchiano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Palladino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelina","family":"Loguercio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Federico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,14]]},"reference":[{"key":"B1","first-page":"378","article-title":"Clinical and Capillaroscopic Evaluation in the Treatment of Chronic Venous Insufficiency with Ruscus Aculeatus, Hesperidin Methylchalcone and Ascorbic Acid in Venous Insufficiency Treatment of Ambulatory Patients","volume":"26","author":"Aguilar Peralta","year":"2007","journal-title":"Int. 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