Research

Horse Chestnut Seed Extract (Aescin)

35 peer-reviewed studies curated from PubMed and Semantic Scholar.

7
Meta-analyses
6
Systematic reviews
21
RCTs
1
Other studies
Meta-analyses (20%)
Systematic reviews (17%)
RCTs (60%)

Studies

Sorted by quality and recency

2021·JPMA. The Journal of the Pakistan Medical Association·Issam Salman Al-Azzawi

The role of Aescin versus Prednisolone in the management of symptomatic lower ureteral calculi: A comparative study.

RCTn = 360

Prospective comparative study evaluating the efficacy and safety of aescin versus prednisolone in managing symptomatic distal ureteral stones. The study involved 360 patients randomized into three groups: aescin, prednisolone, and placebo. Aescin and prednisolone showed significantly better outcomes than placebo, with aescin being more effective than prednisolone. Aescin was effective as a medical expulsive therapy with fewer side effects compared to prednisolone.

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2018·The Cochrane database of systematic reviews·Joanne R Morling, Cathryn Broderick, Su Ern Yeoh, et al

Rutosides for treatment of post-thrombotic syndrome.

Meta-analysisn = 233

Meta-analysis of three studies with 233 participants assessing the effectiveness and safety of rutosides for post-thrombotic syndrome (PTS) treatment. The review found no clear evidence that rutosides were superior to placebo or elastic compression stockings, with limited low-quality evidence supporting their use in reducing PTS symptoms.

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2015·The Cochrane database of systematic reviews·Joanne R Morling, Su Ern Yeoh, Dinanda N Kolbach

Rutosides for treatment of post-thrombotic syndrome.

Meta-analysisn = 233

Meta-analysis of three studies with 233 participants assessing the effectiveness and safety of rutosides for treating post-thrombotic syndrome (PTS) compared to placebo, elastic compression stockings (ECS), or other treatments. The evidence was of low or very low quality, with no significant improvement in PTS symptoms with rutosides compared to other treatments. Mild adverse effects were noted in one study.

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2013·The Cochrane database of systematic reviews·Joanne R Morling, Su Ern Yeoh, Dinanda N Kolbach

Rutosides for treatment of post-thrombotic syndrome.

Meta-analysisn = 233

Meta-analysis of three studies with 233 participants assessing the effectiveness and safety of rutosides for treating post-thrombotic syndrome (PTS) in patients with deep venous thrombosis. The analysis found no significant evidence that rutosides were superior to placebo or elastic compression stockings in reducing PTS symptoms. Mild adverse effects were noted in one study.

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2012·The Cochrane database of systematic reviews·Max H Pittler, Edzard Ernst

Horse chestnut seed extract for chronic venous insufficiency.

Meta-analysisn = 502

This meta-analysis reviews the efficacy and safety of oral horse chestnut seed extract (HCSE) for chronic venous insufficiency (CVI) compared to placebo or reference therapy. The analysis suggests improvement in CVI-related signs and symptoms, including leg pain and leg volume, with HCSE. Adverse events were mild and infrequent, indicating HCSE as a potentially efficacious and safe short-term treatment for CVI.

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2006·The Cochrane database of systematic reviews·M H Pittler, E Ernst

Horse chestnut seed extract for chronic venous insufficiency.

Meta-analysisn = 502

Meta-analysis reviewing the efficacy and safety of oral horse chestnut seed extract (HCSE) for chronic venous insufficiency (CVI). The analysis suggests improvement in CVI-related signs and symptoms, including significant reduction in leg pain and leg volume compared to placebo. HCSE may be as effective as compression stockings, with mild and infrequent adverse events.

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2004·The Cochrane database of systematic reviews·M H Pittler, E Ernst

Horse chestnut seed extract for chronic venous insufficiency.

Systematic reviewn = 289Inflammation

Systematic review of RCTs assessing the efficacy and safety of oral horse chestnut seed extract (HCSE) for chronic venous insufficiency (CVI). The review found that HCSE improved CVI-related signs and symptoms, including significant reductions in leg pain and leg volume compared to placebo. Adverse events were mild and infrequent.

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2002·International angiology : a journal of the International Union of Angiology·U Siebert, M Brach, G Sroczynski, et al

Efficacy, routine effectiveness, and safety of horsechestnut seed extract in the treatment of chronic venous insufficiency. A meta-analysis of randomized controlled trials and large observational studies.

Meta-analysisn = 11,776Inflammation Joint Bone Health

Meta-analysis of 13 RCTs and 3 observational studies evaluating horse chestnut seed extract (HCSE) for chronic venous insufficiency (CVI). HCSE improved symptoms such as leg volume, pain, edema, and itching compared to placebo, with no severe adverse events reported. Observational studies confirmed effectiveness for pain, edema, and leg fatigue/heaviness.

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2002·The Cochrane database of systematic reviews·M H Pittler, E Ernst

Horse chestnut seed extract for chronic venous insufficiency.

Systematic reviewn = 239

Systematic review of randomized controlled trials assessing the efficacy and safety of oral horse chestnut seed extract (HCSE) for chronic venous insufficiency (CVI). The review suggests HCSE improves CVI-related signs and symptoms, including leg pain and leg volume, compared to placebo. HCSE may be as effective as compression stockings, with mild and infrequent adverse effects.

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2024·F1000Research·Anuroop Singhai, Rajanikanth Kambala, Nitin Bhola

Comparison of the efficacy of aescin and diclofenac sodium in the management of postoperative sequelae and their effect on salivary Prostaglandin E2 and serum C-reactive protein levels after surgical removal of impacted mandibular third molar: a randomized, double-blind, controlled clinical trial.

RCTInflammation

This randomized, double-blind, controlled clinical trial compares the efficacy of aescin and diclofenac sodium in managing postoperative discomfort after the surgical removal of impacted mandibular third molars. The study evaluates their effects on salivary Prostaglandin E2 and serum C-reactive protein levels, as well as their effectiveness in managing pain, swelling, and mouth opening.

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2018·The Cochrane database of systematic reviews·Joanne R Morling, Su Ern Yeoh, Dinanda N Kolbach

Rutosides for prevention of post-thrombotic syndrome.

Systematic review

Systematic review aimed to determine the effectiveness and safety of rutosides for prevention of post-thrombotic syndrome (PTS) in patients with deep vein thrombosis (DVT). No studies were identified comparing rutosides versus any alternative in the prevention of PTS, indicating insufficient evidence to support their use as a preventative therapy.

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2015·The Cochrane database of systematic reviews·Joanne R Morling, Su Ern Yeoh, Dinanda N Kolbach

Rutosides for prevention of post-thrombotic syndrome.

Systematic review

Systematic review assessing the effectiveness and safety of rutosides for prevention of post-thrombotic syndrome (PTS) in patients with deep venous thrombosis (DVT). No studies were identified comparing rutosides versus any alternative in the prevention of PTS, indicating insufficient evidence for their use as a preventative therapy.

PubMedRead on PubMed
2013·The Cochrane database of systematic reviews·Joanne R Morling, Su Ern Yeoh, Dinanda N Kolbach

Rutosides for prevention of post-thrombotic syndrome.

Systematic review

Systematic review aimed to determine the effectiveness and safety of rutosides for prevention of post-thrombotic syndrome (PTS) in patients with deep venous thrombosis (DVT). No studies were identified comparing rutosides versus any alternative in the prevention of PTS, highlighting the need for high quality randomised controlled trials.

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2009·Phytomedicine : international journal of phytotherapy and phytopharmacology·Yujiang Fang, Lei Zhao, Feng Yan, et al

Escin improves sperm quality in male patients with varicocele-associated infertility.

RCTn = 219Sexual Health

RCT evaluating the efficacy of escin in improving sperm quality in 219 Chinese male patients with varicocele-associated infertility. The escin group showed significant improvements in sperm density and motility compared to the control group, with higher improvement rates in mild and moderate varicocele severity subgroups.

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2006·Advances in therapy·Andy Suter, Silvia Bommer, Jordan Rechner

Treatment of patients with venous insufficiency with fresh plant horse chestnut seed extract: a review of 5 clinical studies.

Meta-analysisInflammation

Meta-analysis of 5 clinical studies evaluating horse chestnut seed extract (HCSE) for chronic venous insufficiency. HCSE demonstrated effectiveness in reducing lower leg edema and alleviating symptoms like leg pain, heaviness, and itching. Aesculaforce, a fresh plant HCSE, is safe, well tolerated, and offers an alternative treatment for mild to moderate venous insufficiency.

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2011·Panminerva medica·R Luzzi, B Feragalli, G Belcaro, et al

Aescin: microcirculatory activity. Effects of accessory components on clinical and microcirculatory efficacy.

RCTSkin Hair Health

The study tested the effects of Aescin gel formulations with and without heparin and phosphatidylcholine (PDC) on patients with chronic venous insufficiency and diabetic microangiopathy. Aescin improved microcirculation and skin perfusion, with heparin and PDC serving as enhancers without independent effects. Improved perfusion and nutrition of the skin were observed, potentially reducing ulceration incidence.

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2009·World journal of surgery·Qiwei Xie, Xianglong Zong, Baoming Ge, et al

Pilot postoperative ileus study of escin in cancer patients after colorectal surgery.

RCTn = 72Gut Health

Pilot study of escin's effect on gastrointestinal motility in 72 postoperative colorectal cancer patients. Patients were randomized into four groups receiving different doses of escin or placebo. Escin treatment groups showed a reduction in time to recovery of passage of gas, gastrointestinal sounds, and bowel movements compared to placebo, indicating improved recovery of gastrointestinal motility.

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2008·Phytomedicine : international journal of phytotherapy and phytopharmacology·C P Siegers, S Syed Ali, M Tegtmeier

Aescin and troxerutin as a successful combination for the treatment of inner ear perfusion disturbances.

RCTn = 68

RCT comparing aescin and troxerutin combination to pentoxyfyllin in 68 patients with inner ear perfusion disturbances. Hearing significantly improved in 23 of 34 patients treated with aescin and troxerutin, with a threshold change of more than 10dB. Both treatments were well tolerated with no major adverse effects.

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2006·Journal of endourology·Marco De Sio, Riccardo Autorino, Giuseppe Di Lorenzo, et al

Medical expulsive treatment of distal-ureteral stones using tamsulosin: a single-center experience.

RCTn = 96

RCT of 96 patients with symptomatic distal-ureteral calculi comparing diclofenac plus aescin to the same therapy with added tamsulosin. The group with tamsulosin had a higher expulsion rate, shorter expulsion time, lower analgesic use, and fewer hospitalizations.

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2004·Angiology·I Ruffini, G Belcaro, M R Cesarone, et al

Efficacy of topical treatment with aescin + essential phospholipids gel in venous insufficiency and hypertension.

RCTSkin Hair Health Nutrition

RCT assessing the efficacy of aescin and essential phospholipids gel on skin perfusion in subjects with chronic venous insufficiency and venous hypertension. After 2 weeks, transcutaneous PO(2) values increased and PCO(2) values decreased, indicating improved skin perfusion and nutrition.

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2004·Angiology·G Belcaro, M R Cesarone, M Dugall

Microcirculatory efficacy of topical treatment with aescin + essential phospholipids gel in venous insufficiency and hypertension: new clinical observations.

RCTSkin Hair Health

RCT evaluating the efficacy of aescin + essential phospholipids (AEPL) topical gel on microcirculation in subjects with chronic venous insufficiency and venous hypertension. After 2 weeks of treatment, significant improvements in microcirculation were observed, with a decrease in skin flux indicating reduced venous microangiopathy.

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2002·British journal of sports medicine·D Wetzel, W Menke, R Dieter, et al

Escin/diethylammonium salicylate/heparin combination gels for the topical treatment of acute impact injuries: a randomised, double blind, placebo controlled, multicentre study.

RCTn = 158Inflammation

RCT investigating the efficacy and safety of escin-containing gels for treating blunt impact injuries in athletes. The gels with 1% and 2% escin were significantly more effective than placebo in reducing tenderness and providing rapid pain relief. The safety and tolerability were excellent.

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2001·International journal of sports medicine·H Pabst, B Segesser, M Bulitta, et al

Efficacy and tolerability of escin/diethylamine salicylate combination gels in patients with blunt injuries of the extremities.

RCTn = 126Physical Performance

RCT of 126 patients with blunt injuries of the extremities comparing escin/diethylamine salicylate combination gels to placebo. The active gels were significantly superior to placebo in reducing pain, with good tolerability and no adverse events.

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1998·Archives of dermatology·M H Pittler, E Ernst

Horse-chestnut seed extract for chronic venous insufficiency. A criteria-based systematic review.

Systematic review

Systematic review assessing horse-chestnut seed extract (HCSE) for chronic venous insufficiency (CVI). HCSE is suggested to be superior to placebo and as effective as reference medications in reducing lower-leg volume, leg circumference, and symptoms like leg pain and pruritus. Adverse effects are mild and infrequent.

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1996·Lancet (London, England)·C Diehm, H J Trampisch, S Lange, et al

Comparison of leg compression stocking and oral horse-chestnut seed extract therapy in patients with chronic venous insufficiency.

RCTn = 240Inflammation

RCT comparing the efficacy and safety of compression stockings and horse chestnut seed extract (HCSE) in 240 patients with chronic venous insufficiency. Both treatments significantly reduced lower leg volume compared to placebo, with HCSE showing a decrease of 43.8 mL and compression therapy 46.7 mL. Both therapies were well tolerated and considered equivalent in efficacy.

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2013·Drug design, development and therapy·T Iannitti, V Rottigni, B Palmieri

Corticosteroid transdermal delivery to target swelling, edema and inflammation following facial rejuvenation procedures.

RCTn = 40Inflammation

RCT comparing Betesil® plaster to aescin 10% cream in 40 patients after facial rejuvenation procedures. Betesil® significantly improved swelling, edema, and inflammation scores compared to aescin cream, though no significant difference was found in ecchymosis/hematoma scores. Patient satisfaction was higher with Betesil®.

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2005·Urological research·Riccardo Autorino, Marco De Sio, Rocco Damiano, et al

The use of tamsulosin in the medical treatment of ureteral calculi: where do we stand?

RCTn = 64

Prospective randomized study evaluating the effects of adding tamsulosin to standard therapy with diclofenac and aescin for ureteral stones. Group B, receiving tamsulosin, showed a higher stone expulsion rate and shorter expulsion time compared to Group A. Tamsulosin was effective in treating distal ureteral stones.

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2004·Clinical therapeutics·Felix Grases, Ramón García-González, Enrique Redondo, et al

Effects of escin on indinavir crystallization time in the urine of patients with HIV-I infection: a multicenter, randomized, open-label, controlled, four-period crossover trial.

RCTn = 47

This multicenter, randomized, open-label, controlled, four-period crossover trial examined the efficacy of escin in delaying indinavir crystallization time in the urine of HIV-1-infected patients. The study found that escin increased the mean crystallization time by 5.5 minutes, suggesting a potential method to prevent indinavir-associated nephrolithiasis. No significant adverse effects were reported.

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2004·Angiology·A Ricci, I Ruffini, M R Cesarone, et al

Variations in plasma free radicals with topical aescin + essential phospholipids gel in venous hypertension: new clinical data.

RCTn = 10Skin Hair Health

RCT evaluating the effects of topical Aescin + essential phospholipids (AEPL) gel on plasma free radicals in 10 patients with venous hypertension. Treatment with AEPL gel decreased plasma free radical values by over 30%, indicating improved skin perfusion and protection against deterioration.

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2004·Angiology·M R Cesarone, A Ricci, A Di Renzo, et al

Efficacy of topical treatment with aescin + essential phospholipids gel on capillary fragility.

RCTn = 10

Efficacy study evaluating the effect of topical treatment with aescin and essential phospholipids gel on capillary fragility in patients with chronic venous hypertension. The study used a vacuum suction chamber to assess local capillary fragility in the perimalleolar region of 10 patients.

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2003·Advances in therapy·Dagmar Bässler, Samuel Okpanyi, Andreas Schrödter, et al

Bioavailability of beta-aescin from horse chestnut seed extract: comparative clinical studies of two Galenic formulations.

RCTn = 36

Two randomized crossover clinical trials evaluated the bioavailability of beta-aescin from horse chestnut seed extract in 18 healthy volunteers each. The studies compared a nonretarded test medication with a retarded reference formulation, finding no significant difference in absorption rates. Bioequivalence was established for both formulations.

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1996·Arzneimittel-Forschung·D Rehn, M Unkauf, P Klein, et al

Comparative clinical efficacy and tolerability of oxerutins and horse chestnut extract in patients with chronic venous insufficiency.

RCTn = 137

RCT comparing the efficacy and tolerability of oxerutins and horse chestnut extract in 137 female, postmenopausal patients with chronic venous insufficiency. HR (1000 mg/d) was found to be equivalent or better in reducing leg volume compared to HR (1000 mg/d and 500 mg/d) and HCE-treatment. Both compounds showed a substantial carry-over effect.

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1993·Planta medica·C Calabrese, P Preston

Report of the results of a double-blind, randomized, single-dose trial of a topical 2% escin gel versus placebo in the acute treatment of experimentally-induced hematoma in volunteers.

RCT

A double-blind, randomized single-dose trial tested the efficiency of topically applied 2% escin gel versus placebo in reducing tenderness to pressure on experimentally induced hematoma in healthy volunteers.

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1992·VASA. Zeitschrift fur Gefasskrankheiten·C Diehm, D Vollbrecht, K Amendt, et al

Medical edema protection--clinical benefit in patients with chronic deep vein incompetence. A placebo controlled double blind study.

RCTn = 40

A randomized placebo-controlled double-blind study on 40 patients with venous edema due to chronic deep vein incompetence demonstrated that horse chestnut seed extract significantly reduced edema compared to placebo. Measurements confirmed the clinical efficacy of the extract in various conditions, suggesting it as a useful adjunct to compression therapy.

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2020·Journal of Basic and Clinical Physiology and Pharmacology·S. Idris, A. Mishra, M. Khushtar

Phytochemical, ethanomedicinal and pharmacological applications of escin from Aesculus hippocastanum L. towards future medicine

Review

This narrative review discusses the phytochemical, ethanomedicinal, and pharmacological applications of escin, a bioactive compound from Aesculus hippocastanum (horse chestnut). It highlights the potential use of horse chestnut extracts and escin in the prevention and treatment of various disorders such as venous congestion, arthritis, and rheumatism.

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