Evidence supporting the use of: Aescin
For the health condition: Sprains

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Synopsis

Source of validity: Scientific
Rating (out of 5): 3

Aescin, a mixture of triterpene saponins derived from horse chestnut seeds (Aesculus hippocastanum), has been investigated for its anti-inflammatory and anti-edematous properties. Its use in the treatment and support of sprains is primarily justified by scientific evidence, particularly for its ability to reduce swelling and inflammation in acute soft tissue injuries such as sprains.

Several randomized controlled trials and meta-analyses have evaluated topical and oral preparations of aescin for acute sports injuries, including ankle sprains. The results suggest that aescin can significantly reduce edema formation and improve symptoms compared to placebo. The proposed mechanism involves inhibition of enzymes like hyaluronidase and elastase, reduction of vascular permeability, and improvement in venous tone, all of which contribute to decreased swelling and inflammation.

Notably, a 2012 Cochrane review and other systematic reviews have pointed out that, although the quality of some clinical trials is moderate and sample sizes are often small, the overall trend supports the efficacy of aescin in reducing swelling in acute injuries. Side effects are generally mild and infrequent. Traditional use of horse chestnut for vascular conditions further supports its safety profile.

Given the available evidence, aescin is a scientifically justified option for adjunctive management of sprains, particularly for controlling edema, but it should not replace standard care such as rest, ice, compression, and elevation (RICE protocol).

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