Improving lymphatic drainage with herbal preparations: a potentially novel approach to management of lymphedema

Lymphedema is a potentially debilitating condition with particularly high incidence among breast cancer patients following surgery. Horsechestnut ('Aesculus hippocastanum') and butcher's broom ('Ruscus aculeatus') have been shown by herbalists to improve peripheral vascular circulation and lymphatic drainage. Nuclear medicine lymphoscintigraphy offers a tool to quantitate the effects of their combination in Horsechestnut Complex® on lymphatic drainage rates. Methods: A prospective clinical trial in 15 normal volunteers was undertaken using a repeat measures design. Bilateral upper limb lymphoscintigraphy was performed on each volunteer at baseline and following a 3 month course of Horsechestnut Complex®. Lymphatic drainage rates were quantitatively evaluated. Results: A significant increase was noted in the percentage of activity that migrated away from the injection site with respect to baseline versus follow up series. The baseline mean of 6.63% varied significantly from the follow up mean of 8.19% (p = 0.002) over a 2 hour sampling window. The matched pairs t test indicated a statistically significant difference (p = 0.017) with a mean increase in percentage migration of 1.56% after herbal treatment (95% CI 0.30% - 2.82%). Conclusion: The herbal formulation evaluated has the potential to accelerate lymphatic drainage in the normal population. A randomised controlled trial to evaluate the potential clinical benefits in breast cancer patients with post treatment lymphedema may be warranted.