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To systematically evaluate the clinical efficacy and safety of Ginkgo Leaf Tablets(GLT) in the treatment of acute cerebral infarction(ACI). Seven databases both at home and abroad were systematically retrieved from their establishment to March 2020. The data of the included studies were extracted after review and screening. The quality of the included studies was assessed with the Cochrane risk bias assessment tool, and then the included studies were put into Meta-analysis by RevMan 5.3 to evaluate the total cli-nical efficiency, neurological function score, blood lipids and incidence of adverse reactions in treatment of ACI by GLT. Finally, the GRADE system was adopted to evaluate the evidence quality of each outcome indicator and form recommendations. Ten studies involving 886 participants were included, all of which were of low quality. Meta-analysis results showed that,(1)in terms of the total clinical efficiency, GLT+Western medicine was superior to Western medicine alone(RR_(NDS)=1.20, 95%CI[1.06, 1.36], P=0.005; RR_(NIHSS)=1.35, 95%CI[1.09, 1.69], P=0.007), and there was no statistical difference between GLT+Xuesaitong Injection+Wes-tern medicine and Xuesaitong Injection+Western medicine(RR=1.16, 95%CI[1.00, 1.35], P=0.05).(2)In terms of improving neurological function score, GLT+Western medicine was superior to Western medicine alone(MD_(NIHSS[moderate(severe)])=-1.55, 95%CI[-2.22,-0.88], P<0.000 01; MD_(NIHSS(severe))=-7.51, 95%CI[-8.00,-7.02], P<0.000 01; MD_(NDS)=-1.36, 95%CI[-2.39,-0.33], P=0.01), and GLT+Danshen Injection+Western medicine was superior to Danshen Injection+Western medicine(MD_(NDS)=-3.09, 95%CI[-3.84,-2.34], P<0.000 01).(3)In terms of regulating blood lipids, GLT+Western medicine was superior to Wes-tern medicine alone(MD_(TC)=-1.40, 95%CI[-2.13,-0.66], P=0.000 2; MD_(TG)=-1.29, 95%CI[-1.86,-0.73], P<0.000 01; MD_(LDL-C)=-1.48, 95%CI[-2.91,-0.04], P=0.04; MD_(HDL-C)=0.07, 95%CI[0.02, 0.12], P=0.009).(4)In terms of incidence of adverse reactions, there was no statistical difference between GLT+Western medicine and Western medicine alone(RR=0.63, 95%CI[0.30, 1.32], P=0.22). The results of the evaluation showed that the evidence level of each outcome indicator was low, and the recommendation was at weak level. In conclusion, GLT+Western medicine could improve the total clinical efficiency, neurological function score, and blood lipid status, with a low incidence of adverse reactions. However, due to the small amount of included stu-dies, low study quality and low level of evidence, it is expected to carry out clinical studies with standardized design and large sample size in the future to further investigate the clinical efficacy and safety of GLT in the treatment of ACI.
Subject(s)
Humans , Cerebral Infarction/drug therapy , Ginkgo biloba , Plant Leaves , Tablets , Treatment OutcomeABSTRACT
Objective To compare the pharmacokinetic parameters and bioavailability of terpene lactones in Beagle dogs between domestic and imported Ginkgo Leaf Tablets. Methods Beagle dogs were ig administrated demestic and imported Ginkgo Leaf Tablets, and then the plasma of Beagle dogs were detected. LC-MS was used to determine the contents of terpene lactones (including ginkgolide A, ginkgolide B, and ginkgo lactone) in plasma of Beagle dogs. Plasma concentration-time curves were drawn and analyzed by DAS software to obtain pharmacokinetics parameter. Results The area under curve (AUC0-t) of GA, GB, and BB in Beagle dogs after ig administration domestic Ginkgo Leaf Tablets was 51.64, 19.86, and 72.90 ng∙h/mL, while it was 69.98, 24.35, and 169.60 ng∙h/mL after ig administration imported G. biloba leaf extract tablets, respectively. According to the contents of three components in two preparations, the relative bioavailability of GA, GB, and BB of domestic Ginkgo Leaf Tablets respectively was 37.77%, 33.70%, and 95.98%. Conclusion The oral bioavailability of the terpene lactones in imported Ginkgo Leaf Tablets was significantly higher than that of domestic tablets.
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Objective To evaluate the efficacy and safety of oral ginkgo biloba extract EGB761 in patients with mild cognitive impairment.Methods They searched PubMed,Embase,the Cochrane Library ,CNKI,Wanfang and VIP databases for randomly controlled trials of oral ginkgo biloba extract for mild cognitive impairment.After assessed the quality of studies included,RevMan5.2 software was used to analyze data.Results Seven studies which including 815 patients were involved by our inclusion criteria.The results of meta-analysis showed,compared with the control group,ginkgo biloba was superior in improving mild cognitive impairment patients' MMSE level[MD=1.81,95%CI(0.02,3.60),P=0.05;MD=1.96,95%CI(1.48,2.43),P<0.000 01;MD=1.79,95%CI(0.99,2.58),P<0.000 1] after treated three months、six months and twelve months.Ginkgo biloba was also superior in improving mild cognitive impaimant patients.CDT level[MD=0.43,95%CI(0.30,0.57),P<0.000 01;MD=0.57,95%CI(0.39,0.75),P<0.000 01] after treated six months and twelve months.The effect of preventing MCI patients into dementia was better than that of the control group[RR=0.27,95%CI(0.06,1.27),P=0.10;RR=0.32,95%CI(0.16,0.63),P=0.001]after treated six months and twelve months.Conclusion Oral preparation of ginkgo biloba extract in the treatment of MCI clinical efficacy and prevention of dementia occurrence rate was better than that of blank control group.
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Objective To establish the characteristic spectrum of ginkgo leaf tablets,ginkgo leaf capsules,and ginkgo leaf dropping pills.Methods HPLC-ELSD analysis was performed on an Agilent Poroshell 120 EC-C18 column(150 mm×4.6 mm,2.7 μm)with the methanol-0.1% formic acid as mobile phase at the gradient elution mode,flow rate was 0.8 mL·min-1.Results Referring to the reference extract,a total of 12 peaks were established in the characteristic spectrum and selected as the characteristic common peaks.Conclusion The established method was simple and sensitive with good reproducibility,so it could be used to control the quality of ginkgo leaf preparations.