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The Benefits of Ginseng Trafitional our mailing list and help us with a Metabolic syndrome management donation today. We thank you for your support! American ginseng Panax quinquefolius. Photo by Dan J. Pittillo, U. Fish and Wildlife Service.Ginseng for traditional medicine -
All studies were conducted in China. One study was written in English Wang et al. The sample size ranged from 10 participants per arm to participants per arm. Ages ranged from Five ginseng-containing TCMs were included.
Twelve studies were interacted with Shenfu injection SFI Zhao, ; Zhao et al. Nine studies were interacted with Shenmai injection SMI Feng, ; Fu et al.
Four studies were interacted with Shengmai injection SGMI Chang and Yang, ; Xiong and Zhou, ; Zhang et al. One study was interacted with Yangxinshi tablets YXST Sun et al. The detailed compositions of the ginseng-containing TCMs are listed in Table 2. The names of the botanical drugs were standardized by the Kew Medicinal Plant Names Services MPNS.
However, most botanical drugs are protected by patents, so we do not have access to information on ingredient dosages and extraction processes.
We found that all included studies did not mention the quality control and chemical analysis in the trials. TABLE 3. The source, quality control and chemical analysis of five ginseng-containing TCM.
Eleven studies Pan, ; Zhen et al. The duration of treatment differed by 3 days— days. Figure 2 depicts the risk of bias for all included studies, ranging from low to high. We also assess the quality of the studies with modified Jadad scores Supplementary Table S5.
The score ranged from one to 8. All 28 studies referred to randomization, in which 13 used a randomized number table Ai and Xu, ; Feng, ; Fu et al.
One used a randomized program Wang et al. Two studies Deng, ; Wang et al. The other 26 studies did not mention blinding methods and allocation hiding. Overall, two studies were low risk, and one study was of a high risk, the other 25 was of some concerns Supplementary Table S4.
According to the modified Jadad scores Supplementary Table S5 , 15 studies are low quality, and the lowest score is 1 Sun et al. Allocation hiding is common in the low-quality study.
Though the other 13 studies are with a high quality, most studies scored 4. One study scored 5 Deng, and one study scored 7 Wang et al. Overall, the quality of included studies was low. Randomised methods and blinding were the most significant factors limiting the quality of included studies.
FIGURE 2. Risk of bias summary and diagram. A Risk of bias summary. B Risk of bias diagram. Twenty-one trials Ai and Xu, ; Chang and Yang, ; Feng, ; Fu et al.
The meta-analysis discovered that ginseng-containing TCM improved the HFES with compelling homogeneity RR: 1. Six trials Zhen et al. The results indicated that ginseng-containing treatment led to an increase in CSS RR: 1.
However, two articles Pan, ; Zhang, did not mention an efficacy standard. Compared with WT, ginseng-containing TCM improved clinical efficacy RR: 1.
Therefore, ginseng-containing TCM could improve clinical efficacy in the HFES, CSS, and other measurements. Twenty-three studies Ai and Xu, ; Chang and Yang, ; Deng, ; Fu et al. Compared with WT, the combination with ginseng-containing TCM led to an increase in LVEF values MD: 5.
FIGURE 4. Meta-analysis results of LVEF between the experimental and control groupsL VEF, left ventricular ejection fraction. All studies recorded mortality, with the control group recording only one death.
Two studies recorded 6-month readmission rate Sun et al. Heart structure was measured using LVEDD, SV, and LVEDV. Heart function was measured based on BNP or NT-proBNP levels.
Ten studies Ai and Xu, ; Feng, ; Fu et al. SV improved in six trials Huang, ; Ye et al. LVEDV improvement Li et al. For heart function, eight trials Fu et al. Seven studies Zhao, ; Zhao et al. Quality of life was measured using the 6-MWT and MLHFQ. According to the results, compared with WT, statistics showed an increase in 6-MWT MD: Six studies Feng, ; Li et al.
The results demonstrated that ginseng-containing TCM treatment decreased MLHFQ scores MD: 9. Sixteen studies documented adverse cases: six trials Deng, ; Huang et al. Thirteen adverse reactions and cases erythema, headache, arrhythmia, dizziness, vomiting, nausea, red face, chest tightness, chills, liver dysfunction, renal dysfunction, hypokalemia, and low blood pressure were recorded.
One study recorded the length of hospitalization Zhao, , one recorded the integration of dyspnea, edema, and pulmonary rales Zhang and Zhang, , one recorded the efficacy of dyspnea, edema, and pulmonary rales Ai and Xu, , and one recorded the physical fitness of patients Zhang, Y.
Since different interactions, treatment duration was performed in the test groups and control groups, a subgroup analysis was performed to eliminate the effects of confounding factors on the outcomes.
Subgroup studies were conducted according to drug type, treatment duration, and LVEF values. As shown in Table 5 and Supplementary Table S5 , the results of the subgroup analysis were consistent with the overall study results.
After subgroup analysis, heterogeneity was significantly reduced for LVEF, suggesting that treatment duration, drug type, and LVEF may be the source of heterogeneity.
The main outcomes, encompassing the HFES and LVEF, were tested using a sensitivity analysis, which involved removing each trial to assess the robustness of the main outcome. The pooled RR values of the HFES and the MD values of the LVEF were stable, as shown in Supplementary Figures 9 and TSA of the effect of ginseng-containing TCM versus WT on HFES was performed.
In a random-effects model, the TSA-adjusted CI for the meta-analysis of HFES had an RR of 0. In the meta-analysis of ginseng-containing TCM efficacy, the point estimate of the possible intervention effect proposed by a trial with a low risk of bias Wang et al.
The cumulative Z-curve blue line breaks through the conventional statistical boundary green line , trial sequential monitoring boundary for benefit red inward sloping line , and RIS boundary red line with an estimated value of 2, participants, indicating that sufficient information was applied to prove the reliability of HFES.
In contrast, the RIS for the TSA of LVEF was 7, participants based on the intervention effect. In the meta-analysis of the effect of ginseng-containing TCM on LVEF, given by the empirical bias trials, the point estimate of the possible intervention effect was an MD of 5.
The cumulative Z-curve blue line passes the conventional statistical boundary green line and the trial sequential monitoring boundary for benefit red inward sloping line but not the RIS boundary red line , indicating the availability of sufficient evidence to prove that ginseng-containing TCM may enhance LVEF; however, the expected values were not attained Figure 6.
FIGURE 6. TSA of LVEF, left ventricular ejection fraction; TSA, trial sequential analysis. Publication bias was assessed on the outcomes of more than 10 trials.
Our meta-analysis first evaluated the clinical efficacy of ginseng-containing TCM in patients with ADHF with 28 studies. Chinese medicine, especially ginseng-containing TCM, plays an indispensable role in the integrated Chinese and Western medicine treatment of cardiovascular diseases in China and is widely used in patients with ADHF.
Ginsenosides are the most active ingredients of ginseng. More than ginsenosides have been isolated, and the most widely studied include Rg1, Rb1, Re, and Rg3. Available studies have demonstrated that ginsenosides exert their anti-heart failure effects mainly through the inhibition of apoptosis, anti-inflammatory response Ma et al.
In TCM, qi deficiency is the main pathogenic mechanism underlying heart failure, and ginseng tonifies vital energy to restore yang and rescue rebellion. However, evidence of the efficacy of ginseng-containing TCM for treating ADHF is limited.
The main outcomes of our meta-analysis are clinical efficacy and LVEF. HFES and CSS were two mostly used measurements in the including study. HFES was defined with the NYHA improvement while CSS was defined by the change in Chinese syndrome.
It is worth pointing out that in most of the studies, patients with ADHF were rarely treated according to syndrome differentiation, which is contrary to the theory of Chinese medicine. Only four studies mentioned TCM syndrome, including Qi and Yin deficiency, Heart and Kidney Yang deficiency, Yang and Qi deficiency and Yang deficiency and Blood stasis.
This is one of the reasons why CSS has not been reported in most studies. LVEF is another cornerstone of HF diagnosis, characterization, prognosis, patient triage and treatment selection. In our study, we find that with ginseng-containing TCM, the LVEF of patients could be improved.
Left ventricular remodeling is an important etiology of heart failure. Several studies have discovered that LVEDD, LVEDV, and SV are important prognostic predictors in patients with cardiovascular disease recurrence of atrial fibrillation during hospitalization Solomon et al.
The results of this study suggest that ginseng-containing TCM treatments can reduce LVEDD and LVEDV and improve SV in patients, implying that ginseng may inhibit left ventricular remodeling in ADHF. However, limited data may lead to false-positive outcomes, and the high heterogeneity may be due to differences in patients at baseline weight, gender and WT.
Therefore, further studies should be performed to confirm its efficacy. In recent studies, BNP and NT-proBNP levels were considered independent predictors of mortality in patients with ADHF. Higher BNP or NT-proBNP levels at admission have been reported to predict mortality risk in patients Santaguida et al.
In our study, ginseng-containing TCM led to a reduction in BNP and NT-proBNP levels in patients with ADHF. However, none of included studies reported a half-year or 1-year survival rate.
Therefore, we did not know whether ginseng-containing TCM improved survival rates. Poor quality of life is another problem in patients with ADHF. A 6-MWT limited to m is common in patients with ADHF Pandey et al. In our study, the 6-MWT improved and MLHFQ scores reduced, following treatment with ginseng-containing TCM.
Most of the time, ginseng has been reported to protect heart tissues from damage Davis and Behm, ; however, cardiotoxic effects have also been recorded in some clinical and experimental publications Parlakpinar et al. Our study also listed adverse reactions and cases in trials conducted on the safety of ginseng-containing TCM in patients with ADHF.
Ten trials reported adverse cases out of the 17 RCTs that recorded adverse reactions. According to the report, dizziness, renal dysfunction, nausea, and vomiting are the most common adverse reactions and cases during the treatment of ADHF.
Moreover, ginseng-containing TCM treatment did not increase the risk of adverse reactions and cases; instead, it reduced dizziness, suggesting the safety of ginseng-containing TCM.
To our knowledge, only one meta-analysis of botanical drugs interventions in ADHF has been conducted in the literature Ji, Compare with the meta-analysis conducted by Ji et al. In addition, TSA was performed to increase the credibility of the results.
The addition of 6-month readmission rate, BNP, MLHFQ, and specific analysis of side effects or outcomes provided a complete theoretical basis for the efficacy and safety of ginseng-containing TCM in the treatment of ADHF. Since most results are of a high heterogeneity, we performed a subgroup analysis according to drug type, treatment duration and LVEF values.
The results of the subgroup analysis were consistent with the overall study results indicating Ginseng-containing TCM is effective in patients with ADHF, independent of drug types, treatment period and patient EF value.
For some indicators, heterogeneity decreased after subgroup analysis. The above analysis suggests that drug types, LVEF values and treatment duration may be a source of heterogeneity.
Another reason for the heterogeneity was the uncertain risk of bias and low quality of the included studies. According to the Rob two measurement, twenty-five studies were with some concerns because of without mentioning blinding methods and allocation hiding.
The quality of the included studies was measured by the modified Jadad Scores and. Results suggesting 14 included studies are of low quality. One study was measured with a high risk and the Jadad score was 1, which can also brought the heterogeneity.
Lastly, the complexity of ADHF, etiology, disease history, nursing treatment, western treatment strategies, and ginseng origin may all contribute to heterogeneity. There are some differences from the earlier guideline. Firstly, the classification of HF based on LVEF was revised.
Heart failure with improved ejection fraction HFimpEF was invented in the guideline. Secondly, SGLT-2i was recommended to HFrEF to reduce the rehospitalization. The above changes in the new guidelines imply us that we can explore ginseng-containing TCM in HFimpEF as well as the RCT interacted with the combine of ginseng and SGLT-2i.
This study had several limitations. Firstly, a high risk of bias exists owing to the lack of blinding and unclear randomization methods. The low quality of the included studies could weaken the confidence of the results.
Secondly, substantial heterogeneity was observed in most outcomes, except for efficacy and adverse reaction and cases. Additionally, oral take ginseng-related decoction was less reported in the ADHF clinical trials. Due to patent protection, we are only able to list the main components of the drugs included, but the extraction process and dosage of the botanical drugs are not known.
None of the study reported the quality control and chemical analysis. Finally, few reports of follow-up and re-hospitalization recorded in RCTs, leading to the failure of our study to analyses ginseng on the survival of ADHF patients.
All in all, this meta-analysis implies future directions for clinical trials as follow. Firstly, more high-quality RCTs should be conducted to strengthen this evidence, focusing on implementing subject-centered randomization, allocation concealment, and blinding. Moreover, RCTs should be reported completely and comprehensively using the consolidated standards of reporting trials statement Schulz et al.
Thirdly, network meta-analysis can also be performed to compare the differences in ginseng-containing TCM use. More research in specific areas is required to assess the role of these factors in heterogeneity fully, and more clinical trials interacted by oral ginseng-related decoction could be performed to enhance the evidence for ginseng-containing TCM in ADHF.
Lastly, with the knowledge of ADHF developed, we can also explore ginseng-containing TCM in HFimpEF as well as the RCT interacted with the combine of ginseng and SGLT-2i.
Summarily, compared with WT alone, ginseng-containing TCM is a possible way to benefit ADHF patients. Therefore, we should pay more attention to ginseng-containing TCM clinical trials on patients with ADHF.
More carefully designed larger-sample, long-term follow-up RCTs should be conducted in the future to provide reliable evidence for the use of ginseng-containing TCM in treating ADHF. The research was designed by DF and MW. YM, XC, and LY performed a literature search and article selection, BL and XZ assessed methodological bias risk and performed data extraction.
JL, MG, MW conducted a meta-analysis and assessed study quality. XC finished the manuscript draft. All authors contributed to the article and approved the submitted version. This study was supported by the National Natural Science Foundation of China grant numbers and and the Project of Shanghai University of Traditional Medicine grant number LK The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers.
Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
ADHF, Acute decompensated heart failure; BNP, Brain natriuretic peptide; CI, Confidence interval; CSS, Chinese syndrome score; HFES, Heart function efficiency standard; HFimpEF, Heart failure with improved ejection fraction; LVEF, Left ventricular ejection fraction; LVEDD, Left ventricular end-diastolic diameter; LVEDV, Left ventricular end-diastolic volume; MD, Mean difference; MLHFQ, Minnesota living heart failure questionnaire; NT-proBNP, N-terminal pro-B-type natriuretic peptide; QLXX, Qili Qiangxin; RIS, Required information size; RCTs, Randomized controlled trials; RR, Risk ratio; REM, random-effects model; SV, Stroke volume; SMI, Shenmai injection; SGMI, Shengmai injection; SFI, Shenfu injection; 6-MWT, Six-minute walk test; TCM, Traditional Chinese medicine; TSA, Trial sequential analysis; WT, Western therapy; YXST, Yangxinshi tablets.
Ai, K. Clinical effect of Qiliqiangxin capsule in treatment of patients with acute attack of chronic heart failure. Google Scholar.
An, L. Effectiveness of combining recombinant human brain natriuretic peptide with injectable Yiqi Fumai in the treatment of ADHF in elderly people with coronary artery disease.
China 14, 85— Benjamin, E. Additionally, ginseng may reduce the effectiveness of anticoagulant drugs Note that due to the lack of safety studies, ginseng is not recommended for children or people who are pregnant or breastfeeding Lastly, there is evidence suggesting that the extended use of ginseng could decrease its effectiveness in the body.
To maximize its benefits, you should take ginseng in 2—3-week cycles with a one or two week break in between While ginseng appears to be safe, people taking certain medications should pay attention to possible drug interactions.
Ginseng is an herbal supplement that has been used for centuries in Chinese medicine. It is commonly touted for its antioxidant and anti-inflammatory effects. It could also help regulate blood sugar levels and have benefits for certain types of cancer. Ginseng can be consumed raw or lightly steamed.
It can also easily be added to your diet as a supplement and is available in extract, capsule, or powder form. Whether you want to improve a certain condition or simply give your health a boost, ginseng may be worth a try. Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.
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A Quiz for Teens Are You a Workaholic? How Well Do You Sleep? Health Conditions Discover Plan Connect. Nutrition Evidence Based 7 Proven Health Benefits of Ginseng. Medically reviewed by Kathy W. Warwick, R. Reduces inflammation Benefits brain function Improves erectile dysfunction Boosts immunity Protects against cancer Fights fatigue Lowers blood sugar How to use Safety Bottom line Ginseng is an herb that is rich in antioxidants.
Contains antioxidants that may reduce inflammation. May benefit brain function. Could improve erectile dysfunction. May boost the immune system.
May have potential benefits against cancer. May fight tiredness and increase energy levels. Could lower blood sugar. Easy to add to your diet. Safety and potential side effects. The bottom line. How we reviewed this article: History. The HMPC conclusions cover white and red ginseng root preparations which are obtained by drying and comminuting reducing into tiny pieces or powdering the root, or as dry, soft and liquid extracts.
Extracts are obtained by putting the plant material in a solvent such as ethanol or methanol to dissolve compounds and form a liquid extract.
The solvent is then partially or completely evaporated to obtain a soft or dry extract. Herbal medicines containing these ginseng root preparations are usually available as herbal tea to be drunk and in liquid or solid forms to be taken by mouth.
Ginseng root preparations may also be found in combination with other herbal substances in some herbal medicines. These combinations are not covered in this summary. The HMPC concluded that, on the basis of its long-standing use, these ginseng root preparations can be used for treating tiredness and weakness.
Ginseng root medicines should only be used in adults and may be taken for up to 3 months. If symptoms last longer than 2 weeks or worsen during the use of the medicine, a doctor or a qualified healthcare practitioner should be consulted. Detailed instructions on how to take ginseng root medicines and who can use them can be found in the package leaflet that comes with the medicine.
The HMPC conclusions on the use of these ginseng root medicines for tiredness and weakness are based on their 'traditional use'. This means that, although there is insufficient evidence from clinical trials, the effectiveness of these herbal medicines is plausible and there is evidence that they have been used safely in this way for at least 30 years including at least 15 years within the EU.
Moreover, the intended use does not require medical supervision. In its assessment, the HMPC considered numerous animal studies which showed effects of ginseng root medicines on the nervous system, metabolism, the heart and circulation, the immune system, sexual organs and skin.
The HMPC also considered several clinical studies on the effects of ginseng root medicines in patients' brain function and vitality. Although some possible beneficial effects were observed, shortcomings in the design of the studies and inconsistent findings prevented any firm conclusions being drawn on the benefits of treating tiredness and weakness.
Therefore, the HMPC conclusions on the use of these ginseng root medicines are based on their long-standing use. Side effects reported with ginseng medicines include allergic reactions such as itching and itchy rash , insomnia difficulty sleeping and gastrointestinal problems such as stomach discomfort, nausea, vomiting, diarrhoea and constipation.
Further information on the risks associated with these ginseng root medicines, including the appropriate precautions for their safe use, can be found in the monograph under the tab 'All documents'.
Any applications for the licensing of medicines containing ginseng root have to be submitted to the national authorities responsible for medicinal products, which will assess the application for the herbal medicine and take into account the scientific conclusions of the HMPC.
Information on the use and licensing of ginseng root medicines in EU Member States should be obtained from the relevant national authorities.
Tradtional Ginseng for traditional medicine these medicinf are in the Araliaceae plant medjcine, but each has its own Ginseng for traditional medicine effects trditional the body. Panax ginseng is Ginseng for traditional medicine of the most commonly used and highly researched species of ginseng. This species, which is native Ginsenng China, Korea, and Metabolic syndrome management, has been an Ttraditional herbal ofr in trraditional Chinese Embracing natural body variations for Ginsenng of years, where it has been used primarily as a treatment for weakness and fatigue. The main active agents in Panax ginseng are ginsenosides, which are triterpene saponins. The majority of published research on the medicinal activity of Panax ginseng has focused on ginsenosides. Research reviews 24 postulate that extracts of Panax ginseng affect the hypothalamus-pituitary-adrenal axis and the immune system, which could account for many of the documented effects. Animal models and in vitro studies mentioned in these reviews 24 indicate that Panax ginseng enhances phagocytosis, natural killer cell activity, and the production of interferon; improves physical and mental performance in mice and rats; causes vasodilation; increases resistance to exogenous stress factors; and affects hypoglycemic activity.
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