银杏叶制剂的临床新用途

银杏叶为银杏科植物银杏的叶，现代药理研究表明，银杏叶提取物中含有银杏黄酮苷、银杏内酯和白果内酯等多种活性成分,有抗自由基、抗血小板活性、降低血液粘度等多种药理作用。目前广泛用于治疗心脑血管疾病。现将近年来其在临床上的其他用途总结如下。     

银杏达莫注射液治疗急性脑梗死的疗效分析

银杏达莫注射液(杏丁注射液)为银杏叶提取物复方制剂,具有清除自由基、抗血小板聚集、改善血液流变学等药理作用.我们于2006年1～10月,对急性脑梗死患者加用银杏达莫注射液治疗,取得了较好疗效,现报道如下.     

银杏叶提取物对2型糖尿病大鼠肝纤维化的影响

2型糖尿病患者肝脏病变的标准化死亡率比远高于其心血管病变[1].但是,目前有关糖尿病性肝纤维化及药物干预的研究报道甚少.银杏叶提取物(EGB)是由银杏黄酮和银杏内酯组成的制剂,其药理作用主要为清除氧自由基、抑制破脂质过氧化,改善微循环等[2].本研究旨在观察银杏叶提取物对糖尿病大鼠肝纤维化病变的影响,并初步探讨其机制.     

影响银杏叶提取物提取的几点因素

银杏叶为银杏科植物银杏(Gingkgobiloba L.)的干燥叶,银杏黄酮是银杏叶中主要活性成分之一,银杏叶提取物在国内外医药、保健、化妆等领域已得到广泛应用,如何提高银杏叶提取     

冠心病患者银杏叶制剂治疗前后血液流变学特性改善的研究

近年来国内外的一些研究表明，银杏叶制荆由于内含黄酮甙和银杏苦内酯等．因而能降低毛细血管通透性，改善血管脆性．高效拈抗血小板活化因子引起的血小板聚集和微血栓形成，改善体内血液动力学和血液流变学特性．改善冠状动脉循环，增加冠脉流量，降低心肌耗氧量等，可用于动脉硬化、冠状动脉供血不足、心绞痛、心肌梗塞、脑血栓和脑血管痉挛等治疗。为探讨银杏叶制剂在治疗冠心病患时的改善血液流变学特性作用，本检测了76例冠心病患用。     

银杏叶制剂对脑血管病治疗的概况

近年来对银杏叶制剂（ＥＣＢ）研究表明，其有效成分主要是黄酮甙和银杏内酯。ＥＧＢ具有抑制血小板活化因子（ＰＡＦ）、清除自由基、促进血液循环、抑制血栓形成、缓解脑缺血缺氧及脑水肿、影响神经介质和改善学习记忆等作用。     

冠心病患者银杏叶制剂治疗前后血液流变学特性改善的研究

近年来国内外的一些研究表明,银杏叶制剂由于内含黄酮甙和银杏苦内酯等,因而能降低毛细血管通透性,改善血管脆性,高效拮抗血小板活化因子引起的血小板聚集和微血栓形成,改善体内血液动力学和血液流变学特性,改善冠状动脉循环,增加冠脉流量,降低心肌耗氧量等,可用于动脉硬化、冠状动脉供血不足、心绞痛、心肌梗塞、脑血栓和脑血管痉挛等治疗。为探讨银杏叶制剂在治疗冠心病患者时的改善血液流变学特性作用,本文检测了76例冠心病患者用“天保宁”(银杏叶制剂)治疗前后的红细胞压积、红细胞沉降率、红细胞沉降率方程K值、血浆纤维蛋白原、血浆粘度和切变率分别为4s.~(-1)、10s.~(-1)”、20s.~(-1)40s.~(-1)、     

银杏叶制剂对脑血管病治疗的概况

近年来对银杏叶制剂（ｅｘｔｒａｃｔｏｆＧｉｎｋｇｏＢｉｌｏｂａ，ＥＧＢ）研究表明，其有效成分主要是黄酮甙和银杏内酯。ＥＧＢ具有抑制血小板活化因子（ＰＡＦ）、清除自由基、促进血液循环、抑制血栓形成、缓解脑缺血缺氧及脑水肿、影响神经介质和改善学习记忆等作用     

银杏叶提取物抗动脉粥样硬化作用机制的研究进展

银杏叶提取物是从植物药银杏叶中提取的主要有效成份,近年国内外对它的药理作用机制作了大量研究,发现银杏叶提取物能通过保护血管内皮细胞、抗炎症、抗氧化应激、抑制血小板活化与聚集、调节脂代谢等多种机制发挥抗动脉粥样硬化作用。     

银杏叶制剂的心脑血管药理及其临床应用

作者就国内外近年来有关银杏叶制剂对心脑血管的药理与临床应用作一综述,指出银杏叶制剂在治疗肠血管疾病方面具有广阔的临床应用前景。     

Comparison of the hypotensive and bradycardic activity of ginkgo, garlic, and onion extracts

The acute effect of ethanol extracts ginkgo (Ginkgo biloba L.), garlic (Allium sativum L.), and onion (Allium cepa L.) on arterial blood pressure (BP), and heart rate (HR) in anesthetized normotensive rats was examined and compared. Arterial BP was registered in the left carotid artery. The data showed that intravenous administration of the extracts produced dose-dependent and reversible hypotensive and bradycardic effects. The most effective in reducing arterial BP and HR is extract of garlic. There were statistically significant differences in bradycardic and hypotensive effects of the garlic and ginkgo extracts.     

Effect of Ginkgo biloba (EGb 761) and aspirin on platelet aggregation and platelet function analysis among older adults at risk of cardiovascular disease: a randomized clinical trial.

Several case reports have implicated Ginkgo biloba in clinically adverse bleeding disorders. Ginkgo biloba has been reported to increase pain-free walking distance among patients with peripheral artery disease (PAD). Standard PAD therapy includes 325 mg/day aspirin. The objective of this study was to examine potential adverse effects of concomitant aspirin and Ginkgo biloba on platelet function. Ginkgo biloba (EGb 761, 300 mg/day) was compared with placebo for effects on measures of platelet aggregation among adults consuming 325 mg/day aspirin in a randomized, double-blind, placebo-controlled, parallel design trial of 4-week duration. Participants were adults, age 69 +/- 10 years, with PAD or risk factors for cardiovascular disease. Outcome measures included platelet function analysis (PFA-100 analyzer) using ADP as an agonist (n = 26 placebo; n = 29 ginkgo), and platelet aggregation using ADP, epinephrine, collagen and ristocetin as agonists (n = 21 placebo; n = 23 ginkgo). Participants kept daily logs of bleeding or bruising episodes. There were no clinically or statistically significant differences between treatment groups for any agonists, for either PFA-100 analysis or platelet aggregation. Reports of bleeding or bruising were infrequent and similar for both study groups. In conclusion, in older adults with PAD or cardiovascular disease risk, a relatively high dose of Ginkgo biloba combined with 325 mg/day daily aspirin did not have a clinically or statistically detectable impact on indices of coagulation examined over 4 weeks, compared with the effect of aspirin alone. No adverse bleeding events were observed, although the trial was limited to a small sample size.     

银杏酮酯滴丸治疗冠心病PCI术后的临床疗效观察

【摘要】 目的 探讨冠心病PCI术后患者应用银杏酮酯滴丸的临床疗效。方法 选择PCI术后患者273例,对照组131例常规给予西药治疗,治疗组142例在上述治疗的基础上给予加服银杏酮酯滴丸,治疗3个月后观察治疗前后患者临床症状、血脂水平及左室射血分数(EF)。结果 治疗3个月后治疗组患者在心绞痛稳定状态、心绞痛发作情况、躯体活动受限及治疗满意度评分均高于对照组患者(P<0.05)。治疗3个月后治疗组患者血清总胆固醇、甘油三酯及低密度脂蛋白胆固醇水平均低于对照组(P<0.05),两组患者EF值的比较差异无统计学意义(P>0.05)。结论 PCI术后常规给予口服银杏酮酯滴丸可缓解术后临床症状及减低血脂水平。     

Effects of Ginkgo biloba extract on cytoprotective factors in rats with duodenal ulcer

AIM:To investigate the effects of Ginkgo biloba extract on cytoprotective factors in rats with duodenal ulcer.METHODS: Sprague-Dawley rats were randomly divided into four groups: sham operation without ginkgo, sham operation with ginkgo, duodenal ulcer without ginkgo, and duodenal ulcer with ginkgo. Rats with duodenal ulcer were induced by 500mL/L acetic acid. Rats with ginkgo were intravenously injected with Ginkgo biloba extract from the tail at a dose of 0.5mg/(kg&#183;d) for 7 and 14 days.RESULTS:Pathological result showed that duodenal ulcer rats with ginkgo improved mucosal healing and inflammation compared with those without ginkgo after 7d treatment. After 14d treatment, duodenal ulcer rats with ginkgo significantly increased weight gain (34.0&#177;4.5g versus 24.5&#177;9.5g,P&lt;0.05) compared with those without ginkgo. Duodenal ulcer rats significantly increased cell proliferation (27.4&#177;4.0 and 27.8&#177;2.3 BrdU-labeled cells in duodenal ulcer rats with and without ginkgo versus 22.4&#177;3.5 and 20.8&#177;0.5 BrdUlabeled cells in sham operation rats with and without ginkgo,P&lt;0.05) compared with sham operation rats.Mucosal prostaglandin E2 concentration significantly increased by 129% (P&lt;0.05) in duodenal ulcer rats with ginkgo compared with that in those without ginkgo. Duodenal ulcer rats without ginkgo significantly decreased superoxide dismutase activity in the duodenal mucosa and erythrocytes (19.4&#177;6.7U/mg protein versus 38.1&#177;18.9U/mg protein in the duodenal mucosa,and 4.87&#177;1.49 U/rng protein versus 7.78&#177;2.16U/rng protein in erythroo/tes, P&lt;0.05) compared with sham operation rats without ginkgo. However, duodenal ulcer rats with ginkgo significantly increased erythrocyte superoxide dismutase activity (8.22&#177;1.92 U/mg protein versus 4.87&#177;1.49U/mg protein,P&lt;0.05) compared with those without ginkgo. Duodenal ulcer rats without ginkgo significantly increased plasma lipid peroxides (4.18&#177;1.12 μmol/mL versus 1.60&#177;1.10μmol/mL and 1.80&#177;0.73μmol/mL, P&lt;0.05) compared with sham operation rats without ginkgo and duodenal ulcer rats with ginkgo during the experimental period.CONCLUSION: Ginkgo biloba extract can improve weight gain and mucosal healing in duodenal ulcer rats by the actions of cytoprotection and antioxidation.     

Superoxide dismutase activity of Ginkgo biloba extract]

The Ginkgo biloba extract is obtained from green leaves of the Ginkgo biloba tree. Preparations with this active substance are among others used for the treatment of disturbances of the cerebral function and arteriosclerotic diseases. In in-vitro and in-vivo studies antagonistic effects of radical scavenger and PAF (platelet activating factor) were described. In this study a concentration-depending superoxide dismutase activity of the Ginkgo biloba extract r?kan liquid could be made evident.     

Use of an innovative model to evaluate mobility in seniors with lower-limb amputations of vascular origin: a pilot study

Background

The benefit of Ginkgo biloba has been discussed controversially. The aim of this review was to assess the effects of Ginkgo biloba in Alzheimer's disease as well as vascular and mixed dementia covering a variety of outcome domains.

Methods

We searched MEDLINE, EMBASE, the Cochrane databases, CINAHL and PsycINFO for controlled trials of ginkgo for Alzheimer's, vascular or mixed dementia. Studies had to be of a minimum of 12 weeks duration with at least ten participants per group. Clinical characteristics and outcomes were extracted. Meta-analysis results were expressed as risk ratios or standardized mean differences (SMD) in scores.

Results

Nine trials using the standardized extract EGb761^® met our inclusion criteria. Trials were of 12 to 52 weeks duration and included 2372 patients in total. In the meta-analysis, the SMDs in change scores for cognition were in favor of ginkgo compared to placebo (-0.58, 95% confidence interval [CI] -1.14; -0.01, p = 0.04), but did not show a statistically significant difference from placebo for activities in daily living (ADLs) (SMD = -0.32, 95% CI -0.66; 0.03, p = 0.08). Heterogeneity among studies was high. For the Alzheimer subgroup, the SMDs for ADLs and cognition outcomes were larger than for the whole group of dementias with statistical superiority for ginkgo also for ADL outcomes (SMD = -0.44, 95% CI -0.77; -0.12, p = 0.008). Drop-out rates and side effects did not differ between ginkgo and placebo. No consistent results were available for quality of life and neuropsychiatric symptoms, possibly due to the heterogeneity of the study populations.

Conclusions

Ginkgo biloba appears more effective than placebo. Effect sizes were moderate, while clinical relevance is, similar to other dementia drugs, difficult to determine.     

Connexin43在银杏叶片抑制兔动脉粥样硬化斑块形成中的作用

目的观察银杏叶片对兔动脉粥样硬化过程中血脂代谢及斑块形成的变化,探讨在兔动脉粥样硬化模型中银杏叶片对Connexin43（CX43）表达的影响。方法雄性实验兔40只,随机分为5组,每组8只,对照组普通饮食,其他4组高脂饮食,同时辛伐他丁组给予辛伐他丁灌胃、银杏叶片高低剂量组给予相应剂量的银杏叶片灌胃共12周,检测血脂、主动脉病理观察动脉硬化变化情况,运用免疫组化及Western blot检测主动脉CX43的表达情况。结果银杏叶片组兔的血脂较高脂饮食组下降,动脉粥样硬化的程度较高脂组减轻;CX43的表达较高脂组减少。结论银杏叶片具有轻度的降血脂作用,在一定程度上可以减轻高脂饮食兔动脉粥样硬化程度,这种作用可能是通过下调CX43的表达来实现的。     

银杏叶联合尼可地尔对药物洗脱支架治疗后老年冠心病患者多支病变的疗效分析

目的探究银杏叶联合尼可地尔对药物洗脱支架治疗后老年冠心病患者多支病变的疗效。方法选取我院经药物洗脱支架治疗后的老年冠心病多支病变患者128例,根据治疗方案的不同将其分为研究组和对照组各64例。2组入院后均给予尼可地尔治疗,在此基础上,研究组加银杏叶连续治疗4周。比较2组治疗前后心绞痛、左心室功能及斑块稳定性等,观察2组治疗后6个月复发性心绞痛发生情况。结果研究组总有效率明显高于对照组(95.31%vs 81.25%,P=0.013);治疗后4周,研究组心绞痛发作次数、心绞痛持续时间、硝酸甘油用量均明显低于对照组(P<0.01);治疗后研究组左心室收缩末期内径、高敏C反应蛋白、白细胞介素6等均明显低于对照组(P<0.01),LVEF、心排血量明显高于对照组(P<0.01);治疗后6个月研究组心绞痛复发率显著低于对照组(7.81%vs 23.44%,P<0.05)。结论银杏叶联合尼可地尔可减少经药物洗脱支架治疗后老年冠心病多支病变患者复发性心绞痛的发生,同时能缓解血管炎性反应,利于提升斑块稳定性。     

银杏外种皮提取物杀灭钉螺效果的研究

目的 　观察银杏外种皮石油醚提取物（主要成分为银杏酸，含量为64%）、槟榔碱及两药伍用杀灭钉螺效果及对斑马鱼急性毒性。 方法 取7～8螺层、活力强的钉螺，用银杏外种皮干粉、水提取物和石油醚提取物3种制剂以及银杏外种皮石油醚提取物与槟榔碱伍用，采用WHO“杀螺剂实验室终筛方法”中的浸泡法，进行浸杀钉螺试验、钉螺上爬试验以及斑马鱼急性毒性试验。 3项试验均以氯硝柳胺为对照。 结果 　银杏外种皮3种制剂随浸泡时间延长浸杀效果明显提高。 其中，石油醚提取物浸杀效果较好， 浸泡24 h LC₅₀和LC₉₀分别为0.65 mg/L和5.50 mg/L，48 h 分别为0.07 mg/L和0.85 mg/L； 72 h钉螺死亡率近100%。与槟榔碱伍用, 浸杀效果明显提高, 浸泡24 h 银杏外种皮石油醚提取物LC₅₀和LC₉₀分别为0.26 mg/L 和0.56 mg/L，较银杏外种皮石油醚提取物单药LC₅₀降低60%，LC₉₀降低90%(P值均<0.05)。2.50 mg/L银杏外种皮石油醚提取物24 h总上爬率为10%；两药伍用，其银杏外种皮石油醚提取物0.16 mg/L上爬率仅为8%，提高了其抑制钉螺上爬效果。1倍LC₉₀和2倍LC₉₀浓度的银杏外种皮石油醚提取物，斑马鱼存活时间分别为24 h和10 h；伍用后，24 h斑马鱼在2倍LC₉₀浓度中未见死亡，48 h内死亡率为50%，伍用对斑马鱼急性毒性较低。 结论 银杏外种皮石油醚提取物有较好的灭螺效果，是具有研究价值的灭螺植物。     

银杏叶制剂对缺氧性肺动脉高压的影响及其与蛋白激酶C …

OBJECTIVE: To elucidate whether the mechanism of relieving hypoxic hypertension by ginkgo biloba involves attenuation of the function of protein kinase C(PKC) signal channel. METHODS: 1. Wistar rats were randomly divided into control(C), hypoxic(H) and ginkgo biloba treatment(GB + H) (200 mg.kg-1.d-1, orally) groups (n = 7). Each rat was first measured mean pulmonary arterial pressure (mPAP), mean systemic arterial pressure (mSAP) and the ratio of the weight of right ventricle to that of left ventricle plus septum [RV/(LV + S)], than two main pulmonary artery rings were isolated to exposed to PDBu(a specific activator of PKC) to observe the time-response curve and the dose-response curve in response to 500 nmol/L PDBu and 10-11,000 nmol/L PDBu respectively to evaluate the function of protein kinase C signal channel. 2. Intrapulmonary artery rings of human(IARH) from pneumolobectomy were randomly divided into PDBu, RO318220 (inhibitor of PKC) + PDBu and ginkgolide B(BN52021) + PDBu groups(n = 6), the IARH of three groups were exposed to 1-25 nmol/L PDBu to achieve dose-response curves respectively. RESULTS: (1) mPAP, RV/(LV + S) of the H group were greater than those of C and GB + H groups respectively (P < 0.05). mPAP of GB + H group was greater than that of C group (P < 0.05). In PA experiments, the function of protein kinase C of H group was higher than those of C and GB + H groups respectively(P < 0.05). (2) In IARH experiments, the function of protein kinase C of PDBu group was higher than those of RO318220 + PDBu and BN52021 + PDBu groups respectively(P < 0.05). CONCLUSIONS: Ginkgo biloba can reduce chronic hypoxic pulmonary hypertension and relieve the hypertrophy of right ventricle, which is partly related to attenuation of the function of PKC signal channel.