银杏提取物对外周动脉阻塞性病人的血液流变学和行走的研究

AIM: To study the effects of Ginkgo biloba extract 761 (GbE) from the points of view of hemorheology for patients of peripheral arterial occlusive diseases (PAOD). METHODS: The treatment with GbE (240 mg.d-1, po) and the pain-free walking distance (PFWD) were carried out for 24 PAOD patients (12 nondiabetic, ND and 12 diabetic, D) over 48 wk. The parameters erythrocyte stiffness (ES) and relaxation time (RT), the blood plasma viscosity (eta), the plasma fibrinogen concentration (Cf) and the blood sedimentation rate (BSR), the PFWD, and maximal walking distance (MWD) were determined at 6 wk before treatment (-6), at the beginning of the treatment (0), and after 6, 11, 16, and 48 wk of treatment. RESULTS: At wk -6, ES and RT of both the ND- and D-group were not significantly different from a healthy control group. At wk 0, stiffness and RT were significantly higher than healthy control, and the mean PFWD was only 111 m. The eta value was significantly elevated and Cf and BSR were enhanced. Throughout 11 wk of treatment ES, RT, eta, and Cf decreased gradually and PFWD improved. Between 16 and 48 wk, ES, and RT were no longer significantly different from the controls, whereas eta and Cf decreased gradually but remained higher than normal, BSR decreased, and the PFWD improved by a factor of 3.8 times (D) and 3.3 times (ND). CONCLUSION: GbE gives therapeutic effects in PAOD patients.     

Ginkgo biloba special extract EGb 761 in the treatment of peripheral arterial occlusive disease (PAOD)--a review based on randomized, controlled studies

OBJECTIVE: The present review gives an overview and evaluation of clinical studies proving the efficacy of EGb 761 in patients with PAOD. METHODS: Relevant original papers and reports on this topic were identified by means of a literature search. Only randomized, double-blind, placebo-controlled clinical trials in patients with the indication peripheral arterial occlusive disease in stage II according to Fontaine were included (only treatment with the oral form of EGb 761). For the selected studies the ratio theta of the walking distance between EGb 761 and placebo was calculated and a test for relevant superiority of EGb 761 was performed (according to the guidelines of the Deutsche Gesellschaft für Angiologie (German Society of Angiology) [Heidrich et al. 1996]). Furthermore, a pooled estimation of the ratio was carried out. RESULTS: Nine studies complied with the criteria. The methodological quality and design of the trials were heterogeneous. In the majority of the studies, there was an advantage of EGb 761 in the increase of pain-free walking distance compared to placebo. For 7 studies, the advantage was found to be statistically significant. Testing the relevant superiority showed a significant result in 6 of the selected studies. The pooled estimator of the ratio amounts to theta = 1.23 (95% CI: 1.16, 1.31) and demonstrates the efficacy of EGb 761 over placebo as well. CONCLUSIONS: This review confirms the efficacy of Ginkgo biloba special extract EGb 761. It demonstrates not only the statistical significance of the difference with respect to placebo but also the clinical relevance for the treatment of patients with PAOD.     

银杏叶制剂的临床应用新进展

银杏叶为银杏科银杏属植物银杏（Ginkgo biloba L）的干燥叶,含有20多种黄酮类化合物（FG）,包括银杏双黄酮（Ginkgetin）、异银杏双黄酮（Lsoginkget）、7-去甲基银杏双黄酮（bilobe）以及特有的萜烯类,包括萜内酯化合物,此外,还有酚类、25种有益元素、17种氨基酸、生物碱等,     

银杏叶提取物用于治疗神经系统疾病的研究进展

目的：为进一步研究银杏叶提取物用于治疗神经系统疾病提供参考。方法：查阅近年来国内外有关银杏叶提取物治疗神经系统疾病的文献,对研究结果及作用机制进行分析。结果：银杏叶提取物治疗急性脑梗死、蛛网膜下腔出血、帕金森病和周围神经病时具有清除氧自由基、抗血小板和扩张脑部血管等作用且不良反应少,但对阿尔茨海默病的治疗价值尚存争议。结论：银杏叶提取物治疗多种神经系统疾病的效果较好,但用于阿尔茨海默病治疗尚需进一步研究。     

Ginkgo biloba extract (EGb 761) and CNS functions: basic studies and clinical applications

The effects of EGb 761 on the CNS underlie one of its major therapeutic indications; i.e., individuals suffering from deteriorating cerebral mechanisms related to age-associated impairments of memory, attention and other cognitive functions. EGb 761 is currently used as symptomatic treatment for cerebral insufficiency that occurs during normal ageing or which may be due to degenerative dementia, vascular dementia or mixed forms of both, and for neurosensory disturbances. Depressive symptoms of patients with Alzheimer's disease (AD) and aged non-Alzheimer patients may also respond to treatment with EGb 761 since this extract has an "anti-stress" effect. Basic and clinical studies, conducted both in vitro and in vivo, support these beneficial neuroprotective effects of EGb 761. EGb 761 has several major actions; it enhances cognition, improves blood rheology and tissue metabolism, and opposes the detrimental effects of ischaemia. Several mechanisms of action are useful in explaining how EGb 761 benefits patients with AD and other age-related, neurodegenerative disorders. In animals, EGb 761 possesses antioxidant and free radical-scavenging activities, it reverses age-related losses in brain alpha 1-adrenergic, 5-HT1A and muscarinic receptors, protects against ischaemic neuronal death, preserves the function of the hippocampal mossy fiber system, increases hippocampal high-affinity choline uptake, inhibits the down-regulation of hippocampal glucocorticoid receptors, enhances neuronal plasticity, and counteracts the cognitive deficits that follow stress or traumatic brain injury. Identified chemical constituents of EGb 761 have been associated with certain actions. Both flavonoid and ginkgolide constituents are involved in the free radical-scavenging and antioxidant effects of EGb 761 which decrease tissue levels of reactive oxygen species (ROS) and inhibit membrane lipid peroxidation. Regarding EGb 761-induced regulation of cerebral glucose utilization, bilobalide increases the respiratory control ratio of mitochondria by protecting against uncoupling of oxidative phosphorylation, thereby increasing ATP levels, a result that is supported by the finding that bilobalide increases the expression of the mitochondrial DNA-encoded COX III subunit of cytochrome oxidase. With regard to its "anti-stress" effect, EGb 761 acts via its ginkgolide constituents to decrease the expression of the peripheral benzodiazepine receptor (PBR) of the adrenal cortex.     

银杏叶提取物的免疫调节作用研究进展

银杏叶提取物是一种具有广泛生物学功能的活性物质。该文从免疫器官重量、单核巨噬细胞与自然杀伤细胞、体液免疫、细胞免疫、细胞因子以及红细胞免疫、粘膜免疫等方面综述了银杏叶提取物的免疫调节作用。     

银杏叶制剂临床应用回顾与评价

银杏叶为银杏科银杏属（Ginkgo bilobaL.）植物的叶部,主要化学成分为黄酮类和萜类化合物,具有重要的药用价值和市场价值,因此国内不少制药企业开发了许多银杏叶产品,但由于不同产地的银杏叶中黄酮类、萜类组分差异显著,加上一些银杏叶产品的浸膏质量不稳定、有农药残留等因素,所以制剂的质量不一。     

Ginkgo biloba extract ameliorates ischemia reperfusion-induced renal injury in rats.

There is increasing evidence to suggest that reactive oxygen metabolites (ROMs) play a role in the pathogenesis of ischemia/reperfusion injury (I/R) in the kidney. This study was designed to determine the possible protective effect of Ginkgo biloba extract (EGb) on renal ischemia/reperfusion (I/R) injury. Wistar albino rats were unilaterally nephrectomized, and 15 days later they were subjected to 45 min of renal pedicle occlusion followed by 6 h of reperfusion. Ginkgo biloba extract (EGb) (50 mg kg(-1) day(-1)) or saline was administered twice, 15 min prior to ischemia and immediately before the reperfusion period. At the end of the treatment period, all rats were decapitated. Kidney samples were taken for histological examination or determination of the renal malondialdehyde (MDA) and glutathione (GSH) levels, myeloperoxidase (MPO) activity and collagen content. Production of reactive oxidants was monitored by chemiluminescence (CL) assay. Creatinine and urea concentrations in blood were measured for the evaluation of renal function. Tumor necrosis factor-alpha (TNF-alpha) and lactate dehydrogenase (LDH) were also assayed in serum samples. Ischemia/reperfusion caused a significant decrease in GSH level, which was accompanied with significant increases in MDA level, MPO activity and collagen content of kidney tissues. Similarly, serum BUN and creatinine levels, as well as LDH and TNF-alpha, were elevated in the I/R group as compared to control group. On the other hand, EGb treatment reversed all these biochemical indices, as well as histopathological alterations, which were induced by I/R. The findings imply that ROMs play a causal role in I/R-induced renal injury and EGb exerts renoprotective effects probably by the radical scavenging and antioxidant activities.     

银杏叶提取物的研究进展

银杏是最古老的中生代植物,很早就被用作中药,其提取物近年来弓l起国际高度重视。银杏叶中含有黄酮和二萜内酯等化学成分,具有抗氧化、抗衰老等药理作用。综述银杏叶提取物的研发状况、化学成分和药理作用。     

Clinical use and molecular mechanisms of action of extract of Ginkgo biloba leaves in cardiovascular diseases

Ginkgo biloba is one of the oldest living tree species that has been referred to as a living fossil. Extract from Ginkgo biloba leaves (GBE) is among the most commonly used herbal drugs and is popularized for its alleged tonic effect and possible curative and restorative properties. There is an increasing evidence of the potential role of GBE in treating cardiovascular diseases. We examined the history of GBE usage and reviewed the literature on its effects on the cardiovascular system. In the extensive studies involving cell cultures and animal models, GBE has been shown to exert its action through diverse mechanisms. GBE has been reported to have antioxidatant properties, to modify vasomotor function, to reduce adhesion of blood cells to endothelium, to inhibit activation of platelets and smooth muscle cells, to affect ion channels, and to alter signal transduction. In addition, relevant clinical trials with CBE are being carried out, particularly in the treatment of arterial and venous insufficiency and in the prevention of thrombosis. Finally, the controversial clinical findings and the possible adverse interactions between GBE and other drugs are discussed. This review underscores the potential benefits of Ginkgo biloba in cardiovascular diseases, highlights the gaps in our current research, and suggests the necessity for more rigorous systematic investigation of cardiovascular properties of CBE.     

Effects of Ginkgo biloba extract on number and activity of endothelial progenitor cells from peripheral blood

The aim of this study is to investigate whether Ginkgo biloba extract can augment endothelial progenitor cells numbers, and promote the cells' proliferative, migratory, adhesive, and in vitro vasculogenesis capacity. Total mononuclear cells were isolated from peripheral blood by Ficoll density gradient centrifugation, and then the cells were plated on fibronectin-coated culture dishes. After 7 days culture, attached cells were stimulated with Ginkgo biloba extract (to make a series of final concentrations: 10 mg/L, 25 mg/L, and 50 mg/L) or vehicle control for the respective time points (6 hours, 12 hours, 24 hours, and 48 h). Endothelial progenitor cells were characterized as adherent cells double positive for DiLDL-uptake and lectin binding by direct fluorescent staining under a laser scanning confocal microscope. They were further documented by demonstrating the expression of KDR, VEGFR-2, and AC133 with flow cytometry. Endothelial progenitor cells proliferation, migration, and in vitro vasculogenesis activity were assayed with 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide assay, modified Boyden chamber assay, and in vitro vasculogenesis kit, respectively. Endothelial progenitor cells adhesion assay was performed by replating those on fibronectin-coated dishes, and then counting adherent cells. Incubation of isolated human mononuclear cells with Ginkgo biloba extract dose- and time-dependently increased the number of endothelial progenitor cells, maximum at 25 mg/L, 24 hours (approximately 1-fold increase, P < 0.01). In addition, Ginkgo biloba extract also dose- and time-dependently promoted endothelial progenitor cells proliferative, migratory, adhesive, and in vitro vasculogenesis capacity. The results of the present study defined a novel functional effect of Ginkgo biloba extract: the augmentation of endothelial progenitor cells with enhanced functional activity.     

银杏叶提取物的胃粘膜保护作用(英文)

目的:研究银杏叶提取物的胃粘膜保护作用.方法:采用大鼠束缚-冷冻应激(RCS)模型和小鼠无水乙醇损伤模型观察GbE对胃粘膜损伤指数的影响;采用幽门结扎法收集胃液,观察GbE对胃液分泌量,胃液酸度和胃蛋白酶活性的影响;采用硫代巴比妥酸(TBA)法测定胃粘膜及血清中丙二醛(MDA)含量.结果:GbE(25,50,100 mg/kg,bid×5 d,ig)剂量依赖性地抑制RCS和无水乙醇引起的胃粘膜损伤.用药组应激后的胃粘膜损伤指数分别为对照组的58％,43％和31％;用药组乙醇诱发的胃粘膜损伤指数降至对照组的62％,36％和26％;GbE尚能增强西米替丁对胃粘膜的保护作用,但对大鼠胃液分泌量、胃液酸度及胃蛋白酶活性GbE并无明显影响.小鼠经无水乙醇ig后1 h,胃粘膜和血清中的MDA含量显著升高(P<0.01),而GbE(25,50,100 mg/kg,ig)预处理则可以明显抑制MDA的升高.结论:GbE具有胃粘膜保护作用,并且与西米替丁在治疗急性胃粘膜损伤方面具有协同作用.     

Effect of Ginkgo biloba extract on microsomal enzyme induction

Twenty-four healthy volunteers were divided in three groups who were randomly assigned different treatments for 13 days: group I received 400 mg/day of a defined Ginkgo biloba extract (GBE), group II 300 mg/day of phenytoin and group III a placebo. The elimination half-life of antipyrine was measured with a high performance liquid chromatographic technique initially and on the last day of the administration of the treatments. The results show that the half-life of antipyrine was not affected by GBE and placebo treatments, whereas it was significantly decreased (p less than 0.05) frm 12.2 to 6.8 h after phenytoin control treatment. This study demonstrates that GBE has no effect on the hepatic microsomal drug oxidation system.     

银杏叶提取物的研究进展与应用前景

银杏是我国特有的一种中药材,具有活血、化淤、通络的功效,一般用于心脑血管疾病的防治。本文对银杏叶提取物的药理作用、服用剂量、制备工艺及应用前景等进行了总结与描述。