银杏叶提取物质量标准比较及标准提高思路探讨

银杏叶提取物（GBE）及其制剂在国内外广泛用于治疗心脑血管疾病。作者通过比较各国药典中GBE质量标准,对不同国家标准中的主要检测指标进行比较,并进一步与另一种GBE—银杏酮酯（GBE50）质量标准作对比分析。在此基础上,作者对GBE质量标准提高思路进行了探讨,目的为提高GBE的质量可控性,也为类似的天然药物提取物质量标准内容的选择提供参考。     

银杏叶提取物质量标准比较及标准提高思路探讨

银杏叶提取物(GBE)及其制剂在国内外广泛用于治疗心脑血管疾病。作者通过比较各国药典中GBE质量标准,对不同国家标准中的主要检测指标进行比较,并进一步与另一种GBE—银杏酮酯(GBE50)质量标准作对比分析。在此基础上,作者对GBE质量标准提高思路进行了探讨,目的为提高GBE的质量可控性,也为类似的天然药物提取物质量标准内容的选择提供参考。     

银杏叶提取物对细胞色素P450影响的研究进展

银杏叶提取物(Ginkgo biloba extract,GBE)是目前使用最为广泛的中草药之一。GBE与其他药物合用是否产生药物相互作用得到关注。GBE与其他药物合用,可能通过影响肝药酶的活性发生药物相互作用,其中GBE对肝药酶的诱导或抑制作用的研究较为深入。本综述回顾了近年来报道的关于GBE对细胞色素P450 CYP3A4、CYP2C9、CYP1A2、CYP2C19的影响。     

银杏提取物-羟丙基-β-环糊精包合物的工艺优选及鉴定

目的:筛选制备银杏提取物与羟丙基-β-环糊精(HP-β-CD)包合物的最佳工艺,并进行包合物的鉴定。方法:采用正交设计试验,以包合率为指标筛选最佳工艺条件,以溶液-搅拌法制备包合物;以相溶解度法、差示扫描量热(DSC)法、红外分光光度法对包合物进行鉴定。结果:最佳包合条件为银杏提取物:HP-β-CD=1·5:1(质量比),搅拌时间为6h,包合温度为50℃。结论:银杏提取物与HP--CD初步被证明形成包合物。HP--CD对药物有较好的增溶作用。     

银杏叶提取物对神经及心血管系统的调节机制

银杏叶提取物是从银杏叶中提取的复方组分，其组分中含多种化学单体，这些成分可在神经及心血管系统等部位发挥一定的调节效应，具有改善神经及心血管系统疾病的作用。银杏叶提取物是目前许多国家常用的神经及心血管疾病治疗药物，同时也是在国际上得到认可的中药之一，这主要得益于药物严格的质控及深入的机制研究。本文选取银杏叶提取物这一传统中药，介绍其对神经及心血管系统调节作用的分子机制，初步反映目前国际化中药的研究状况。     

The effects of Ginkgo biloba extract (LI 1370) supplementation on activities of daily living in free living older volunteers: a questionnaire survey

This survey assessed the impact of four months supplementation with 120 mg/day of the standardized Ginkgo biloba special extract (LI 1370) on activities of daily living and various aspects of mood and sleep in a population of free living older volunteers using both observer- and self-rated scales. 5028 Participants (mean age 68.9 years) were recruited through a magazine editorial. One thousand received Ginkgo biloba extract (GBE) and the remainder were allocated to the Control group. The B-ADL (activities of daily living) Scale was completed at baseline and at the end of month 4 by an informant familiar with the participant, a Self-rating ADL scale and Line Analogue Ratings Scales of mood and sleep were completed by the participants at the end of months 1, 2, 3, and 4. There were significant differences between the GBE and Control groups on all scales at each time point. The GBE group felt better able to cope with their daily activities and showed positive changes in mood and sleep compared to the Control group. These results suggest that GBE supplementation has beneficial effects on areas of functioning that have implications for quality of life in an older population. Copyright 2000 John Wiley & Sons, Ltd.     

银杏叶片长期给药后对大鼠灌服氯沙坦的药代动力学影响

目的:研究银杏叶提取物(GBE)制剂银杏叶片长期给药后对大鼠灌服氯沙坦(Los)的药代动力学影响.方法:SD大鼠随机分为Los单用组,GBE+ Los联合用药组.试验第1天起,联合用药组大鼠灌胃给予GBE 100 mg/kg,共14 d.单用组大鼠灌胃给予等量纯净水.第15天,单用药组大鼠灌胃给予Los 10 mg/kg,GBE+Los联合给药组大鼠同时灌胃给予GBE 100 mg/kg和Los 10 mg/kg.于Los给药后0.5、1、2、3、4、6、8、10、12、24 h从大鼠眼眦静脉丛取血.HPLC法测定血浆中Los及其活性代谢产物EXP3174的浓度,计算其主要药代动力学参数,并进行统计学分析.结果:合用GBE后,Los的各药代动力学参数差异无统计学意义.EXP3174的tmax显著缩短(P＜0.05),Cmax、AUC0-8和AUC0-∞显著增加(P＜0.01),CL显著降低(P＜0.05),t1/2、MRT变化无统计学差异.结论:GBE能够影响EXP3174的体内代谢,但对Los的药代动力学过程影响没有统计学意义.     

Effects of ginkgo biloba on <Emphasis Type="Italic">in vitro</Emphasis> osteoblast cells and ovariectomized rat osteoclast cells

Ginkgo biloba extract (GBE) has a selective estrogen receptor modulator (SERM)-like biphasic effect on estrogen, and could be a potential alternative to hormone replacement therapy (HRT). Here, we investigated whether GBE can ameliorate estrogen-depleted osteoporosis in in vitro osteoblast cells and in estrogen-deprived ovariectomized (OVX) rats, a classical animal model for postmenopausal osteoporosis. GBE (50–150 μg/mL) significantly increased ALP (Alkaline phosphatase) activity of osteoblast cells, indicating that GBE promotes osteoblast mineralization. OVX rats exposed to GBE (100 and 200 mg/kg/day, oral treatment), raloxifene (3 mg/kg/day, oral treatment) or estradiol (E₂, 10 μg/kg/day, subcutaneous injection) decreased osteoclast resorptive activity compared with OVX rats. GBE and raloxifene did not increase uterine weight compared with OVX rats, while E₂ and Sham control did, suggesting that GBE has no uterotrophic activity, which is a disadvantage of estrogen therapy. In OVX rats, GBE did not restore severe bone density loss induced by OVX, indicating that GBE may be insufficient as therapeutic material for severe osteoporosis. However, despite its no effects on bone density loss in OVX rats, GBE did stimulate osteoblast differentiation and antiosteoclastic activity in vitro. Therefore, GBE may have preventive potential on osteoporosis as do other phytoestrogens.     

Effects of Ginkgo biloba extract on pharmacokinetics and pharmacodynamics of tolbutamide and midazolam in healthy volunteers

This study was undertaken to clarify the influence of repeated oral administration of Ginkgo biloba extract (GBE) on CYP2C9 and CYP3A4. CYP2C9 probe (tolbutamide, 125 mg) and CYP3A4 probe (midazolam, 8 mg) were orally administered to 10 male healthy volunteers before and after GBE intake (360 mg/d) for 28 days, and they received 75 g glucose after the dosing of tolbutamide. Plasma drug concentrations and blood glucose levels were measured. The area under concentration versus time curve (AUC0-infinity) for tolbutamide after GBE intake was slightly but significantly (16%) lower than that before GBE intake. Concomitantly, GBE tended to attenuate AUC0-2 of blood glucose-lowering effect of tolbutamide. AUC0-infinity for midazolam was significantly (25%) increased by GBE intake and oral clearance was significantly (26%) decreased. Thus, it is suggested that the combination of GBE and drugs should be cautious in terms of the potential interactions, especially in elderly patients or patients treated with drugs exerting relatively narrow therapeutic windows.     

Induction and recovery of hepatic drug metabolizing enzymes in rats treated with Ginkgo biloba extract.

Herb-drug interactions, especially cytochrome P450 (CYP)-mediated interactions, cause an enhancement or attenuation in efficacy of co-administered drugs. In a previous study, we reported that repeated oral ingestion of Ginkgo biloba extract (GBE) markedly induced hepatic drug metabolizing enzymes in rats. In this study, we focused on the recovery of GBE-induced hepatic drug metabolizing enzymes after the discontinuation of GBE in rats. Feeding of a 0.5% GBE diet to rats for 1 week markedly increased liver weight, content of total CYP, activities of 6 CYP subtypes and glutathione S-transferase (GST). The content and activities of CYP enzymes were recovered to almost basal levels within 1 week after the discontinuation of GBE, while the activity of GST gradually decreased and recovered to the control level after 3 weeks. These results indicated that GBE-induced hepatic drug metabolizing enzymes in rats, especially CYPs, were rapidly recovered by discontinuation of GBE in rats even after excess treatment, and suggested that interactions of GBE with drugs could be avoided by discontinuation of GBE.     

银杏叶提取物对实验性高脂血症大鼠的调脂机制

目的 研究银杏叶提取物对实验性高脂血症大鼠的调脂机制.方法 预防给药,即以高脂饲料造模的同时连续给药28 d,于末次给药后测定大鼠血浆中总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的含量和脂蛋白脂酶(LPL)、肝脂酶(HL)的活性及大鼠粪便中胆汁酸(FBA)的排泄量;治疗给药,即给予高脂饲料喂养28 d,造模成功后连续给药28 d,测定大鼠血浆中TC、TG、HDL-C、LDL-C的含量和LPL、HL的活性及大鼠FBA的排泄量.结果 预防性给药后,银杏叶提取物高、中剂量组与高脂模型组比较,能显著降低血浆中TC、LDL-C,显著升高HDL-C,同时可显著提高HL和LPL的活性及增加大鼠FBA的排泄量;治疗性给药后,银杏叶提取物高、中剂量组与高脂模型组比较,能显著降低已形成高脂血症大鼠血浆中的TC、LDL-C,显著升高HDL-C,同时可显著提高HL、LPL的活性及增加大鼠FBA的排泄量.结论 银杏叶提取物对大鼠实验性高脂血症具有显著的预防和治疗作用.其作用机制可能与药物提高LPL和HL的活性并加速体内胆固醇的代谢有关.     

Pretreatment with Ginkgo biloba extract weakens the hypnosis action of phenobarbital and its plasma concentration in rats

In a previous study, we found that orally administered Ginkgo biloba extract (GBE) induced hepatic cytochrome P450 (CYP) in rats, especially the CYP2B type. This fact suggested that GBE influenced the availability and safety of drugs that were metabolized via CYP2B type enzymes. To confirm this possibility, in this study we examined the effect of feeding a 0.1, 0.5 and 1.0% GBE diet for 2 weeks on the pharmacokinetics and pharmacological action of phenobarbital, which is known to be metabolized by CYP2B in Wistar rats. The feeding of GBE markedly shortened the sleeping time in rats. Furthermore, the maximal phenobarbital plasma concentration (Cmax) and the 24-h area under the curve (AUC0-24) were decreased in rats fed GBE. These findings indicate that GBE reduces the therapeutic potency of phenobarbital via enhancement of cytochrome P450 expression, and raises the possibility that GBE and drug interactions may occur clinically.     

Effects of Ginkgo biloba on corticosterone stress responses after inescapable shock exposure in the rat

Extracts from the leaves of the Ginkgo biloba tree (GBE) are found to be clinically effective in neuroprotection, cerebral and cardiovascular function and cognitive processing. Recent animal findings suggest that GBE also may improve stress adaptation and prevent learned helplessness, as evidenced by its reduction of behavioral acquisition deficits of active avoidance after inescapable shock exposure. In the present report, the effects of two doses of GBE were studied on corticosterone stress responses and acquisition of active avoidance after inescapable shock exposure. Forty-eight rats were divided into three groups: either receiving a daily dose of 50 mg/kg or 150 mg/kg of GBE (containing 24% flavonoid and 6% terpenoid) or vehicle for 2 weeks. After 2 weeks of administration, animals were trained for active-avoidance acquisition following inescapable shock exposure (stress induction) or nonshock exposure (nonstress). Administration of 150 mg/kg but not of 50 mg/kg of GBE significantly prevented a corticosterone stress response after inescapable shock exposure (P<.0001) without any beneficial behavioral effect on active avoidance. Repeated administration of GBE particularly improves biological adaptation to noxious stimuli without beneficial behavioral consequences. Present findings do not support previous claims about the benefits of G. biloba on improving behavioral stress adaptation and acquisition of active avoidance and on reducing behavioral deficits indicative of "learned helplessness."     

Ginkgo biloba extract attenuates the development of hypertension in deoxycorticosterone acetate-salt hypertensive rats

1. We examined the effects of Ginkgo biloba extract (GBE) on the development of hypertension, platelet activation and renal dysfunction in deoxycorticosterone acetate (DOCA)-salt hypertensive rats. Both DOCA-salt hypertensive rats and normotensive rats were fed a 2% GBE diet for 20 days. Blood pressure (BP) was measured by two methods, namely by the tail-cuff and telemetry methods. 2. Development of hypertension was attenuated in rats fed a 2% GBE diet. In addition, an increase in heart weight, an indicator of sustained high BP, was inhibited significantly by feeding of the GBE diet. 3. Decreases in 5-hydroxytryptamine content in platelets, a marker of platelet activation in vivo associated with hypertension, were also prevented by feeding of the GBE diet. Ginkgo biloba extract itself did not inhibit ADP- and collagen-induced platelet aggregation examined in vitro. Feeding of the GBE diet tended to inhibit increases in plasma urea nitrogen due to hypertension. 4. The telemetry study demonstrated that BP and heart rate (HR) showed a clear circadian rhythm and the antihypertensive effect of GBE was prominent in the daytime, a resting period for rats. This anti-hypertensive effect of GBE was not detected in normotensive rats. In contrast, the inhibitory effect of GBE on HR was independent of time and was observed in both normotensive and hypertensive rats. 5. These results indicate that GBE has an anti-hypertensive and bradycardiac action, which are time dependent and independent, respectively. Thus, it appears that the chronopharmacological action of GBE may be ascribed not to pharmacokinetic factors, but rather to a circadian susceptibility rhythm to GBE in DOCA-salt hypertensive rats.     

中药色谱指纹图谱潜信息特征判据研究

目的对中药色谱指纹图谱潜信息特征进行判据研究，用F和I等37个指标揭示色谱指纹图谱的潜信息特征。方法用银杏叶提取物(GBE)、银杏达莫注射液(GLEDI)和苦碟子(ISH)与苦碟子注射液(ISHI)的HPLC指纹图谱进行比较研究。结果从积分信号强度、信号均化程度、分离度、指纹信息量等多方面综合评价出GBE指纹图谱好于GLEDI，ISH指纹图谱好于ISHI，GBE与ISH指纹图谱基本相当。结论F和I等37个指标可客观、真实、全面地揭示中药指纹图谱的潜信息特征。     

2009-2011年上海医院心血管系统疾病用药分析

目的：了解近年来上海医院心血管系统疾病用药的情况和变化趋势。方法：统计2009—2011年上海119家样本医院心血管系统疾病用药销售金额、排序和增长率等,结合临床应用进行分析和讨论。结果：心血管系统疾病用药金额仅次于抗感染类药物,列为第2大类,复合年均增长率11．81％。用药金额领先品种有银杏叶制剂、氨氯地平、缬沙坦、发酵虫草制剂等,增速较快的有银杏叶制剂、丹参多酚酸盐、替米沙坦、厄贝沙坦和灯盏花素等。结论：心血管系统用药是一大类常用药物,需求量逐渐增大,市场前景广阔。     

Studies on interactions between functional foods or dietary supplements and medicines. IV. Effects of ginkgo biloba leaf extract on the pharmacokinetics and pharmacodynamics of nifedipine in healthy volunteers

The effects of Ginkgo biloba leaf extract (GBE), a widely used herbal dietary supplement in Japan, on the pharmacokinetics and pharmacodynamics of nifedipine (NFP), a calcium-channel blocker, were studied using 8 healthy volunteers. Simultaneous oral ingestion of GBE (240 mg) did not significantly affect any of the mean pharmacokinetic parameters of either NFP or dehydronifedipine, a major metabolite of NFP, after oral administration of NFP (10 mg). However, the maximal plasma NFP concentrations in 2 subjects were approximately doubled by GBE, and they had severer and longer-lasting headaches with GBE than without GBE, with dizziness or hot flushes in combination with GBE. The mean heart rate after oral administration of NFP with GBE tended to be faster than that without GBE at every time point. Accordingly, it was concluded that GBE and NFP should not be simultaneously ingested as much as possible, and careful monitoring is needed when administering NFP concomitantly with GBE to humans.     

Ginkgo biloba inhibits hydrogen peroxide-induced activation of nuclear factor kappa B in vascular endothelial cells.

The present study determined the effects of Ginkgo biloba extract (GBE) on the activation of nuclear factor kappa B (NF-kappaB) and the level of hydrogen peroxide (H2O2) in bovine pulmonary artery endothelial cells (PAEC). H2O2 showed a concentration-dependent activation of NF-kappaB. GBE demonstrated a concentration-dependent suppression of NF-kappaB activated by H2O2. GBE directly scavenged H2O2 in a cell-free system; it also decreased H2O2 levels in PAEC. These results suggest that the inhibitory effect of GBE on H2O2-induced NF-kappaB activation may be caused by its scavenging and suppression of H2O2. Our experiments demonstrate that GBE can inhibit NF-kappaB activation induced by H2O2 and may thus be effective for the prevention or treatment of atherosclerosis and other disorders related to NF-kappaB activation.     

银杏叶提取物GBE50对HepG2细胞甘油三酯代谢的影响

目的观察银杏叶提取物GBE50对HepG2细胞内甘油三酯含量的影响以及甘油三酯代谢关键基因CPT1A表达的调节。方法检测GBE50对培养细胞HepG2甘油三酯含量的影响;测定GBE50处理HepG2细胞24 h后CPT1A酶活性,用定量PCR检测药物处理后CPT1A基因表达水平的改变,Western blot检测CPT1A蛋白表达。结果 GBE50可降低培养细胞HepG2内甘油三酯含量。同时可以促进细胞CPT1A基因的表达,且能增加CPT1A酶的活性。结论 GBE50可有效降低HepG2细胞内甘油三酯的含量,CPT1A基因表达量的改变可能是GBE50调节HepG2细胞内甘油三酯水平的机制之一。