Journal of Ginseng Research

The Korean Society of Ginseng (고려인삼학회)
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Panax ginseng: An Overview of the Clinical Evidence

  • Ernst, Edzard (Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth)
  • Received : 2010.07.16
  • Accepted : 2010.12.10
  • Published : 2010.12.29
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Abstract

This overview is focused on Panax ginseng, one of the most commonly used herbal remedies. The currently available data regarding its clinical efficacy is somewhat confusing, despite the fact that many clinical trials and systematic reviews have been published. The risks of Panax ginseng seem to be only minor. Numerous mechanisms of action have been described. Future studies of this fascinating herbal remedy seem warranted but they should overcome the methodological limitations of the previous research.

Keywords

References

  1. Lu JM, Yao Q, Chen C. Ginseng compounds: an update on their molecular mechanisms and medical applications. Curr Vasc Pharmacol 2009;7:293-302. https://doi.org/10.2174/157016109788340767
  2. Jia L, Zhao Y. Current evaluation of the millennium phytomedicine--ginseng (I): etymology, pharmacognosy, phytochemistry, market and regulations. Curr Med Chem 2009;16:2475-2484. https://doi.org/10.2174/092986709788682146
  3. Xiang YZ, Shang HC, Gao XM, Zhang BL. A comparison of the ancient use of ginseng in traditional Chinese medicine with modern pharmacological experiments and clinical trials. Phytother Res 2008;22:851-858. https://doi.org/10.1002/ptr.2384
  4. Ernst E. The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John’s wort, ginseng, Echinacea, saw palmetto, and kava. Ann Intern Med 2002;136:42-53. https://doi.org/10.7326/0003-4819-136-1-200201010-00010
  5. Heavey S. Herbs, supplements often sold deceptively: U.S. report. Available from: http://http://www.reuters.com/article/idUSTRE64P5MY20100526.
  6. Chen CF, Chiou WF, Zhang JT. Comparison of the pharmacological effects of Panax ginseng and Panax quinquefolium. Acta Pharmacol Sin 2008;29:1103-1108. https://doi.org/10.1111/j.1745-7254.2008.00868.x
  7. Choi KT. Botanical characteristics, pharmacological effects and medicinal components of Korean Panax ginseng C. A. Meyer. Acta Pharmacol Sin 2008;29:1109-1118. https://doi.org/10.1111/j.1745-7254.2008.00869.x
  8. ConsumerLab.com. Product review: ginseng supplements. Available from: https://www.consumerlab.com/reviews/ginseng_supplements/ginseng/.
  9. Sievenpiper JL, Arnason JT, Vidgen E, Leiter LA, Vuksan V. A systematic quantitative analysis of the literature of the high variability in ginseng (Panax spp.): should ginseng be trusted in diabetes? Diabetes Care 2004;27:839-840. https://doi.org/10.2337/diacare.27.3.839
  10. Vogler BK, Pittler MH, Ernst E. The effi cacy of ginseng. A systematic review of randomised clinical trials. Eur J Clin Pharmacol 1999;55:567-575. https://doi.org/10.1007/s002280050674
  11. Coleman CI, Hebert JH, Reddy P. The effects of Panax ginseng on quality of life. J Clin Pharm Ther 2003;28:5-15. https://doi.org/10.1046/j.1365-2710.2003.00467.x
  12. Buettner C, Yeh GY, Phillips RS, Mittleman MA, Kaptchuk TJ. Systematic review of the effects of ginseng on cardiovascular risk factors. Ann Pharmacother 2006;40:83-95. https://doi.org/10.1345/aph.1G216
  13. Jang DJ, Lee MS, Shin BC, Lee YC, Ernst E. Red ginseng for treating erectile dysfunction: a systematic review. Br J Clin Pharmacol 2008;66:444-450. https://doi.org/10.1111/j.1365-2125.2008.03236.x
  14. Lee MS, Yang EJ, Kim JI, Ernst E. Ginseng for cognitive function in Alzheimer’s disease: a systematic review. J Alzheimers Dis 2009;18:339-344. https://doi.org/10.3233/JAD-2009-1149
  15. Seida JK, Durec T, Kuhle S. North American (Panax quinquefolius) and Asian ginseng (Panax ginseng) preparations for prevention of the common cold in healthy adults: a systematic review. Evid Based Complement Alternat Med 2009; Epub ahead of print.
  16. Bahrke MS, Morgan WP, Stegner A. Is ginseng an ergogenic aid? Int J Sport Nutr Exerc Metab 2009;19:298-322. https://doi.org/10.1123/ijsnem.19.3.298
  17. Kim S, Lee MS, Shin BC, Sim H, Ernst E. Red ginseng for treating type 2 diabetes mellitus: a systematic review and meta-analysis. submitted.
  18. Huh MH, Lee MS, Kim C, Ernst E. Ginseng for the treatment of hypertension: a systematic review. J Ginseng Res 2010;34:342-347. https://doi.org/10.5142/jgr.2010.34.4.342
  19. Helms S. Cancer prevention and therapeutics: Panax ginseng. Altern Med Rev 2004;9:259-274.
  20. Barton DL, Soori GS, Bauer BA, Sloan JA, Johnson PA, Figueras C, Duane S, Mattar B, Liu H, Atherton PJ, et al. Pilot study of Panax quinquefolius (American ginseng) to improve cancer-related fatigue: a randomized, double-blind, dose-finding evaluation: NCCTG trial N03CA. Support Care Cancer 2010;18:179-187. https://doi.org/10.1007/s00520-009-0642-2
  21. Huntley AL, Ernst E. A systematic review of herbal medicinal products for the treatment of menopausal symptoms. Menopause 2003;10:465-476. https://doi.org/10.1097/01.GME.0000058147.24036.B0
  22. Liu JP, Yang M, Du XM. Herbal medicines for viral myocarditis. Cochrane Database Syst Rev 2004;(3):CD003711.
  23. Coon JT, Ernst E. Panax ginseng: a systematic review of adverse effects and drug interactions. Drug Saf 2002;25:323-344. https://doi.org/10.2165/00002018-200225050-00003
  24. Seely D, Dugoua JJ, Perri D, Mills E, Koren G. Safety and efficacy of Panax ginseng during pregnancy and lactation. Can J Clin Pharmacol 2008;15:e87-e94.
  25. Chen C, Xiao YP, Song YQ. Investigation and analysis of organochlorine pesticide residues in traditional Chinese medicinal. J Shaanxi Norm Univ. Natural sciences edition 2006; 34:264-271.
  26. Li LL, Yuan WJ, Zhang SL. Analysis of organochlorine pesticide residues in the imported American ginseng and Senna. Zhong Cao Yao 2003;34:610.
  27. Xia PH, Zhang MS, Chen WS, Wu Q. Pyrethroid pesticide residues in medicianl plants in Guizhou GAP bases. Lishizhen Med & Materia Med Res 2008;19:3010-3012.
  28. Zhang MS, Zhang ZK, Xia PH. Investigation on the organochlorine pesticides residues in Chinese herbal materials from Guizhou GAP bases. Shenyang Yao Ke Da Xue Xue Bao 2009;26:473-476.
  29. Christensen LP. Ginsenosides chemistry, biosynthesis, analysis, and potential health effects. Adv Food Nutr Res 2009;55:1-99.
  30. Kiefer D, Pantuso T. Panax ginseng. Am Fam Physician 2003;68:1539-1542.
  31. Zhou W, Chai H, Lin PH, Lumsden AB, Yao Q, Chen CJ. Molecular mechanisms and clinical applications of ginseng root for cardiovascular disease. Med Sci Monit 2004;10:RA187-RA192.
  32. Sengupta S, Toh SA, Sellers LA, Skepper JN, Koolwijk P, Leung HW, Yeung HW, Wong RN, Sasisekharan R, Fan TP. Modulating angiogenesis: the yin and the yang in ginseng. Circulation 2004;110:1219-1225. https://doi.org/10.1161/01.CIR.0000140676.88412.CF
  33. Cabral de Oliveira AC, Perez AC, Prieto JG, Duarte ID, Alvarez AI. Protection of Panax ginseng in injured muscles after eccentric exercise. J Ethnopharmacol 2005;97:211-214. https://doi.org/10.1016/j.jep.2004.10.029
  34. Jia L, Zhao Y, Liang XJ. Current evaluation of the millennium phytomedicine-ginseng (II): collected chemical entities, modern pharmacology, and clinical applications emanated from traditional Chinese medicine. Curr Med Chem 2009;16:2924-2942. https://doi.org/10.2174/092986709788803204
  35. Rausch WD, Liu S, Gille G, Radad K. Neuroprotective effects of ginsenosides. Acta Neurobiol Exp (Wars) 2006;66:369-375.
  36. Lee TK, Johnke RM, Allison RR, O’Brien KF, Dobbs LJ Jr. Radioprotective potential of ginseng. Mutagenesis 2005;20:237-243. https://doi.org/10.1093/mutage/gei041
  37. Cheng Y, Shen LH, Zhang JT. Anti-amnestic and antiaging effects of ginsenoside Rg1 and Rb1 and its mechanism of action. Acta Pharmacol Sin 2005;26:143-149. https://doi.org/10.1111/j.1745-7254.2005.00034.x
  38. Radad K, Gille G, Liu L, Rausch WD. Use of ginseng in medicine with emphasis on neurodegenerative disorders. J Pharmacol Sci 2006;100:175-186. https://doi.org/10.1254/jphs.CRJ05010X

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