Systematic Review of Randomized Controlled Trials Evaluating the Efficacy and Safety of Ginseng

JAMS Journal of Acupuncture and Meridian Studies

Volumn 4, Issue 2, 2011, Pages 85-97

  Lee, Nam Hun ^a   Son, Chang Gue ^a  

^a Daejeon University   (South Korea)

Author keywords

Efficacy; Ginseng; Randomized controlled trial; Safety; Systematic review

Indexed keywords

CVT E002; GINSENG EXTRACT; UNCLASSIFIED DRUG;

CEREBROVASCULAR DISEASE; DATA BASE; DATA EXTRACTION; DIARRHEA; DRUG EFFICACY; DRUG SAFETY; ERECTILE DYSFUNCTION; GINSENG; GLUCOSE METABOLISM; HEADACHE; HEART FUNCTION; HUMAN; HYPOGLYCEMIA; INSOMNIA; LUNG DISEASE; NAUSEA AND VOMITING; NON INSULIN DEPENDENT DIABETES MELLITUS; NONHUMAN; PHYSICAL PERFORMANCE; PRIORITY JOURNAL; PSYCHOMOTOR ACTIVITY; QUALITY CONTROL; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; SEXUAL FUNCTION; STOMACH DISEASE; SYSTEMATIC REVIEW; THORAX DISEASE;

EID: 79959537267     PISSN: 20052901     EISSN: 20938152     Source Type: Journal    
DOI: 10.1016/S2005-2901(11)60013-7     Document Type: Review

References (111)

1. Chong SK, Oberholzer VG Ginseng-is there a use in clinical medicine?. Postgrad Med J 1988, 64:841-846.
2. Kiefer D, Pantuso T Panax ginseng. Am Fam Physician 2003, 68:1539-1542.
3. Kaneko H, Nakanishi K Proof of the mysterious efficacy of ginseng: basic and clinical trials: clinical effects of medical ginseng, Korean red ginseng: specifically, its anti-stress action for prevention of disease. J Pharmacol Sci 2004, 95:158-162.
4. Coleman CI, Hebert JH, Reddy P The effects of Panax ginseng on quality of life. J Clin Pharm Ther 2003, 28:5-15.
5. Angelova N, Kong HW, van der Heijden R, Yang SY, Choi YH, Kim HK, et al. Recent methodology in the phytochemical analysis of ginseng. Phytochem Anal 2008, 19:2-16.
6. Attele AS, Wu JA, Yuan CS Ginseng pharmacology: multiple constituents and multiple actions. Biochem Pharmacol 1999, 58:1685-1693.
7. Levy SH The risk-benefit profile of commonly used herbal therapies. Ann Intern Med 2002, 137:1008. author reply.
8. Kronenberg F, Fugh-Berman A Complementary and alternative medicine for menopausal symptoms: a review of randomized, controlled trials. Ann Intern Med 2002, 137:805-813.
9. Coon JT, Ernst E Panax ginseng: a systematic review of adverse effects and drug interactions. Drug Safety 2002, 25:323-344.
10. 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.
11. Firenzuoli F, Gori L Herbal medicine today: clinical and research issues. Evid Based Complement Alternat Med 2007, 4:37-40.
12. Ghosh AK Clinical applications and update on evidence-based medicine. J Assoc Physicians India 2007, 55:787-794.
13. Kulaputana O, Thanakomsirichot S, Anomasiri W Ginseng supplementation does not change lactate threshold and physical performances in physically active Thai men. J Med Assoc Thai 2007, 90:1172-1179.
14. Engels HJ, Fahlman MM, Wirth JC Effects of ginseng on secretory IgA, performance, and recovery from interval exercise. Med Sci Sports Exerc 2003, 35:690-696.
15. Medline [Date accessed: April 1, 2009]. http://www.ncbi.nlm.nih.gov/pubmed.
16. CINAHL [Date accessed: April 1, 2009]. http://www.ebscohost.com/cinahl/.
17. EMBASE [Date accessed: April 1, 2009]. http://www.embase.com/.
18. Korean Studies Information [Date accessed: April 1, 2009]. http://kiss.kstudy.com/english/main.asp.
19. DBPIA [Date accessed: April 1, 2009]. http://www.dbpia.co.kr/.
20. Korea Institute of Science and Technology Information [Date accessed: April 1, 2009]. http://www.kisti.re.kr/.
21. Korea-Med [Date accessed: April 1, 2009]. http://koreamed.org/SearchBasic.php.
22. Research Information Center for Health [Date accessed: April 1, 2009]. http://www.medric.or.kr/.
23. China Academic Journal [Date accessed: April 1, 2009]. http://211.218.126.155/caj/caj.htm.
24. Century Journal Project [Date accessed: April 1, 2009]. http://china.eastview.com/kns50/Navigator.aspx?ID=72.
25. China Doctor/Master Dissertation Full-Text [Date accessed: April 1, 2009]. http://211.218.126.155/kns50/index.aspx.
26. China Proceedings of Conference Full-Text [Date accessed: April 1, 2009]. http://211.218.126.155/kns50/index.aspx.
27. Cochrane Library [Date accessed: April 1, 2009]. http://www.cochrane.org/.
28. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials 1996, 17:1-12.
29. Slavin RE Best evidence synthesis: an intelligent alternative to meta-analysis. J Clin Epidemiol 1995, 48:9-18.
30. van Tulder MW, Cherkin DC, Berman B, Lao L, Koes BW The effectiveness of acupuncture in the management of acute and chronic low back pain. A systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine (Phila Pa 1976) 1999, 24:1113-1123.
31. Vuksan V, Sung MK, Sievenpiper JL, Stavro PM, Jenkins AL, Di Buono M, et al. Korean red ginseng (Panax ginseng) improves glucose and insulin regulation in well-controlled, type 2 diabetes: results of a randomized, double-blind, placebo-controlled study of efficacy and safety. Nutr Metab Cardiovasc Dis 2008, 18:46-56.
32. Reay JL, Kennedy DO, Scholey AB Effects of Panax ginseng, consumed with and without glucose, on blood glucose levels and cognitive performance during sustained 'mentally demanding' tasks. J Psychopharmacol 2006, 20:771-781.
33. Sievenpiper JL, Sung MK, Di Buono M, Seung-Lee K, Nam KY, Arnason JT, et al. Korean red ginseng rootlets decrease acute postprandial glycemia: results from sequential preparation-and dose-finding studies. J Am Coll Nutr 2006, 25:100-107.
34. Reay JL, Kennedy DO, Scholey AB The glycaemic effects of single doses of Panax ginseng in young healthy volunteers. Br J Nutr 2006, 96:639-642.
35. Reay JL, Kennedy DO, Scholey AB Single doses of Panax ginseng (G115) reduce blood glucose levels and improve cognitive performance during sustained mental activity. J Psychopharmacol 2005, 19:357-365.
36. Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V Decreasing, null and increasing effects of eight popular types of ginseng on acute postprandial glycemic indices in healthy humans: the role of ginsenosides. J Am Coll Nutr 2004, 23:248-258.
37. Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V Null and opposing effects of Asian ginseng (Panax ginseng C.A. Meyer) on acute glycemia: results of two acute dose escalation studies. J Am Coll Nutr 2003, 22:524-532.
38. Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V Variable effects of American ginseng: a batch of American ginseng (Panax quinquefolius L.) with a depressed ginsenoside profile does not affect postprandial glycemia. Eur J Clin Nutr 2003, 57:243-248.
39. Vuksan V, Sievenpiper JL, Wong J, Xu Z, Beljan-Zdravkovic U, Arnason JT, et al. American ginseng (Panax quinquefolius L.) attenuates postprandial glycemia in a time-dependent but not dose-dependent manner in healthy individuals. Am J Clin Nutr 2001, 73:753-758.
40. Vuksan V, Stavro MP, Sievenpiper JL, Koo VY, Wong E, Beljan-Zdravkovic U, et al. American ginseng improves glycemia in individuals with normal glucose tolerance: effect of dose and time escalation. J Am Coll Nutr 2000, 19:738-744.
41. Vuksan V, Stavro MP, Sievenpiper JL, Beljan-Zdravkovic U, Leiter LA, Josse RG, et al. Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes. Diabetes Care 2000, 23:1221-1226.
42. Vuksan V, Sievenpiper JL, Koo VY, Francis T, Beljan-Zdravkovic U, Xu Z, et al. American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med 2000, 160:1009-1013.
43. Yoon SJ, Kim KH, Kim CJ, Park HC, Kang KH, Kim MJ, et al. Effects of red ginseng supplementation on aerobic, anaerobic performance, central and peripheral fatigue. J Ginseng Res 2008, 32:210-219.
44. Hsu CC, Ho MC, Lin LC, Su B, Hsu MC American ginseng supplementation attenuates creatine kinase level induced by submaximal exercise in human beings. World J Gastroenterol 2005, 11:5327-5331.
45. Engels HJ, Kolokouri I, Cieslak TJ, Wirth JC Effects of ginseng supplementation on supramaximal exercise performance and short-term recovery. J Strength Cond Res 2001, 15:290-295.
46. Allen JD, McLung J, Nelson AG, Welsch M Ginseng supplementation does not enhance healthy young adults' peak aerobic exercise performance. J Am Coll Nutr 1998, 17:462-466.
47. Engels HJ, Wirth JC No ergogenic effects of ginseng (Panax ginseng C.A. Meyer) during graded maximal aerobic exercise. J Am Diet Assoc 1997, 97:1110-1115.
48. Morris AC, Jacobs I, McLellan TM, Klugerman A, Wang LC, Zamecnik J No ergogenic effect of ginseng ingestion. Int J Sport Nutr 1996, 6:263-271.
49. Engels HJ, Said JM, Wirth JC Failure of chronic ginseng supplementation to affect work performance and energy metabolism in healthy adult females. Nutr Res 1996, 16:1295-1305.
50. Lee ST, Chu K, Sim JY, Heo JH, Kim M Panax ginseng enhances cognitive performance in Alzheimer disease. Alzheimer Dis Assoc Disord 2008, 22:222-226.
51. Heo JH, Lee ST, Chu K, Oh MJ, Park HJ, Shim JY, et al. An open-label trial of Korean red ginseng as an adjuvant treatment for cognitive impairment in patients with Alzheimer's disease. Eur J Neurol 2008, 15:865-868.
52. Sunram-Lea SI, Birchall RJ, Wesnes KA, Petrini O The effect of acute administration of 400 mg of Panax ginseng on cognitive performance and mood in healthy young volunteers. Curr Top Nutraceutical Res 2005, 3:65-74.
53. Scholey AB, Kennedy DO Acute, dose-dependent cognitive effects of Ginkgo biloba, Panax ginseng and their combination in healthy young volunteers: differential interactions with cognitive demand. Hum Psychopharmacol 2002, 17:35-44.
54. Kennedy DO, Scholey AB, Wesnes KA Modulation of cognition and mood following administration of single doses of Ginkgo biloba, ginseng, and a ginkgo/ginseng combination to healthy young adults. Physiol Behav 2002, 75:739-751.
55. Kennedy DO, Scholey AB, Wesnes KA Dose dependent changes in cognitive performance and mood following acute administration of Ginseng to healthy young volunteers. Nutr Neurosci 2001, 4:295-310.
56. Cardinal BJ, Engels HJ Ginseng does not enhance psychological well-being in healthy, young adults: results of a double-blind, placebo-controlled, randomized clinical trial. J Am Diet Assoc 2001, 101:655-660.
57. Ziemba AW, Chmura J, Kaciuba-Uscilko H, Nazar K, Wisnik P, Gawronski W Ginseng treatment improves psychomotor performance at rest and during graded exercise in young athletes. Int J Sport Nutr 1999, 9:371-377.
58. de Andrade E, de Mesquita AA, Claro Jde A, de Andrade PM, Ortiz V, Paranhos M, et al. Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction. Asian J Androl 2007, 9:241-244.
59. Choi HK, Choi YJ, Kim JH Penile blood change after oral medication of Korean red ginseng in erectile dysfunction patients. J Ginseng Res 2003, 27:165-170.
60. Hong B, Ji YH, Hong JH, Nam KY, Ahn TY A double-blind crossover study evaluating the efficacy of Korean red ginseng in patients with erectile dysfunction: a preliminary report. J Urol 2002, 168:2070-2073.
61. Choi HK, Choi YJ Evaluation of clinical efficacy of Korea red ginseng for erectile dysfunction by international index of erectile function. J Ginseng Res 2001, 25:112-117.
62. Kim SW, Paick JS Clinical efficacy of Korean red ginseng on vasculogenic impotent patients. Korean J Androl 1999, 17:23-28.
63. Choi HK, Choi YD, Adaikan G, Jiang Y Effectiveness of Korea red ginseng in erectile dysfunction-multi-national approach. J Ginseng Res 1999, 23:247-256.
64. Choi HK, Seong DH Effectiveness for erectile dysfunction after the administration of Korean red ginseng. J Ginseng Res 1995, 19:17-21.
65. Stavro PM, Woo M, Heim TF, Leiter LA, Vuksan V North American ginseng exerts a neutral effect on blood pressure in individuals with hypertension. Hypertension 2005, 46:406-411.
66. Stavro PM, Woo M, Leiter LA, Heim TF, Sievenpiper JL, Vuksan V Long-term intake of North American ginseng has no effect on 24-hour blood pressure and renal function. Hypertension 2006, 47:791-796.
67. Caron MF, Hotsko AL, Robertson S, Mandybur L, Kluger J, White CM Electrocardiographic and hemodynamic effects of Panax ginseng. Ann Pharmacother 2002, 36:758-763.
68. Ding DZ, Shen TK, Cui YZ Effects of red ginseng on the congestive heart failure and its mechanism. Zhongguo Zhong Xi Yi Jie He Za Zhi 1995, 15:325-327. [In Chinese].
69. Zhao XZ Antisenility effect of ginseng-rhizome saponin. Zhong Xi Yi Jie He Za Zhi 1990, 10:586-589. 79. [In Chinese].
70. Zhan Y, Xu XH, Jiang YP Protective effects of ginsenoside on myocardiac ischemic and reperfusion injuries. Zhonghua Yi Xue Za Zhi 1994, 74:626-628. 48. [In Chinese].
71. Vohra S, Johnston BC, Laycock KL, Midodzi WK, Dhunnoo I, Harris E, et al. Safety and tolerability of North American ginseng extract in the treatment of pediatric upper respiratory tract infection: a phase II randomized, controlled trial of 2 dosing schedules. Pediatrics 2008, 122:e402-e410.
72. McElhaney JE, Goel V, Toane B, Hooten J, Shan JJ Efficacy of COLD-fX in the prevention of respiratory symptoms in community-dwelling adults: a randomized, double-blinded, placebo controlled trial. J Altern Complement Med 2006, 12:153-157.
73. Predy GN, Goel V, Lovlin R, Donner A, Stitt L, Basu TK Efficacy of an extract of North American ginseng containing poly-furanosyl-pyranosyl-saccharides for preventing upper respiratory tract infections: a randomized controlled trial. CMAJ 2005, 173:1043-1048.
74. McElhaney JE, Gravenstein S, Cole SK, Davidson E, O'Neill D, Petitjean S, et al. A placebo-controlled trial of a proprietary extract of North American ginseng (CVT-E002) to prevent acute respiratory illness in institutionalized older adults. J Am Geriatr Soc 2004, 52:13-19.
75. Gross D, Shenkman Z, Bleiberg B, Dayan M, Gittelson M, Efrat R Ginseng improves pulmonary functions and exercise capacity in patients with COPD. Monaldi Arch Chest Dis 2002, 57:242-246.
76. Scaglione F, Weiser K, Alessandria M Effects of the standardised ginseng extract G115 in patients with chronic bronchitis: a nonblinded, randomised, comparative pilot study. Clin Drug Invest 2001, 21:41-45.
77. Jeong DW, Moon SK, Hong JW, Shin WJ, Park YM, Jung JH, et al. Effects of Korean ginseng, Korean red ginseng and fermented Korean red ginseng on cerebral blood flow, cerebrovascular reactivity, systemic blood pressure and pulse rate in humans. J Korean Oriental Med 2006, 27:48-60.
78. Kennedy DO, Scholey AB, Drewery L, Marsh VR, Moore B, Ashton H Electroencephalograph effects of single doses of Ginkgo biloba and Panax ginseng in healthy young volunteers. Pharmacol Biochem Behav 2003, 75:701-709.
79. Biondo PD, Robbins SJ, Walsh JD, McCargar LJ, Harber VJ, Field CJ A randomized controlled crossover trial of the effect of ginseng consumption on the immune response to moderate exercise in healthy sedentary men. Appl Physiol Nutr Metab 2008, 33:966-975.
80. Gaffney BT, Hugel HM, Rich PA The effects of Eleutherococcus senticosus and Panax ginseng on steroidal hormone indices of stress and lymphocyte subset numbers in endurance athletes. Life Sei 2001, 70:431-442.
81. Lee SH, Ahn YM, Ahn SY, Doo HK, Lee BC Interaction between warfarin and Panax ginseng in ischemic stroke patients. J Altern Complement Med 2008, 14:715-721.
82. Yuan CS, Wei G, Dey L, Karrison T, Nahlik L, Maleckar S, et al. Brief communication: American ginseng reduces warfarin's effect in healthy patients: a randomized, controlled Trial. Ann Intern Med 2004, 141:23-27.
83. Seo JC, Han SW, Byun JS, An HD, Ha ID, Cho GH, et al. The effects of ginseng and American ginseng on general symptoms in Koreans and Chinese: double-blind randomized controlled trials. J Ginseng Res 2005, 29:27-36.
84. Ellis JM, Reddy P Effects of Panax ginseng on quality of life. Ann Pharmacother 2002, 36:375-379.
85. Seo JC, Han SW, Byun JS, Ha ID, Leem KH, Heo ZJ, et al. Double-blind randomized controlled trials on superficial body temperature of Korean and American ginseng in Koreans and Chinese. Korean J Herbology 2003, 18:71-86.
86. Forgo I, Kayasseh L, Staub JJ Effect of a standardized ginseng extract on general well-being, reaction time, lung function and gonadal hormones. Med Welt 1981, 32:751-756. [In German].
87. Chung GY Sentence retrieval for abstracts of randomized controlled trials. BMC Med Inform Decis Mak 2009, 9:10.
88. Ang-Lee MK, Moss J, Yuan CS Herbal medicines and perioperative care. JAMA 2001, 286:208-216.
89. 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.
90. Choi KT Botanical characteristics, pharmacological effects and medicinal components of Korean Panax ginseng C A Meyer. Acta Pharmacol Sin 2008, 29:1109-1118.
91. Yun TK Panax ginseng-a non-organ-specific cancer preventive?. Lancet Oncol 2001, 2:49-55.
92. Jin Y, Hofseth AB, Cui X, Windust AJ, Poudyal D, Chumanevich AA, et al. American ginseng suppresses colitis through p53-mediated apoptosis of inflammatory cells. Cancer Prev Res (Phila Pa) 2010, 3:339-347.
93. Luo JZ, Luo L American ginseng stimulates insulin production and prevents apoptosis through regulation of uncoupling protein-2 in cultured beta cells. Evid Based Complement Alternat Med 2006, 3:365-372.
94. Lee WK, Kao ST, Liu IM, Cheng JT Increase of insulin secretion by ginsenoside Rh2 to lower plasma glucose in Wistar rats. Clin Exp Pharmacol Physiol 2006, 33:27-32.
95. Kim K, Kim HY Korean red ginseng stimulates insulin release from isolated rat pancreatic islets. J Ethnopharmacol 2008, 120:190-195.
96. Van Kampen J, Robertson H, Hagg T, Drobitch R Neuroprotective actions of the ginseng extract G115 in two rodent models of Parkinson's disease. Exp Neurol 2003, 184:521-529.
97. Yamaguchi Y, Higashi M, Kobayashi H Effects of ginsenosides on impaired performance caused by scopolamine in rats. Eur J Pharmacol 1996, 312:149-151.
98. Mook-Jung I, Hong HS, Boo JH, Lee KH, Yun SH, Cheong MY, et al. Ginsenoside Rb1 and Rg1 improve spatial learning and increase hippocampal synaptophysin level in mice. J Neurosci Res 2001, 63:509-515.
99. Song ZJ, Johansen HK, Faber V, Hoiby N Ginseng treatment enhances bacterial clearance and decreases lung pathology in athymic rats with chronic P. aeruginosa pneumonia. APMIS 1997, 105:438-444.
100. Song Z, Moser C, Wu H, Faber V, Kharazmi A, Hoiby N Cytokine modulating effect of ginseng treatment in a mouse model of Pseudomonas aeruginosa lung infection. J Cyst Fibros 2003, 2:112-119.
101. 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.
102. Jeon BH, Kim CS, Kim HS, Park JB, Nam KY, Chang SJ Effect of Korean red ginseng on blood pressure and nitric oxide production. Acta Pharmacol Sin 2000, 21:1095-1100.
103. Kim ND, Kang SY, Schini VB Ginsenosides evoke endothelium-dependent vascular relaxation in rat aorta. Gen Pharmacol 1994, 25:1071-1077.
104. Vogler BK, Pittler MH, Ernst E The efficacy of ginseng. A systematic review of randomised clinical trials. Eur J Clin Pharmacol 1999, 55:567-575.
105. Bucci LR Selected herbals and human exercise performance. Am J Clin Nutr 2000, 72:624S-636S.
106. Schulz KF, Chalmers I, Hayes RJ, Altman DG Empirical evidence of bias. Dimensions of methodological quality associated with estimates of treatment effects in controlled trials. JAMA 1995, 273:408-412.
107. Jones DR Meta-analysis: weighing the evidence. Stat Med 1995, 14:137-149.
108. Shader RI, Greenblatt DJ Phenelzine and the dream machine-ramblings and reflections. J Clin Psychopharmacol 1985, 5:65.
109. Jones BD, Runikis AM Interaction of ginseng with phenelzine. J Clin Psychopharmacol 1987, 7:201-202.
110. Hu Z, Yang X, Ho PC, Chan SY, Heng PW, Chan E, et al. Herb-drug interactions: a literature review. Drugs 2005, 65:1239-1282.
111. Izzo AA, Ernst E Interactions between herbal medicines and prescribed drugs: a systematic review. Drugs 2001, 61:2163-2175.