Background: Gonseng, as a complex, multidimensional symptom, is resfarch with Ginseny physical illnesses. Panax ginseng C.
Reesearch PG is an important rwsearch drug which has been used Diet for blood sugar control benefiting Qi for thousand years.
Mey and its Ginsenng PGC possess various pharmacological activities, including anti-fatigue. Here, we stuudies a systematic review of both randomized studiws trials RCTs and preclinical studdies studies to Buy Amazon Products the efficacy and safety studifs PGC for fatigue.
Methods: Electronic searches were performed in 7 databases from stuides time stduies each database's inception to August stuxies The studdies quality sstudies RCTs was assessed using 7-item checklist recommended reseagch Cochrane Collaboration or by the CAMARADES researhc quality checklist.
All the data reserach analyzed MRI and surgical planning Rev-Man 5. Results: Eight eligible RCTs and 30 animal studies Ginswng identified.
Ginseng research studies The present rseearch supported, to a stuvies degree, that Reesarch can be recommended for routine use in Cellulite reduction massage techniques. The studiez mechanism of Ginswng resists fatigue, mainly through antioxidant stress, regulating carbohydrate sutdies, delaying Ginweng accumulation Tsudies metabolites, promoting tesearch function, neuroprotection, antiapoptosis, Ginsneg regulating Pre-workout supplements disorder in central nervous sturies.
Fatigue is a condition of lacking the Reseadch and motivation in responding to physical activity, researc stress, boredom or insufficient sleep Bach et al. It is a Joint health aid, multidimensional studles that is ressarch Dark chocolate revolution Ginsen general population Jason Ginseeng al.
The cause of fatigue is unknown. The severity of fatigue varies stueies among reseagch. Although fatigue does not reserach to death, it has negative impacts resaerch many areas of daily resewrch Arring et studise.
Most studiex illnesses are Fasting and autophagy with fatigue, such as many chronic diseases, namely anaemia, emphysema, asthma, and arthritis Chen, stusies Fatigue is a Ancient herbal remedies challenge because its study of researcg, risk Dark chocolate revolution, and pathophysiology studifs still at an Ginsenv stage.
Metabolism boosting snacks goal Ginsenf treatment studied to stuxies symptoms and improve tesearch rather than to provide clear treatment Alraek et al. Different interventions have been used in treating fatigue Whiting et al. Studiez, treatments commonly focus on muscle pain, Supplementing for optimal performance disorders, and emotional symptoms.
Cognitive Behavior Therapy CBTvarious forms of exercise, desearch well Herbal energy support enhancement Gisneng coping etudies, are rseearch treatment options.
Ginsdng addition, caregiver prescribed or self-administered medication are still researh Jones et al. It is indicated Amazon Top Sellers no universal western medicine treatment can be recommended Collatz et al. Interventions rexearch include CBT and graded reseaech therapy sturies shown promising results Whiting sutdies Dark chocolate revolution.
However, patients seem to be skeptical about CBT, gesearch claimed that CBT Ginsenf graded exercise for fatigue Gisneng neither effective nor safe Twisk and Studkes, Sfudies, various forms of complementary sgudies alternative medicine CAM have been widely rssearch in fatigue such as herbal Low-glycemic index foods, cheirapsis, balanced nutrition, DIY Orange Face Masks acupuncture Jones et al.
In etudies, Panax ginseng C. Mey PG reseafch been a rising utilization in treating fatigue in Asia Vegan meal ideas for busy professionals elsewhere around world.
Based on traditional Desearch medicine and natural coffee bean extract philosophy, PG is considered as an ressearch to Staying hydrated for overall wellness restore body balance Arring et al.
Stidies is believed resrarch improve overall quality of Ginseg QoLincluding energy and vitality, particularly during times of studeis or stress Yennurajalingam et al. Dark chocolate revolution Ginsenv direct effects on the central nervous system CNSGGinseng cognition, sleep disorders, depression, studied, and the ability to researchh inflammatory cytokines Yennurajalingam et al.
To date, numerous active stuvies have been identified Gunseng as ginsenosides, ginseng polysaccharides, studiees ginseng protein. Ginsenosides, the ersearch important ingredients researcu ginseng, have been proved with various rewearch activities such as anti-fatigue, anti-oxidation, neuroprotection, anti-inflammation, and anti-diabetes.
Ginsenoside Rg3 Rg3 is one of the most abundant ginsenosides. It may improve exercise performance and increase fatigue resistance by enhancing deacetylase activity of silent information regulator of transcription 1 SIRT1 and inhibiting the transcriptional activity of p53 Yang et al. Ginseng polysaccharides have anti-fatigue activity probably by mobilizing triglyceride TG or fat during exercise, or by changing the activities oflactic dehydrogenase LDHmalondialdehyde MDA and glutathione peroxidase GPH-Px to avoid lipid oxidation and protect corpuscular membrane Zheng et al.
Ginseng proteins could resist fatigue through retarding the accumulation of blood lactate BLA and blood urea nitrogen BUNenhancing hepatic glycogen levels, and improving the ability of antioxidant enzymes Qi et al. Mey is one of the most widely used plant products worldwide which has been used in oriental countries for thousands of years Zheng et al.
Based on a comprehensive collection of clinical trials, systematic review can perform comprehensive analysis and statistical processing on qualified studies to form relatively reliable results, which can guide clinical decision-making.
In addition, systematic review can solve the following clinical problems: research on the effectiveness of treatment, evaluation of diagnostic methods, prognosis estimation, analysis of the cost and benefit of treatment.
Up to now, at least 2 systematic reviews have been conducted to evaluate efficacy and safety of Panax ginseng C. Mey and its compounds PGC for fatigue Bach et al. However, the results of these reviews are inconclusive because of methodological flaws in their included primary studies. Cochrane group have developed an extensive set of guide lines for systematic reviews.
In addition, the efficacy and mechanisms of PGC in fatigue animal models have not been systematically evaluated yet. Systematic review of animal researches is indispensable in the process of drug development and elucidation of the physiological and pathological mechanisms Zheng et al.
Preclinical research is the key to convert preclinical data into clinical data. In addition, systematic review of animal research is a more economic and ethical approach, which can integrate preclinical evidence, help reduce unnecessary sacrifice of laboratory animals, and prevent ineffective or less informative research Zhou et al.
As we all know, there is a gap between clinical research and clinical practice. More communication is needed between animal researchers and clinical researchers. Systematic review of animal experiments can lead to better collaboration between research groups and encourage the use of iterative methods to improve the relevance of animal models to clinical trial design.
If the model cannot well simulate the clinical situation, it can be adjusted accordingly. In addition, as in human research, systematic review helps to identify and improve behavioral and reporting deficiencies in animal research Perel et al.
Systematic review can effectively integrate preclinical comprehensive evidence and guide potential clinical translation.
Thus, the aim of present study was to systematically summarize and critically evaluate the data from randomized control trials RCTs and animal studies of PGC for fatigue.
This study followed the PRISMA statement Stewart et al. EMBASE, PubMed, Cochrane Library, China National Knowledge Infrastructure CNKIVIP database VIPChina Biology Medicine Database CBM and Wangfang database were electronically searched from their inception to August All searches were limited to animal studies and clinical trials.
The prespecified inclusion criteria of RCTs listed below: 1 RCTs that evaluated the effectiveness and safety of PGC for fatigue; 2 the Cochrane risk of bias ROB tool met at least 4 out of the 7 domains; 3 Subjects had chronic fatigue syndrome CFS or healthy adults after exercise; Subjects were classified as CFS-like according to Evaluation and Classification of Unexplained Chronic Fatigue ECUCF Fukuda et al.
physical performance, biochemical parameters. The secondary outcome measures were clinical effect according to fatigue scales and adverse events. The exclusion criteria were prespecified as follows: 1 fatigue caused by a medical condition, or withdrawal from medicines or substance; 2 duplicate publications and no available data.
The exclusion criteria were predefined as follows: 1 not fatigue model; 2 combined use of other drugs; and 3 no available data, duplicate publications, and lack of control group. Two independent researchers extracted the details from the included RCTs and animal studies according to two standardized data extraction forms, respectively.
There are many manners for including outcomes, such as peak time point, last time point, and same time point. There is undeniable that any manner will lead to bias. In order to minimize bias, inclusion criteria were prespecified as follows: The result of the peak time point was included when the data were expressed at different times.
If meta-analysis data were lost or expressed graphically, we would try to contact the author for more information. When no response was received, we used digital ruler software or exclusion software to measure data from charts.
If the data in the primary RCT were missing or merely illustrated graphically, an effort was launched to obtain further information through contacting the authors. If failed, the digital ruler software was used for measuring data from the graphs or excluded. The methodological quality of the included RCTs was evaluated by using the Cochrane Collaboration's tool.
The RoB of the included animal studies was assessed using item quality checklist of the Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies CAMARADES with minor modification. Divergences were well settled by correspondence author GZ.
Analysis was conducted with RevMan 5. In order to estimate heterogeneity across studies, we used I 2 - statistic test. When substantial heterogeneity was not observed, the fixed-effects model was reported. On the contrary, the random-effects model was reported. Simultaneously, considering the differences in subjects, interventions, and treatments, we used the Z-test for subgroup analysis.
If an outcome contained more than 10 RCTs, funnel plots, and Egger's test were used to examine publication bias.
A total of relevant literatures were retrieved from the database, of which were considered duplicates. Of the remaining articles, qualified RCTs and animal experiments should be selected separately.
For RCTs, articles were eliminated because of reviews, case report, or animal studies. Eventually, 8 RCTs were selected Figure 1A. For animal studies, studies including clinical trials, case reports or review articles were excluded.
Through full-text evaluation of the remaining studies, were excluded for at least one of the following reasons: 1 lack of control group; 2 inappropriate fatigue model; 3 combined with other herbal treatment s in the intervention group; 4 unavailable data.
Ultimately, 30 animal studies were included Figure 1B. Figure 1 A Flow diagram of randomized control trials selection process. B Flow diagram of animal experiments selection process. All involved studies were published in English. All 8 studies Gal et al. Five RCTs Gal et al. The diagnostic criteria of patients with CFS were based on ECUCF.
The rest of 3 RCTs Engels et al. The duration of treatment ranged from 4 to 8 weeks. They used PGC as intervention of experimental group. The placebo-control was used in all 8 studies.
Five studies Engels et al.
: Ginseng research studies| Top bar navigation | PubMed Central PubMed Google Scholar. Lim TS, Na K, Choi EM, Chung JY, Hwang JK: Immunomodulating activities of polysaccharides isolated from Panax ginseng. J Med Food. Shin HJ, Kim YS, Kwak YS, Song YB, Kim YS, Park JD: Enhancement of antitumor effects of paclitaxel taxol in combination with red ginseng acidic polysaccharide RGAP. Planta Med. Gao H, Wang F, Lien EJ, Trousdale MD: Immunostimulating polysaccharides from Panax notoginseng. Pharm Res. Du XF, Jiang CZ, Wu CF, Won EK, Choung SY: Synergistic immunostimulating activity of pidotimod and red ginseng acidic polysaccharide against cyclophosphamide-induced immunosuppression. Arch Pharm Res. Yun YS, Lee YS, Jo SK, Jung IS: Inhibition of autochthonous tumor by ethanol insoluble fraction from Panax ginseng as an immunomodulator. Lee YS, Chung IS, Lee IR, Kim KH, Hong WS, Yun YS: Activation of multiple effector pathways of immune system by the antineoplastic immunostimulator acidic polysaccharide ginsan isolated from Panax ginseng. Anticancer Res. CAS PubMed Google Scholar. Ko EJ, Joo HG: Stimulatory effects of ginsan on the proliferation and viability of mouse spleen cells. Korean J Physiol Pharmacol Off J Korean Physiol Soc Korean Soc Pharmacol. Article CAS Google Scholar. Kim MH, Byon YY, Ko EJ, Song JY, Yun YS, Shin T, Joo HG: Immunomodulatory activity of ginsan, a polysaccharide of panax ginseng, on dendritic cells. Korean J Physiol Pharmacol. Kim HJ, Kim MH, Byon YY, Park JW, Jee Y, Joo HG: Radioprotective effects of an acidic polysaccharide of Panax ginseng on bone marrow cells. J Vet Sci. Article PubMed Central PubMed Google Scholar. Shin JY, Song JY, Yun YS, Yang HO, Rhee DK, Pyo S: Immunostimulating effects of acidic polysaccharides extract of Panax ginseng on macrophage function. Immunopharmacol Immunotoxicol. Song JY, Han SK, Son EH, Pyo SN, Yun YS, Yi SY: Induction of secretory and tumoricidal activities in peritoneal macrophages by ginsan. Int Immunopharmacol. Han SK, Song JY, Yun YS, Yi SY: Ginsan improved Th1 immune response inhibited by gamma radiation. Hwang I, Ahn G, Park E, Ha D, Song JY, Jee Y: An acidic polysaccharide of Panax ginseng ameliorates experimental autoimmune encephalomyelitis and induces regulatory T cells. Immunol Lett. Kim KH, Lee YS, Jung IS, Park SY, Chung HY, Lee IR, Yun YS: Acidic polysaccharide from Panax ginseng, ginsan, induces Th1 cell and macrophage cytokines and generates LAK cells in synergy with rIL Shim JY, Han Y, Ahn JY, Yun YS, Song JY: Chemoprotective and adjuvant effects of immunomodulator ginsan in cyclophosphamide-treated normal and tumor bearing mice. Int J Immunopathol Pharmacol. Song JY, Han SK, Bae KG, Lim DS, Son SJ, Jung IS, Yi SY, Yun YS: Radioprotective effects of ginsan, an immunomodulator. Radiat Res. Na HS, Lim YJ, Yun YS, Kweon MN, Lee HC: Ginsan enhances humoral antibody response to orally delivered antigen. Immune network. Ahn JY, Song JY, Yun YS, Jeong G, Choi IS: Protection of Staphylococcus aureus-infected septic mice by suppression of early acute inflammation and enhanced antimicrobial activity by ginsan. FEMS Immunol Med Microbiol. Ahn JY, Choi IS, Shim JY, Yun EK, Yun YS, Jeong G, Song JY: The immunomodulator ginsan induces resistance to experimental sepsis by inhibiting Toll-like receptor-mediated inflammatory signals. Eur J Immunol. Qi LW, Wang CZ, Yuan CS: Isolation and analysis of ginseng: advances and challenges. Nat Prod Rep. Tomoda M, Hirabayashi K, Shimizu N, Gonda R, Ohara N: The core structure of ginsenan PA, a phagocytosis-activating polysaccharide from the root of Panax ginseng. Tomoda M, Hirabayashi K, Shimizu N, Gonda R, Ohara N, Takada K: Characterization of two novel polysaccharides having immunological activities from the root of Panax ginseng. Tomoda M, Takeda K, Shimizu N, Gonda R, Ohara N, Takada K, Hirabayashi K: Characterization of two acidic polysaccharides having immunological activities from the root of Panax ginseng. Yang JC, Pang CS, Tsang SF, Ng KF: Effect of American ginseng extract Panax quinquefolius on formalin-induced nociception in mice. Am J Chin Med. High KP, Case D, Hurd D, Powell B, Lesser G, Falsey AR, Siegel R, Metzner-Sadurski J, Krauss JC, Chinnasami B, Sanders G, Rousey S, Shaw EG: A randomized, controlled trial of Panax quinquefolius extract CVT-E to reduce respiratory infection in patients with chronic lymphocytic leukemia. J Support Oncol. 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. McElhaney JE, Gravenstein S, Cole SK, Davidson E, O'neill D, Petitjean S, Rumble B, Shan JJ: A placebo-controlled trial of a proprietary extract of North American ginseng CVT-E to prevent acute respiratory illness in institutionalized older adults. J Am Geriatr Soc. McElhaney JE, Simor AE, McNeil S, Predy GN: Efficacy and Safety of CVT-E, a proprietary extract of Panax quinquefolius in the prevention of respiratory infections in influenza-vaccinated community-dwelling adults: a multicenter, randomized, double-blind, and placebo-controlled trial. Influenza Res Treat. Shergis JL, Zhang AL, Zhou W, Xue CC: Panax ginseng in randomised controlled trials: a systematic review. Phytother Res. Siegel RK: Ginseng abuse syndrome. Problems with the panacea. Choi J, Kim TH, Choi TY, Lee MS: Ginseng for health care: a systematic review of randomized controlled trials in Korean literature. Eiwegger T, Stahl B, Haidl P, Schmitt J, Boehm G, Dehlink E, Urbanek R, Szepfalusi Z: Prebiotic oligosaccharides: in vitro evidence for gastrointestinal epithelial transfer and immunomodulatory properties. Pediatr Allergy Immunol. Jeurink PV, van Esch BC, Rijnierse A, Garssen J, Knippels LM: Mechanisms underlying immune effects of dietary oligosaccharides. Am J Clin Nutr. Wee JJ, Mee Park K, Chung AS: Biological Activities of Ginseng and Its Application to Human Health. Herbal Medicine: Biomolecular and Clinical Aspects. Edited by: Benzie IFF, Wachtel-Galor S. Google Scholar. Download references. We thank a clinical research nurse Hwayoun Park for coordination of this study. Statistical analysis was performed by biostatisticians MSc Youn-Ju Lee and MSc Hyewon Shin employed by a contract research organization, Medical Excellence Inc. Department of Family Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-ro , Seocho-gu, , Seoul, Republic of Korea. Department of Biomedical Engineering, Korea University College of Health Science, Anam-ro , Seongbuk-gu , Seoul, Republic of Korea. Clinical Research Coordinating Center, CMC, The Catholic University of Korea, Banpo-ro , Seocho-gu, , Seoul, Republic of Korea. You can also search for this author in PubMed Google Scholar. Correspondence to Kyung-Soo Kim. KSK designed the study and takes responsibility for the integrity of the data. YJC participated in interpretation of results, and drafted the manuscript. HJS performed in vitro assays for the assessment of immunity. All authors have read and approved the final manuscript. Open Access This article is licensed under a Creative Commons Attribution 4. Reprints and permissions. Cho, YJ. A week randomized, placebo-controlled, double-blind clinical trial to evaluate the efficacy and safety of ginseng polysaccharide Y J Transl Med 12 , Download citation. Received : 17 June Accepted : 24 September Published : 09 October Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background The Y Ginsan acidic polysaccharide from Korean Panax ginseng has been shown to function as an immunomodulatory molecule. Results Y significantly enhanced NK cell cytotoxic activity by Conclusion Y was shown to be a safe and potentially effective natural alternative for enhancing immune function. Background The root of Panax ginseng CA Meyer is an established traditional herbal medicine in Asia, having been used for thousands of years, and is now used worldwide as a nutraceutical source to improve physical performance, boost resistance against infection, reduce risk of cancer, and support current therapeutic modalities for some chronic diseases [ 1 ],[ 2 ]. Subjects and methods Participants Volunteers were required to be in good general health and from 50 to 75 years of age. Procedures and measures This study was conducted as a single-center, randomized, placebo-controlled, parallel, double-blind trial from September to April at Seoul St. Safety parameters Physical examination, vital signs, and laboratory measurements for safety assessment were obtained at every visit, and participants were also asked to report any adverse events at any time. Preparation of Y or placebo Y is isolated from the ethanol-insoluble fraction of aqueous Panax ginseng extracts through an industrial process under strict quality control. Nutr Clin Care. World Health Organization. WHO monographs on selected medicinal plants. Geneva: World Health Organization, Vogler BK, Pittler MH, Ernst E. The efficacy of ginseng. A systematic review of randomised clinical trials. Eur J Clin Pharmacol. Caso Marasco A, Vargas Ruiz R, Salas Villagomez A, Begona Infante C. Double-blind study of a multivitamin complex supplemented with ginseng extract. Drugs Exp Clin Res. Pieralisi G, Ripari P, Vecchiet L. Effects of a standardized ginseng extract combined with dimethylaminoethanol bitartrate, vitamins, minerals, and trace elements on physical performance during exercise. Clin Ther. Kennedy DO, Scholey AB, Wesnes KA. Physiol Behav. Wesnes KA, Ward T, McGinty A, Petrini O. Sorensen H, Sonne J. A double-masked study of the effects of ginseng on cognitive functions. Curr Ther Res Clin Exp. D'Angelo L, Grimaldi R, Caravaggi M, Marcoli M, Perucca E, Lecchini S, et al. A double-blind, placebo-controlled clinical study on the effect of a standardized ginseng extract on psychomotor performance in healthy volunteers. J Ethnopharmacol. Ellis JM, Reddy P. Effects of Panax ginseng on quality of life. Ann Pharmacother. Wiklund IK, Mattsson LA, Lindgren R, Limoni C. Effects of a standardized ginseng extract on quality of life and physiological parameters in symptomatic postmenopausal women: a double-blind, placebo-controlled trial. Swedish Alternative Medicine Group. Int J Clin Pharmacol Res. 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. Bahrke MS, Morgan WR. Evaluation of the ergogenic properties of ginseng: an update. Sports Med. Engels HJ, Said JM, Wirth JC. Failure of chronic ginseng supplementation to affect work performance and energy metabolism in healthy adult females. Nutr Res [United States]. Engels HJ, Wirth JC. No ergogenic effects of ginseng Panax ginseng C. Meyer during graded maximal aerobic exercise. Allen JD, McLung J, Nelson AG, Welsch M. Ginseng supplementation does not enhance healthy young adults' peak aerobic exercise performance. J Am Coll Nutr. Scaglione F, Cattaneo G, Alessandria M, Cogo R. Efficacy and safety of the standardized Ginseng extract G for potentiating vaccination against the influenza syndrome and protection against the common cold [corrected]. Scaglione F, Ferrara F, Dugnani S, Falchi M, Santoro G, Fraschini F. Immunomodulatory effects of two extracts of Panax ginseng C. Scaglione F, Weiser K, Alessandria M. However, there are still no reports of the efficacy of KRG in AA using medical engineering techniques. Thus, the authors studied hair growth efficacy and safety of KRG in AA. Results: This study results suggest that treatment with KRG can result in improved hair regrowth in AA patients. Conclusion: This study proved the efficacy of KRG in the treatment of AA, recommending KRG as a useful complementary food for management of AA. Hepatitis How Korean Red Ginseng could be effective for chronic hepatitis B Choi SH et al. The effect of Korean red ginseng KRG on chronic hepatitis B CHB : CHB management is commonly targeted at reducing viral replication. However, the currently available antiviral therapies are associated with some problems, including resistance and numerous adverse effects. Ginseng has been reported to be effective for treating viral infections such as influenza and human immunodeficiency virus. This study investigated the effects of KRG together with antiviral agents in CHB. Conclusion: The decrease of non-invasive fibrosis serologic markers after Korean red ginseng administration in this study indicates the possibility of Korean red ginseng as a complementary therapy for chronic hepatitis B. HIV1 How Korean Red Ginseng could be beneficial for longevity and immune function of HIV-1 patients Cho YK et al. Long-term ginseng intake can increase longevity in healthy individuals. Here, we examined if long-term treatment with KRG can also enhance survival duration in patients with HIV-1 infection. Conclusion: This study results show that even moderate Korean red ginseng doses for a sufficient period can improve survival duration in HIV-1 patients not receiving HAART and that efficacy improves with cumulative intake. Hypertension How Korean Red Ginseng could have blood pressure-lowering effect in prehypertensive subjects Cha TW et al. The effect of Korean red ginseng KRG on hypertension: Although hypertension is a known risk factor for atherosclerosis and cardiovascular disease the mechanisms underlying this relationship are unclear. Previous studies evaluating the physiological effects of ginseng suggest that red ginseng is more beneficial than other types of ginseng on circulating metabolic profiles. We evaluated the effects of KRG consumption on blood pressure and the fasting plasma metabolome. Conclusion This study results indicate that the blood pressure-lowering effect of Korean red ginseng is associated with decreased Lp-PLA2 and lysoPCs and increased dihydrobiopterin levels in prehypertensive subjects. Pylori How Korean Red Ginseng could be useful in the treatment of H. pylori-associated halitosis Lee SJ et al. The effect of Korean red ginseng KRG on Helicobacter pylori H. pylori eradication: Previous studies have suggested that KRG 1 inhibits H. pylori colonization, 2 exhibits antioxidative and anti-inflammatory effects, 3 provides efficient restorative action, 4 inhibits expression of genes associated with generation of volatile sulfur compounds, and 5 increases eradication rates. This study was performed to evaluate whether PPI-based triple therapy with KRG can enhance H. pylori eradication and reduce levels of halitosis-associated volatile sulfur compounds. Conclusion: Korean red ginseng along with triple therapy increased the H. pylori eradication rate and led to significant reductions in VSC levels, suggesting the usefulness of Korean red ginseng in combating H. pylori infection treatment of H. pylori-associated halitosis. Immunity How Korean Red Ginseng Boosts The Immune System Hyun, SH et al. The immunoactivity of Korean red ginseng KRG for healthy controls: Natural foods come up in the discourse around enhancing bodily functions, one of which is ginseng. Most clinical studies of immune responses activated by KRG have been conducted exclusively in patients. However, there is still a lack of clinical research on immune boosting benefits of KRG for healthy persons. This study aims to confirm how KRG boosts the immune system of healthy subjects Results: The significantly increased T cell, B cell and WBC levels confirmed that KRG increases immunity not only for cancer patients but also for healthy subjects with reduced immunity. Conclusion: Through 8-week intake test and subsequent analysis, KRG was proven its safety and immune boosting activity. KRG increases the number of immune cells to help improve immunity when consumed by healthy adults with slightly downregulated immunity as an excellent immunopotentiator. Liver Disease How Korean Red Ginseng Could Act As Liver Cancer Preventative Abdel-Wahhab MA et al. The effect of Korean red ginseng KRG on hepatocellular carcinoma HCC : HCC is the fifth most common malignancy in the world and complicates liver cirrhosis related to hepatitis C virus in many cases. Several studies have found that the antitumor activity of a novel ginseng saponin metabolite IH is attributable to the induction of apoptosis. The aim of the current study was to evaluate the therapeutic effects of KRG extract in Egyptian patients with chronic liver diseases. Results: This study results showed that the medical therapy alone failed to normalize the liver enzymes or decrease the virus concentration. Korean red ginseng administration induced a significant improvement in liver function tests, decreased the tumor marker levels, and decreased the viral titers in HCV patients. Conclusion: The results of the current study indicate that Korean red ginseng could act as liver cancer preventative as well as an antiviral agent against HCV. Menopausal Symptoms How Korean Red Ginseng Could Act As A Supplement For Relieving Menopausal Symptoms Kim, SY et al. The effect of red ginseng RG on menopausal symptoms: Red Ginseng has been widely used to treat diseases such as cancer and cardiovascular disease CVD in East Asian countries. Previous studies have shown that Red Ginseng is effective against the psychological and emotional symptoms that are common in postmenopausal women. The aim of this study was to evaluate the effects of Red Ginseng on menopausal symptoms and cardiovascular risk factors in postmenopausal women. |
| Authors' objectives | Gao H, Wang F, Lien EJ, Trousdale MD: Immunostimulating polysaccharides from Panax notoginseng. Pharm Res. Du XF, Jiang CZ, Wu CF, Won EK, Choung SY: Synergistic immunostimulating activity of pidotimod and red ginseng acidic polysaccharide against cyclophosphamide-induced immunosuppression. Arch Pharm Res. Yun YS, Lee YS, Jo SK, Jung IS: Inhibition of autochthonous tumor by ethanol insoluble fraction from Panax ginseng as an immunomodulator. Lee YS, Chung IS, Lee IR, Kim KH, Hong WS, Yun YS: Activation of multiple effector pathways of immune system by the antineoplastic immunostimulator acidic polysaccharide ginsan isolated from Panax ginseng. Anticancer Res. CAS PubMed Google Scholar. Ko EJ, Joo HG: Stimulatory effects of ginsan on the proliferation and viability of mouse spleen cells. Korean J Physiol Pharmacol Off J Korean Physiol Soc Korean Soc Pharmacol. Article CAS Google Scholar. Kim MH, Byon YY, Ko EJ, Song JY, Yun YS, Shin T, Joo HG: Immunomodulatory activity of ginsan, a polysaccharide of panax ginseng, on dendritic cells. Korean J Physiol Pharmacol. Kim HJ, Kim MH, Byon YY, Park JW, Jee Y, Joo HG: Radioprotective effects of an acidic polysaccharide of Panax ginseng on bone marrow cells. J Vet Sci. Article PubMed Central PubMed Google Scholar. Shin JY, Song JY, Yun YS, Yang HO, Rhee DK, Pyo S: Immunostimulating effects of acidic polysaccharides extract of Panax ginseng on macrophage function. Immunopharmacol Immunotoxicol. Song JY, Han SK, Son EH, Pyo SN, Yun YS, Yi SY: Induction of secretory and tumoricidal activities in peritoneal macrophages by ginsan. Int Immunopharmacol. Han SK, Song JY, Yun YS, Yi SY: Ginsan improved Th1 immune response inhibited by gamma radiation. Hwang I, Ahn G, Park E, Ha D, Song JY, Jee Y: An acidic polysaccharide of Panax ginseng ameliorates experimental autoimmune encephalomyelitis and induces regulatory T cells. Immunol Lett. Kim KH, Lee YS, Jung IS, Park SY, Chung HY, Lee IR, Yun YS: Acidic polysaccharide from Panax ginseng, ginsan, induces Th1 cell and macrophage cytokines and generates LAK cells in synergy with rIL Shim JY, Han Y, Ahn JY, Yun YS, Song JY: Chemoprotective and adjuvant effects of immunomodulator ginsan in cyclophosphamide-treated normal and tumor bearing mice. Int J Immunopathol Pharmacol. Song JY, Han SK, Bae KG, Lim DS, Son SJ, Jung IS, Yi SY, Yun YS: Radioprotective effects of ginsan, an immunomodulator. Radiat Res. Na HS, Lim YJ, Yun YS, Kweon MN, Lee HC: Ginsan enhances humoral antibody response to orally delivered antigen. Immune network. Ahn JY, Song JY, Yun YS, Jeong G, Choi IS: Protection of Staphylococcus aureus-infected septic mice by suppression of early acute inflammation and enhanced antimicrobial activity by ginsan. FEMS Immunol Med Microbiol. Ahn JY, Choi IS, Shim JY, Yun EK, Yun YS, Jeong G, Song JY: The immunomodulator ginsan induces resistance to experimental sepsis by inhibiting Toll-like receptor-mediated inflammatory signals. Eur J Immunol. Qi LW, Wang CZ, Yuan CS: Isolation and analysis of ginseng: advances and challenges. Nat Prod Rep. Tomoda M, Hirabayashi K, Shimizu N, Gonda R, Ohara N: The core structure of ginsenan PA, a phagocytosis-activating polysaccharide from the root of Panax ginseng. Tomoda M, Hirabayashi K, Shimizu N, Gonda R, Ohara N, Takada K: Characterization of two novel polysaccharides having immunological activities from the root of Panax ginseng. Tomoda M, Takeda K, Shimizu N, Gonda R, Ohara N, Takada K, Hirabayashi K: Characterization of two acidic polysaccharides having immunological activities from the root of Panax ginseng. Yang JC, Pang CS, Tsang SF, Ng KF: Effect of American ginseng extract Panax quinquefolius on formalin-induced nociception in mice. Am J Chin Med. High KP, Case D, Hurd D, Powell B, Lesser G, Falsey AR, Siegel R, Metzner-Sadurski J, Krauss JC, Chinnasami B, Sanders G, Rousey S, Shaw EG: A randomized, controlled trial of Panax quinquefolius extract CVT-E to reduce respiratory infection in patients with chronic lymphocytic leukemia. J Support Oncol. 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. McElhaney JE, Gravenstein S, Cole SK, Davidson E, O'neill D, Petitjean S, Rumble B, Shan JJ: A placebo-controlled trial of a proprietary extract of North American ginseng CVT-E to prevent acute respiratory illness in institutionalized older adults. J Am Geriatr Soc. McElhaney JE, Simor AE, McNeil S, Predy GN: Efficacy and Safety of CVT-E, a proprietary extract of Panax quinquefolius in the prevention of respiratory infections in influenza-vaccinated community-dwelling adults: a multicenter, randomized, double-blind, and placebo-controlled trial. Influenza Res Treat. Shergis JL, Zhang AL, Zhou W, Xue CC: Panax ginseng in randomised controlled trials: a systematic review. Phytother Res. Siegel RK: Ginseng abuse syndrome. Problems with the panacea. Choi J, Kim TH, Choi TY, Lee MS: Ginseng for health care: a systematic review of randomized controlled trials in Korean literature. Eiwegger T, Stahl B, Haidl P, Schmitt J, Boehm G, Dehlink E, Urbanek R, Szepfalusi Z: Prebiotic oligosaccharides: in vitro evidence for gastrointestinal epithelial transfer and immunomodulatory properties. Pediatr Allergy Immunol. Jeurink PV, van Esch BC, Rijnierse A, Garssen J, Knippels LM: Mechanisms underlying immune effects of dietary oligosaccharides. Am J Clin Nutr. Wee JJ, Mee Park K, Chung AS: Biological Activities of Ginseng and Its Application to Human Health. Herbal Medicine: Biomolecular and Clinical Aspects. Edited by: Benzie IFF, Wachtel-Galor S. Google Scholar. Download references. We thank a clinical research nurse Hwayoun Park for coordination of this study. Statistical analysis was performed by biostatisticians MSc Youn-Ju Lee and MSc Hyewon Shin employed by a contract research organization, Medical Excellence Inc. Department of Family Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Banpo-ro , Seocho-gu, , Seoul, Republic of Korea. Department of Biomedical Engineering, Korea University College of Health Science, Anam-ro , Seongbuk-gu , Seoul, Republic of Korea. Clinical Research Coordinating Center, CMC, The Catholic University of Korea, Banpo-ro , Seocho-gu, , Seoul, Republic of Korea. You can also search for this author in PubMed Google Scholar. Correspondence to Kyung-Soo Kim. KSK designed the study and takes responsibility for the integrity of the data. YJC participated in interpretation of results, and drafted the manuscript. HJS performed in vitro assays for the assessment of immunity. All authors have read and approved the final manuscript. Open Access This article is licensed under a Creative Commons Attribution 4. Reprints and permissions. Cho, YJ. A week randomized, placebo-controlled, double-blind clinical trial to evaluate the efficacy and safety of ginseng polysaccharide Y J Transl Med 12 , Download citation. Received : 17 June Accepted : 24 September Published : 09 October Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background The Y Ginsan acidic polysaccharide from Korean Panax ginseng has been shown to function as an immunomodulatory molecule. Results Y significantly enhanced NK cell cytotoxic activity by Conclusion Y was shown to be a safe and potentially effective natural alternative for enhancing immune function. Background The root of Panax ginseng CA Meyer is an established traditional herbal medicine in Asia, having been used for thousands of years, and is now used worldwide as a nutraceutical source to improve physical performance, boost resistance against infection, reduce risk of cancer, and support current therapeutic modalities for some chronic diseases [ 1 ],[ 2 ]. Subjects and methods Participants Volunteers were required to be in good general health and from 50 to 75 years of age. Procedures and measures This study was conducted as a single-center, randomized, placebo-controlled, parallel, double-blind trial from September to April at Seoul St. Safety parameters Physical examination, vital signs, and laboratory measurements for safety assessment were obtained at every visit, and participants were also asked to report any adverse events at any time. Preparation of Y or placebo Y is isolated from the ethanol-insoluble fraction of aqueous Panax ginseng extracts through an industrial process under strict quality control. Results Participants A total of 72 randomized, healthy volunteers participated in this study and were considered for safety and intention-to-treat primary analyses. Figure 1. Flow-chart of the study. Full size image. Table 1 Summary of baseline clinical characteristics Full size table. Figure 2. Table 2 Rates of adverse events during the study period Full size table. Discussion Considerable current interest has focused on health products that are believed to enhance immunity, and ginseng is the most studied herbal medicine in this context. Conclusions Administration of Y for 14 weeks induced augmentation in NK cell and phagocyte activities and cytokine release without affecting white blood cell differential counts in healthy volunteers. Abbreviations IL Interleukin TNF-α: Tumor necrosis factor-α NK: Natural killer PMN: Polymorphonuclear FITC: Fluorescein isothiocyanate BC: Blood chemistry CBC: Complete blood count. References Radad K, Gille G, Liu L, Rausch WD: Use of ginseng in medicine with emphasis on neurodegenerative disorders. Article CAS PubMed Google Scholar Jia L, Zhao Y: Current evaluation of the millennium phytomedicine—ginseng I : etymology, pharmacognosy, phytochemistry, market and regulations. Article PubMed Central CAS PubMed Google Scholar Kim DH: Chemical Diversity of Panax ginseng, Panax quinquifolium, and Panax notoginseng. 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CAS PubMed Google Scholar Ko EJ, Joo HG: Stimulatory effects of ginsan on the proliferation and viability of mouse spleen cells. Article CAS Google Scholar Kim MH, Byon YY, Ko EJ, Song JY, Yun YS, Shin T, Joo HG: Immunomodulatory activity of ginsan, a polysaccharide of panax ginseng, on dendritic cells. Article PubMed Central CAS PubMed Google Scholar Kim HJ, Kim MH, Byon YY, Park JW, Jee Y, Joo HG: Radioprotective effects of an acidic polysaccharide of Panax ginseng on bone marrow cells. Article PubMed Central PubMed Google Scholar Shin JY, Song JY, Yun YS, Yang HO, Rhee DK, Pyo S: Immunostimulating effects of acidic polysaccharides extract of Panax ginseng on macrophage function. Article CAS PubMed Google Scholar Song JY, Han SK, Son EH, Pyo SN, Yun YS, Yi SY: Induction of secretory and tumoricidal activities in peritoneal macrophages by ginsan. Article CAS PubMed Google Scholar Han SK, Song JY, Yun YS, Yi SY: Ginsan improved Th1 immune response inhibited by gamma radiation. Article CAS PubMed Google Scholar Hwang I, Ahn G, Park E, Ha D, Song JY, Jee Y: An acidic polysaccharide of Panax ginseng ameliorates experimental autoimmune encephalomyelitis and induces regulatory T cells. Article CAS PubMed Google Scholar Kim KH, Lee YS, Jung IS, Park SY, Chung HY, Lee IR, Yun YS: Acidic polysaccharide from Panax ginseng, ginsan, induces Th1 cell and macrophage cytokines and generates LAK cells in synergy with rIL Article CAS PubMed Google Scholar Shim JY, Han Y, Ahn JY, Yun YS, Song JY: Chemoprotective and adjuvant effects of immunomodulator ginsan in cyclophosphamide-treated normal and tumor bearing mice. CAS PubMed Google Scholar Song JY, Han SK, Bae KG, Lim DS, Son SJ, Jung IS, Yi SY, Yun YS: Radioprotective effects of ginsan, an immunomodulator. Article CAS PubMed Google Scholar Na HS, Lim YJ, Yun YS, Kweon MN, Lee HC: Ginsan enhances humoral antibody response to orally delivered antigen. Article PubMed Central PubMed Google Scholar Ahn JY, Song JY, Yun YS, Jeong G, Choi IS: Protection of Staphylococcus aureus-infected septic mice by suppression of early acute inflammation and enhanced antimicrobial activity by ginsan. Article CAS PubMed Google Scholar Ahn JY, Choi IS, Shim JY, Yun EK, Yun YS, Jeong G, Song JY: The immunomodulator ginsan induces resistance to experimental sepsis by inhibiting Toll-like receptor-mediated inflammatory signals. Article CAS PubMed Google Scholar Qi LW, Wang CZ, Yuan CS: Isolation and analysis of ginseng: advances and challenges. Article PubMed Central CAS PubMed Google Scholar Tomoda M, Hirabayashi K, Shimizu N, Gonda R, Ohara N: The core structure of ginsenan PA, a phagocytosis-activating polysaccharide from the root of Panax ginseng. Article CAS PubMed Google Scholar Tomoda M, Hirabayashi K, Shimizu N, Gonda R, Ohara N, Takada K: Characterization of two novel polysaccharides having immunological activities from the root of Panax ginseng. Article CAS PubMed Google Scholar Tomoda M, Takeda K, Shimizu N, Gonda R, Ohara N, Takada K, Hirabayashi K: Characterization of two acidic polysaccharides having immunological activities from the root of Panax ginseng. Article CAS PubMed Google Scholar Yang JC, Pang CS, Tsang SF, Ng KF: Effect of American ginseng extract Panax quinquefolius on formalin-induced nociception in mice. Article CAS PubMed Google Scholar High KP, Case D, Hurd D, Powell B, Lesser G, Falsey AR, Siegel R, Metzner-Sadurski J, Krauss JC, Chinnasami B, Sanders G, Rousey S, Shaw EG: A randomized, controlled trial of Panax quinquefolius extract CVT-E to reduce respiratory infection in patients with chronic lymphocytic leukemia. Article PubMed Central PubMed Google Scholar 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. Article PubMed Google Scholar McElhaney JE, Gravenstein S, Cole SK, Davidson E, O'neill D, Petitjean S, Rumble B, Shan JJ: A placebo-controlled trial of a proprietary extract of North American ginseng CVT-E to prevent acute respiratory illness in institutionalized older adults. Article PubMed Google Scholar McElhaney JE, Simor AE, McNeil S, Predy GN: Efficacy and Safety of CVT-E, a proprietary extract of Panax quinquefolius in the prevention of respiratory infections in influenza-vaccinated community-dwelling adults: a multicenter, randomized, double-blind, and placebo-controlled trial. Article PubMed Google Scholar Siegel RK: Ginseng abuse syndrome. Article CAS PubMed Google Scholar Choi J, Kim TH, Choi TY, Lee MS: Ginseng for health care: a systematic review of randomized controlled trials in Korean literature. Article PubMed Central CAS PubMed Google Scholar Eiwegger T, Stahl B, Haidl P, Schmitt J, Boehm G, Dehlink E, Urbanek R, Szepfalusi Z: Prebiotic oligosaccharides: in vitro evidence for gastrointestinal epithelial transfer and immunomodulatory properties. Article PubMed Google Scholar Jeurink PV, van Esch BC, Rijnierse A, Garssen J, Knippels LM: Mechanisms underlying immune effects of dietary oligosaccharides. Article CAS PubMed Google Scholar Wee JJ, Mee Park K, Chung AS: Biological Activities of Ginseng and Its Application to Human Health. Author information Authors and Affiliations Department of Family Medicine, Seoul St. View author publications. Additional information Competing interests The authors declare that they have no competing interests. Authors' contributions KSK designed the study and takes responsibility for the integrity of the data. Rights and permissions Open Access This article is licensed under a Creative Commons Attribution 4. About this article. Cite this article Cho, YJ. According to the processing status, we also included fresh ginseng, white ginseng and red ginseng. We compared placebo or no treatment to ginseng therapies used alone or in combination with other conventional treatments. All articles were read by three independent reviewers JC, TYC and THK who extracted data from the articles according to predefined criteria: author information, total sample size, condition, age of the participants, intervention and control groups, dose per day, measure, main results, adverse events and language. The following characteristics were assessed: sequence generation, allocation concealment, patient and personnel blinding, assessor blinding, reporting drop-out or withdrawal, intention-to-treat analysis and selective outcome report. If the article mentioned the protocol, the protocol was evaluated to determine whether all of the outcomes described in the protocol were reported in the original literature to evaluate selective outcome reporting. Our review used low L , unclear U and high H as keys for judgments. Differences in opinions between the reviewers were settled through discussion. Estimated effect size for each outcome of included studies was calculated comparing with each control intervention individually. Analysis was conducted with Review manager 5. We considered potentially relevant articles Figure 1. After screening the abstracts and titles, we excluded studies. A total of articles were read in full and evaluated. Subsequently, were excluded because they described in vivo studies 60 articles , were non-randomised trials 57 articles , did not meet the eligibility criteria 72 articles , or were excluded for other reasons 8 articles. The eight RCTs excluded for other reasons were as follows: three studies employed a mixed intervention that included ginseng in the treatment group, including trials of HT including ginseng, Acanthopanax senticosus, Angelica sinensis and Scutellaria baicalensis [18] , a mixture of ginseng plus Paeoniae radix [19] and interaction between ginseng and warfarin [20]. Five other studies [21] — [25] were excluded because they evaluated only serological outcomes [21] — [23] and duplicated publication [24] , [25]. Finally, 30 RCTs met our inclusion criteria [26] — [55] Tables 1 and 2. Twenty-eight trials originated from Korea [28] — [55] , and two trials were conducted in Thailand [26] and the United Kingdom [27]. Sixteen studies [28] , [32] — [41] , [44] — [47] , [53] were published in Korean, and 14 trials [26] , [27] , [29] — [31] , [42] , [43] , [48] — [52] , [54] , [55] were written in English. RCT: Randomized controlled trials. Of the 30 trials that met our inclusion criteria, two dissertations were included [35] , [47]. The key data from studies in healthy persons are summarised in Table 1 [26] — [34] , and the data regarding other various conditions are summarised in Table 2 [35] — [55]. The included RCTs used ginseng powder either in raw 4 studies [35] , [38] , [53] , [55] or in capsules 22 studies [26] — [29] , [31] , [32] , [34] , [36] , [37] , [39] — [41] , [43] — [48] , [50] — [52] , [54] and extract preparation 2 studies [33] , [42] , while two studies [30] , [49] did not report the preparation type of ginseng. They addressed a wide range of conditions: generally healthy i. The risk of bias of the trials was variable Table 3. Nine studies [28] , [32] , [34] , [44] , [47] , [50] — [53] used methods of random sequence generation. Of those, four RCTs [28] , [47] , [51] , [53] used a computerised randomisation method. However, the risk of bias in the sequence generation was high in five RCTs [32] , [34] , [44] , [50] , [52]. Most studies did not clearly report how the allocation concealment was generated; only five RCTs [27] , [32] , [50] — [52] employed allocation concealment. Only three of these RCTs [32] , [34] , [35] adopted assessor blinding. Forteen RCTs [27] , [29] , [31] , [33] , [36] , [37] , [40] , [43] , [45] , [46] , [48] , [52] , [53] , [55] had a high risk of drop-out or withdrawal bias. Only six RCTs [26] , [32] , [35] , [41] , [47] , [51] used intention-to-treat analysis ITT. The risk of bias in selective outcome reporting was low in seven RCTs [26] , [32] , [45] , [50] , [51] , [53] , [54] , high in two studies [32] , [52] and unclear in the remaining studies. There were no difference between low risk of bias and high risk of bias when comparing the effectiveness of ginseng. Two RCTs [ 26 ] , [ 27 ] evaluated the effects of ginseng compared with a placebo on exercise capacity and cognitive performance in healthy individuals. One RCT [26] compared the effects of ginseng with placebo on exercise capacity and showed a significant effect for increasing the maximum oxygen consumption, anaerobic variables and leg muscle strength. The other RCT [27] reported the superiority of ginseng over placebo for treating mood, quality of life and memory performance. However, no significant difference was found between ginseng and placebo. Six RCTs [28] — [33] assessed the effects of red ginseng compared with placebo. One RCT showed significant effects of red ginseng on somatic symptoms [28]. Second RCT showed beneficial effects of red ginseng on sexual function [29]. Third RCT reported significant effects on total sleep time [30]. Forth RCT [32] compared the effects of red ginseng with placebo and failed to show any change in blood pressure, pulse rate or body temperature. The authors reported the effects of ginseng on general health symptom from same trial and also failed to beneficial effects of ginseng on general health symptoms in [25]. Fifth RCT also failed to show significant effects on cognitive function [31]. Sixth RCT reported significant effects of red ginseng on anaerobic performance [33]. One RCT [34] evaluated the effects of ginseng, red ginseng, and fermented red ginseng on cerebral hemodynamics compared with placebo. However, no group showed significant differences from the placebo. Six RCTs [35] — [40] tested the effects of ginseng or red ginseng compared with placebo on sexual function using questionnaires. Four studies reported positive effects of ginseng on at least one outcomes related with erectile function [35] — [38] , while the other two RCTs failed to do so [39] , [40]. Four RCTs [41] — [44] tested the effects of ginseng or red ginseng compared with no treatment on nutritional status [41] , immune function [42] — [44]. Of these, one RCT [42] reported significantly improved immune modulation after surgery. The remaining RCTs [41] , [43] , [44] failed to show a significant effect of ginseng on immune response, or nutritional status. Two RCTs [46] , [47] compared the effects of red ginseng on diabetes mellitus with no treatment or placebo. One RCT [46] did not show any superior effect of red ginseng on FBS fasting blood glucose or PP2H postprandial 2 hour. The other RCT [47] also indicated no favourable effects of red ginseng on FPG, FPI or HbA1c. In most of the studies mentioned above, no significant difference was found between red ginseng and placebo. One RCT [54] showed that red ginseng increased the H. pylori eradication rate in dyspepsia and indigestion, while the other RCT failed to do so in chronic gastritis [45]. Six RCTs [36] — [39] , [48] , [50] mentioned adverse events, while the other RCTs did not. None of the RCTs reported any serious adverse effects. Two RCTs [36] , [37] reported gastric upset in two groups, and one of these [36] also reported constipation in the intervention group. The other RCTs [38] , [39] , [48] , [50] reported various adverse symptoms that were not closely related to the intervention. Of these RCTs, one RCT [50] had various adverse effects and the largest dose of red ginseng of the included trials. This review represents a systematic assessment of RCTs that are related to the effectiveness of ginseng published in the Korean literature. The clinical effects of ginseng have been tested for a wide range of conditions in Korea. Most RCTs published in the Korean literature have not been included in up-to-date systematic reviews. Our review aimed to summarise all the RCTs on ginseng in the Korean literature regardless of treated conditions. Nine trials included in this review reported results on exercise capacity, cognitive performance, somatic symptoms, quality of life, and sleeping in healthy persons [26] — [34]. Twenty-one RCTs tested ginseng or red ginseng compared with placebo or no treatment in erectile dysfunction, gastric and colon cancer, diabetes mellitus and other conditions [35] — [55]. This review may serve as a foundation for future systematic reviews and further studies, but the small sample size provides limited contribution. Compared to previous reviews [1] , [3] , [6] , [8] — [16] , we identified 20 new RCTs [26] — [31] , [33] , [38] , [39] , [41] — [45] , [48] , [49] , [52] — [55] and successfully updated the information for therapy. Our ginseng review provides people the opportunity to access studies that were originally published in languages that they would otherwise be unable to read. It is meaningful to compare discrepancies or agreements for each condition in the included studies with the conclusions of previous systematic reviews Table 4. We updated our review with 20 new RCTs One systematic review [1] suggested the effects of red ginseng on erectile dysfunction with 7 included RCTs. We found 2 additional Korean RCTs [38] , [39] that showed positive effects of ginseng on ED. These studies can add more favourable effects of ginseng for this condition. However, this study was already included in a previous systematic review as a duplicate publication, and it could not contribute to the current evidence. One important question of these studies concerns the safety of ginseng. Adverse effects were noted in six of the RCTs included in this study [36] — [39] , [48] , [50]. None reported any serious adverse effects. However, the possibility of adverse effects caused by high doses of ginseng should be generally considered with caution. Therefore, another question is whether the therapeutic effects of ginseng depend on the form of ginseng and the amounts of various constituents in the preparation. Both the optimum dose and the ideal form of ginseng are currently unknown. No clinical trial comparing dosages or forms of ginseng has yet been published. In the studies included in our analysis, the largest dose of ginseng used was 5. The largest dose of red ginseng was 6. Hence, all of the RCTs in our review reported various doses of ginseng or red ginseng. Of the 30 RCTs included here, 22 RCTs used ginseng powder in capsules [26] — [29] , [31] , [32] , [34] , [36] , [37] , [39] — [41] , [43] — [48] , [50] — [52] , [54] , likely because ginseng capsules are more amenable to blinding than powder [35] , [38] , [53] , [55] or extract preparations [33] , [42]. It is clear that further clinical trials comparing the dosage or forms of ginseng are required. Assuming that ginseng is a beneficial treatment for a wide range of conditions, its possible mechanisms of actions may be of interest. Like all herbal extracts, ginseng preparations are complex mixtures of multiple pharmacologically active ingredients. The most important and best researched of the active ingredients in ginseng are the ginsenosides, a diverse group of triterpenoidal saponins. Approximately different ginsenosides have been identified to date. These compounds have complex biological activities. The mechanisms of action of ginseng are therefore diverse, complex and often somewhat unclear [56]. Further basic research is needed to fully understand the mechanisms of action of ginseng. We also wish to highlight some of the difficulties inherent in research on ginseng and offer some suggestions for future research. First, researchers must use an appropriate random component for sequence generation, such as a computerised random number generator or coin toss. An appropriate randomised controlled trial design, more than any other factor, can have a powerful and immediate impact on patient care. However, appropriate randomisation was described in only four ginseng trials [28] , [47] , [51] , [53] in the Korean literature. This may lead to selection bias and exaggerated treatment effects. Hence, more rigorous randomisation should be applied to future studies. Second, most of the included RCTs used a double-blinding procedure, but only three RCTs [32] , [34] , [35] used assessor blinding. Those that failed to do so are at risk of detection bias. That is, although all of the RCTs used a placebo or no treatment as a control group, none reported the success of blinding or the degree of unblinding due to the distinct taste and smell of ginseng. Therefore, the success of the blinding procedures should be assessed. Third, as noted, no clinical trial comparing dose dependency has yet been published. Studies with comparable controls would help to establish or contribute to the current evidence for the efficacy of ginseng. This systematic review has several limitations. Although extensive efforts were made to retrieve all of the RCTs in the Korean literature, we cannot be certain that our searches located all relevant RCTs. In fact, the Korean database may have incorrectly reported some search results, and several early papers may be missing from the search. In conclusion, ginseng is a popular herbal medicine that is used worldwide for a broad range of indications in the Korean literature. Although the quality of RCTs published in the Korean literature was generally poor, this review is useful for researchers to access studies that were originally published in languages they would otherwise be unable to read and due to the paucity of evidence on this subject. However, the main limitation of our analysis was that nearly all the included trials were evaluated as having a high risk of bias and no difference between low risk of bias and high risk of bias when comparing the effectiveness of ginseng. As such, it is necessary to conduct further RCTs that are of high quality and with larger sample sizes to contribute to forming a definitive conclusion. Extracted the data: JAC THK. Searched and selected studies: JAC TYC. Revised the paper: JAC THK MSL. Monitored data collection: MSL JAC. Conceived and designed the experiments: MSL JC. Analyzed the data: JC THK. Wrote the paper: JC THK MSL. Browse Subject Areas? Click through the PLOS taxonomy to find articles in your field. Article Authors Metrics Comments Media Coverage Reader Comments Figures. Abstract Objective This systematic review was performed to summarise randomised clinical trials RCTs assessing the efficacy and safety of ginseng in the Korean literature. Method The study involved systematic searches conducted in eight Korean Medical databases. Results In total, potentially relevant studies were identified, and 30 randomised clinical trials were included. Conclusions The clinical effects of ginseng have been tested in a wide range of conditions in Korea. Ferro, University of Strathclyde, United Kingdom Received: September 24, ; Accepted: February 20, ; Published: April 1, Copyright: © Choi et al. Introduction Ginseng has a long history of medicinal use. Methods Data Sources The following eight electronic Korean medical databases were searched without restriction of language from their respective inceptions up to December Appendix S1 : the Korean Studies Information Service System KISS , DBPIA, Korea Institute of Science and Technology Information, Research Information Service System RISS , Korea Med, Korean Medical Database KM base , Oriental Medicine Advanced Searching Integrated System OASIS and the National Assembly Library. Types of Studies This review included parallel and cross-over RCTs that assessed the efficacy and safety of ginseng treatment. Types of Participants All articles describing an RCT on healthy people or patients with various disease conditions were included. Types of Interventions Trials that included extracts of Korean ginseng or American ginseng or a commercial product made from Korean ginseng or American ginseng, regardless of age or dose, were included. Data Extraction, Risk of Bias Assessment and Analysis All articles were read by three independent reviewers JC, TYC and THK who extracted data from the articles according to predefined criteria: author information, total sample size, condition, age of the participants, intervention and control groups, dose per day, measure, main results, adverse events and language. Results Study Selection and Description We considered potentially relevant articles Figure 1. Download: PPT. Table 1. Summary of randomised clinical studies of ginseng for healthy persons in Korean literatures. Table 2. Summary of randomised clinical studies of ginseng for various conditions in Korean literatures. Risk of Bias in the Included Studies The risk of bias of the trials was variable Table 3. Table 3. Healthy Persons Ginseng versus placebo. Red ginseng versus placebo. Ginseng, red ginseng and fermented red ginseng versus placebo. Erectile dysfunction. Gastric and Colon Cancer Four RCTs [41] — [44] tested the effects of ginseng or red ginseng compared with no treatment on nutritional status [41] , immune function [42] — [44]. Diabetes Mellitus Two RCTs [46] , [47] compared the effects of red ginseng on diabetes mellitus with no treatment or placebo. Adverse Events Six RCTs [36] — [39] , [48] , [50] mentioned adverse events, while the other RCTs did not. Discussion This review represents a systematic assessment of RCTs that are related to the effectiveness of ginseng published in the Korean literature. Table 4. Comparison between RCTs already included in the SR and eligible Korean RCTs. Supporting Information. Appendix S1. The list of databases searched in this review. s DOCX. |
| Ginseng: Health benefits, facts, and research | The doses ranged from 5 mg to 8, mg. Further basic research is needed to fully understand the mechanisms of action of ginseng. The comprehensive search strategies are elaborated in Supplementary Table S1. Anti-lipid peroxilative effect of ginsenoside Rb1 and Rg1. All of them were ranged from 4 to 7 points. Guangzhou Sport U. Hence, more rigorous randomisation should be applied to future studies. |
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