Systematic review of randomized controlled trials evaluating the efficacy and safety of ginseng

Chronic toxicity of ginsenoside Re on Sprague-Dawley rats

ETHNOPHARMACOLOGICAL RELEVANCE

Ginseng has been widely used for hundreds of years in both China and other countries. It is well accepted that the pharmacological effects of ginseng are attributed to ginsenosides. Ginsenoside Re is one of the active ingredients in ginseng. The present study was carried out to characterize the toxicity of ginsenoside Re after repeated oral administration in Sprague-Dawley rats.

MATERIALS AND METHODS

Rats (60 males, 60 females) were administrated ginsenoside Re orally in 0, 38, 113, or 375 mg/kg/day doses for 26 weeks (n=15/group each sex). Clinical signs, mortality, body weights, feed consumption, urinalysis, hematology, serum biochemistry, gross findings, organ weights and histopathology were examined at the end of the test period, as well as after the 4-week recovery period.

RESULTS

Ginsenoside Re did not induce death, adverse effects or dose-dependent changes in feed consumption, or body weight gain. Some statistically significant differences were observed in hematological and biochemical parameters, as well as in body weights of rats treated with ginsenoside Re. However, there was no abnormality of any organs noted in both gross and histopathological examinations.

CONCLUSIONS

Ginsenoside Re is well tolerated up to a 375 mg/kg/day oral dosage level and non-toxic in both male and female rats.

Panax ginseng in randomised controlled trials: a systematic review

Panax ginseng C.A. Meyer is a common herb with many purported health benefits. However, there is no conclusive evidence supporting its use in the treatment of any particular disease. We conducted a systematic review to evaluate randomised controlled trials. Four English databases were searched with no publication date restriction. Included studies evaluated P. ginseng in patients with any type of disease or in healthy individuals. We assessed the quality of studies using the Cochrane risk of bias tool. Of the 475 potentially relevant studies, 65 met the inclusion criteria. These studies examined P. ginseng's effects on psychomotor performance (17 studies), physical performance (ten), circulatory system (eight), glucose metabolism (six), the respiratory system (five), erectile dysfunction (four), immunomodulation (four), quality of life/mood (four), antioxidant function (two), cancer (two), menopausal symptoms (two) and dry mouth (one). The risk of bias was unclear in most studies. Authors evaluated adverse events in 40 studies, with 135 minor events and no serious adverse events reported. P. ginseng shows promising results for improving glucose metabolism and moderating the immune response. This may have implications for several diseases including type 2 diabetes and chronic respiratory conditions. Further studies are needed to explore P. ginseng's potential as an effective treatment for these and other health conditions.

Ginsenoside rb1 modulates level of monoamine neurotransmitters in mice frontal cortex and cerebellum in response to immobilization stress

Cerebral monoamines play important roles as neurotransmitters that are associated with various stressful stimuli. Some components such as ginsenosides (triterpenoidal glycosides derived from the Ginseng Radix) may interact with monoamine systems. The aim of this study was to determine whether ginsenoside Rb1 can modulate levels of the monoamines such as dihydroxyphenylalanine (DOPA), dopamine (DA), norepinephrine (NE), epinephrine (EP), 3,4-dihydroxyphenylacetic acid (DOPAC), 5-hydorxytryptamine (5-HT), 5-hydroxindole-3-acetic acid (5-HIAA), and 5-hydroxytryptophan (5-HTP) in mice frontal cortex and cerebellum in response to immobilization stress. Mice were treated with ginsenoside Rb1 (10 mg/kg, oral) before a single 30 min immobilization stress. Acute immobilization stress resulted in elevation of monoamine levels in frontal cortex and cerebellum. Pretreatment with ginsenoside Rb1 attenuated the stress-induced changes in the levels of monoamines in each region. The present findings showed the anti-stress potential of ginsenoside Rb1 in relation to regulation effects on the cerebral monoaminergic systems. Therefore, the ginsenoside Rb1 may be a useful candidate for treating several brain symptoms related with stress.

The history of ginseng in the management of erectile dysfunction in ancient China (3500-2600 BCE)

Emperor Shen-Nung was the second of China's mythical emperors (3500-2600 BCE). Widely considered the father of Chinese medicine, he catalogued over 365 species of medicinal plants which he personally tasted. Through his treatise ‘Shen Nung Benchau Jing’, we relive Emperor Shen-Nung's contribution to urology with reference to his management of erectile dysfunction. Time-related sources in medical and historical literature were reviewed, including the ‘Shen Nung Benchau Jing’ (The medicine book of Emperor Shen-Nung), archives and manuscripts at the Wellcome History of Medicine Collection, the Royal Society of Medicine, London, The Hong Kong Museum of Medical Sciences, and The Museum of Medical History, Shanghai, China. Chinese traditional herbal medicine began approximately 5000 years ago. Agricultural clan leader, Emperor Shen-Nung, was said to have a ‘crystal-like belly’ to watch the reactions in his own stomach of the herbs he collected. Ginseng was among of Shen Nung's contributions to herbal medicine. He experienced a warm and sexually pleasurable feeling after chewing the root. He advocated this as a treatment for erectile dysfunction and used it to stimulate sexual appetite. The reputation of ginseng as an aphrodisiac is based on the doctrine of signatures, since the adult root has a phallic shape. Shen-Nung believed that ginseng's resemblance to the human form is proof of its rejuvenative and aphrodisiac properties. It was believed that the closer the similarity to the human figure, the more potent the root. The use of ginseng for erectile dysfunction by Emperor Shen-Nung was unique for its time. It continues to hold parallels as a modern-day herbal aphrodisiac 5000 years on.