Written by Chrystal Moulton, Science Writer. Patients in the Ginkgo biloba extract group had significantly better scores on the Barthel and hemorheology indices, the NIHSS, and the serum inflammatory and platelet activation factors than the conventional group (P <0.05).
In Chinese medicine, stroke is characterized as when the qi and blood are in disarray resulting in blockage and blood stasis1. Therefore, treatment requires activation of blood circulation and meridian channels, regulation of qi and blood, and elimination of blood stasis2,3. Ginkgo biloba extract, which has an array of biologic activities from antioxidant to antiplatelet aggregation4, has demonstrated improvement in cerebral blood flow, neuroprotective effects, and a range of pharmacological effects supporting therapeutic improvement in both cardiovascular and cerebrovascular diseases. In the current study, researchers investigated the efficacy of Ginkgo biloba extract in treating elderly patients suffering from stroke1.
Elderly patients admitted to the hospital between August 2022 and August 2023, who were 60 years old or more, and clinically diagnosed by CT or MRI scan with stroke were eligible for this trial. All patients in this study were experiencing stroke for the first time and were fully informed of the nature of this trial. These were randomly assigned to receive conventional treatment or conventional treatment and Ginkgo biloba extract injection. All participants received routine treatment which included glucose monitoring, maintaining electrolyte balance, reducing intracranial pressure, and other symptom treatment along with aspirin 100mg twice daily. However, patients in the Ginkgo biloba extract group received a 70mg Ginkgo biloba extract injection that was slowly titrated intravenously once daily. Study duration was two weeks and was designed as a double-blind randomized clinical control trial. At baseline, researchers measured neurological function, inflammatory markers, platelet activation factors, hemodynamic indices, and a clinical efficacy. These measurements were taken again after 14 days of treatment. They also gathered anthropometric measurements and socio-demographic information. Researchers also assessed each individual’s ability to perform daily life activities which was measured using the Barthel index. Patients were characterized into four groups based on the Barthel index with higher scores indicating autonomous activity and lower scores indicating dysfunction. Adverse reactions were tracked during the two weeks of the trial.
A total of 120 patients were randomly assigned to the treatment with Ginkgo biloba extract (n = 60) or conventional therapy (n = 60). No significant differences were observed in demographics, age, BMI, hypertension nor hyperlipidemia among the patients. After 14 days of treatment, both groups experienced significant decreases in National Institute of Health Stroke Scale (NIHSS), whole blood low-shear viscosity, plasma viscosity, hematocrit, as well as TNF- alpha, IL-6, and platelet activating factor [PAF] levels compared to baseline (P <0.05). However, patients in the Ginkgo biloba extract group had significantly better scores on the Barthel index, the NIHSS, the hemorheology indices [hematocrit, plasma viscosity, and whole blood low shear viscosity], inflammatory factors [IL-6 and TNF- alpha], and platelet activation factor than the conventional group (P <0.05). Out of the 60 patients assigned to the Ginkgo biloba extract group, 58 showed moderate to significant improvement across all measured indices and thus had a significantly higher clinical efficacy compared to the conventional group [50 of 60 patients had moderate to significant improvement] (P = 0.033). No significant differences were observed in adverse reactions between the conventional and Ginkgo biloba extract group.
Results from this study suggest that Ginkgo biloba extract injection together with conventional treatment could significantly improve clinical outcomes for elderly patients diagnosed with stroke for the first time. Additional studies will be needed to verify these results across various populations.
Source: Zhu, Qiuhong, and Dilongtian Liu. “Clinical efficacy and mechanism of Ginkgo biloba extract in the treatment of elderly ischemic cerebrovascular disease.” (2024): 705-713.
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Posted November 18, 2024.
Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.
References:
- Zhu Q, Liu D. Clinical efficacy and mechanism of Ginkgo biloba extract in the treatment of elderly ischemic cerebrovascular disease. 2024.
- Zhang H, Jin B, You X, et al. Pharmacodynamic advantages and characteristics of traditional Chinese medicine in prevention and treatment of ischemic stroke. Chin Herb Med. Oct 2023;15(4):496-508. doi:10.1016/j.chmed.2023.09.003
- Li XH, Yin FT, Zhou XH, et al. The Signaling Pathways and Targets of Natural Compounds from Traditional Chinese Medicine in Treating Ischemic Stroke. Molecules. May 12 2022;27(10)doi:10.3390/molecules27103099
- Yin CY, Lian YP, Xu JD, et al. Study on network pharmacology of Ginkgo biloba extract against ischaemic stroke mechanism and establishment of UPLC-MS/MS methods for simultaneous determination of 19 main active components. Phytochem Anal. Mar 2024;35(2):254-270. doi:10.1002/pca.3286
