Chow Tony, Browne Vaughn, Heileson Heather L, Wallace Desiree, Anholm James, Green Steven M
Department of Emergency Medicine, Loma Linda University Medical Center and Children's Hospital, Loma Linda, CA 92354, USA.
Arch Intern Med. 2005 Feb 14;165(3):296-301. doi: 10.1001/archinte.165.3.296.
Acute mountain sickness (AMS) commonly occurs when unacclimatized individuals ascend to altitudes above 2000 m. Acetazolamide and Ginkgo biloba have both been recommended for AMS prophylaxis; however, there is conflicting evidence regarding the efficacy of Ginkgo biloba use. We performed a randomized, placebo-controlled trial of acetazolamide vs Ginkgo biloba for AMS prophylaxis.
We randomized unacclimatized adults to receive acetazolamide, Ginkgo biloba, or placebo in double-blind fashion and took them to an elevation of 3800 m for 24 hours. We graded AMS symptoms using the Lake Louise Acute Mountain Sickness Scoring System (LLS) and compared the incidence of AMS (defined as LLS score > or =3 and headache).
Fifty-seven subjects completed the trial (20 received acetazolamide; 17, Ginkgo biloba, and 20, placebo). The LLS scores were significantly different between groups; the median score of the acetazolamide group was significantly lower than that of the placebo group (P=.01; effect size, 2; and 95% confidence interval [CI], 0 to 3), unlike that of the Ginkgo biloba group (P=.89; effect size, 0; and 95% CI, -2 to 2). Acute mountain sickness occurred less frequently in the acetazolamide group than in the placebo group (effect size, 30%; 95% CI, 61% to -15%), and the frequency of occurrence was similar between the Ginkgo biloba group and the placebo group (effect size, -5%; 95% CI, -37% to 28%).
In this study, prophylactic acetazolamide therapy decreased the symptoms of AMS and trended toward reducing its incidence. We found no evidence of similar efficacy for Ginkgo biloba.
急性高原病（AMS）通常发生在未适应环境的个体攀升至海拔2000米以上时。乙酰唑胺和银杏叶都被推荐用于预防急性高原病；然而，关于使用银杏叶的疗效存在相互矛盾的证据。我们进行了一项关于乙酰唑胺与银杏叶预防急性高原病的随机、安慰剂对照试验。
我们将未适应环境的成年人随机分为三组，以双盲方式分别给予乙酰唑胺、银杏叶或安慰剂，然后将他们带至海拔3800米处停留24小时。我们使用路易斯湖急性高原病评分系统（LLS）对急性高原病症状进行分级，并比较急性高原病的发生率（定义为LLS评分≥3且伴有头痛）。
57名受试者完成了试验（20人接受乙酰唑胺；17人接受银杏叶；20人接受安慰剂）。各组之间的LLS评分存在显著差异；乙酰唑胺组的中位数评分显著低于安慰剂组（P = 0.01；效应量为2；95%置信区间[CI]为0至3），而银杏叶组则不然（P = 0.89；效应量为0；95% CI为 -2至2）。乙酰唑胺组急性高原病的发生率低于安慰剂组（效应量为30%；95% CI为61%至 -15%），银杏叶组与安慰剂组的发生率相似（效应量为 -5%；95% CI为 -37%至28%）。
在本研究中，预防性使用乙酰唑胺疗法可减轻急性高原病症状，并呈降低其发生率的趋势。我们未发现银杏叶有类似疗效的证据。
