Gardner Christopher D, Taylor-Piliae Ruth E, Kiazand Alexandre, Nicholus Joel, Rigby Alison J, Farquhar John W
Stanford Prevention Research Center, Stanford University Medical School, Stanford, California 94305, USA.
J Cardiopulm Rehabil Prev. 2008 Jul-Aug;28(4):258-65. doi: 10.1097/01.HCR.0000327184.51992.b8.
Medical therapies for treatment of peripheral artery disease (PAD) are limited. Ginkgo biloba has been reported to increase maximal and pain-free walking distance among patients with PAD; however, the evidence is inconsistent. The objective of this study was to compare the effects of 300 mg/d of Ginkgo biloba (EGb 761) versus placebo on treadmill walking time and related cardiovascular measures among patients with PAD.
A double-blind, placebo-controlled, parallel design trial with a 4-month duration was used. Participants were 62 adults, aged 70 +/- 8 years (mean +/- SD), with claudication symptoms of PAD. The primary study outcomes were maximal and pain-free walking time on a treadmill. Secondary outcomes included flow-mediated vasodilation, a measure of antioxidant status as assessed by determining antibody levels to epitopes of oxidized low-density lipoprotein, and questionnaires addressing walking impairment and quality of life.
Maximal treadmill walking time increased by 20 +/- 80 and 91 +/- 242 seconds in the placebo and the EGb 761 groups, respectively (P = .12). Pain-free walking time increased by 15 +/- 31 and 21 +/- 43 seconds, respectively (P = .28). No significant differences were detected between groups for any of the secondary outcomes.
In older adults with PAD, Ginkgo biloba produced a modest but insignificant increase in maximal treadmill walking time and flow-mediated vasodilation. These data do not support the use of Ginkgo biloba as an effective therapy for PAD, although a longer duration of use should be considered in any future trials.
治疗外周动脉疾病（PAD）的医学疗法有限。据报道，银杏叶可增加PAD患者的最大步行距离和无痛步行距离；然而，证据并不一致。本研究的目的是比较每日300毫克银杏叶提取物（EGb 761）与安慰剂对PAD患者跑步机步行时间及相关心血管指标的影响。
采用为期4个月的双盲、安慰剂对照、平行设计试验。参与者为62名年龄在70±8岁（均值±标准差）的成年人，有PAD的跛行症状。主要研究结局是跑步机上的最大步行时间和无痛步行时间。次要结局包括血流介导的血管舒张、通过测定氧化型低密度脂蛋白表位抗体水平评估的抗氧化状态指标，以及关于步行障碍和生活质量的问卷。
安慰剂组和EGb 761组的跑步机最大步行时间分别增加了20±80秒和91±242秒（P = 0.12）。无痛步行时间分别增加了15±31秒和21±43秒（P = 0.28）。两组在任何次要结局方面均未检测到显著差异。
在患有PAD的老年人中，银杏叶提取物使跑步机最大步行时间和血流介导的血管舒张有适度增加，但不显著。这些数据不支持将银杏叶提取物用作PAD的有效疗法，不过在未来任何试验中应考虑更长的使用时间。
