Nicolaï Saskia P A, Kruidenier Lotte M, Bendermacher Bianca L W, Prins Martin H, Teijink Joep A W
Department of Vascular Surgery, Atrium Medical Center, PO Box 4446, Heerlen, Netherlands, 6401 CX.
Cochrane Database Syst Rev. 2009 Apr 15(2):CD006888. doi: 10.1002/14651858.CD006888.pub2.
People with intermittent claudication suffer from pain in the muscles of the leg occurring during exercise which is relieved by a short period of rest. Symptomatic relief can be achieved by (supervised) exercise therapy and pharmacological treatments. Ginkgo biloba is a vasoactive agent and is used to treat intermittent claudication.
To assess the effect of Ginkgo biloba on walking distance in people with intermittent claudication.
The Cochrane Peripheral Vascular Diseases (PVD) Group searched their Trials Register (last searched 3 February 2009) and the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (last searched 2009, Issue 1). We searched MEDLINE/PUBMED (January 1966 to May 2008) and EMBASE (January 1985 to May 2008) and contacted manufacturers.
Randomised controlled trials of Ginkgo biloba extract, irrespective of dosage, versus placebo in people with intermittent claudication.
Two authors independently assessed trials for selection, assessed study quality and extracted data. We extracted number of patients, mean walking distances or times and standard deviations. To standardise walking distance or time, caloric expenditures were used to express the difference between the different treadmill protocols, which were calculated from the speed and incline of the treadmill.
Fourteen trials with a total of 739 participants were included. Eleven trials involving 477 participants compared Ginkgo biloba with placebo and assessed the absolute claudication distance. Following treatment with Ginkgo biloba at the end of the study the absolute claudication distance increased with an overall effect size of 3.57 kilocalories (confidence interval -0.10 to 7.23, P = 0.06), compared with placebo. This translates to an increase of just 64.5 (confidence interval -1.8 to 130.7) metres on a flat treadmill with an average speed of 3.2 km/h. Publication bias leading to missing data or "negative" trials is likely to have inflated the effect size.
AUTHORS' CONCLUSIONS: Overall, there is no evidence that Ginkgo biloba has a clinically significant benefit for patients with peripheral arterial disease.
间歇性跛行患者在运动时腿部肌肉会疼痛，短时间休息后疼痛会缓解。通过（有监督的）运动疗法和药物治疗可实现症状缓解。银杏叶是一种血管活性药物，用于治疗间歇性跛行。
评估银杏叶对间歇性跛行患者步行距离的影响。
Cochrane外周血管疾病（PVD）小组检索了他们的试验注册库（最后检索时间为2009年2月3日）以及Cochrane图书馆中的Cochrane对照试验中心注册库（CENTRAL）（最后检索时间为2009年第1期）。我们检索了MEDLINE/PUBMED（1966年1月至2008年5月）和EMBASE（1985年1月至2008年5月），并联系了制造商。
银杏叶提取物与安慰剂对比治疗间歇性跛行患者的随机对照试验，不考虑剂量。
两位作者独立评估试验以进行选择、评估研究质量并提取数据。我们提取了患者数量、平均步行距离或时间以及标准差。为了标准化步行距离或时间，使用热量消耗来表示不同跑步机方案之间的差异，这些差异是根据跑步机的速度和坡度计算得出的。
纳入了14项试验，共739名参与者。11项试验涉及477名参与者，比较了银杏叶与安慰剂，并评估了绝对跛行距离。在研究结束时用银杏叶治疗后，与安慰剂相比，绝对跛行距离增加，总体效应量为3.57千卡（置信区间为 -0.10至7.23，P = 0.06）。这相当于在平均速度为3.2公里/小时的平板跑步机上仅增加64.5米（置信区间为 -1.8至130.7）。导致数据缺失或“阴性”试验的发表偏倚可能夸大了效应量。
总体而言，没有证据表明银杏叶对周围动脉疾病患者具有临床显著益处。
