Nicolaï Saskia P A, Kruidenier Lotte M, Bendermacher Bianca L W, Prins Martin H, Stokmans Rutger A, Broos Pieter P H L, Teijink Joep A W
Department of General Practice, Maastricht University, Maastricht, Netherlands.
Cochrane Database Syst Rev. 2013 Jun 6;2013(6):CD006888. doi: 10.1002/14651858.CD006888.pub3.
People with intermittent claudication (IC) 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 IC.
To assess the effect of Ginkgo biloba on walking distance in people with intermittent claudication.
For this update the Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (March 2013) and CENTRAL (2013, Issue 2).
Randomised controlled trials of Ginkgo biloba extract, irrespective of dosage, versus placebo in people with IC.
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 (ACD). Following treatment with Ginkgo biloba at the end of the study the ACD increased with an overall effect size of 3.57 kilocalories (confidence interval (CI) -0.10 to 7.23, P = 0.06), compared with placebo. This translates to an increase of just 64.5 ( CI -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（IC）患者在运动期间会出现腿部肌肉疼痛，短时间休息后疼痛会缓解。（在监督下的）运动疗法和药物治疗均可实现症状缓解。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。
本次更新中，Cochrane外周血管疾病组试验搜索协调员检索了专业注册库（2013年3月）和Cochrane系统评价数据库（2013年第2期）。
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，不限剂量。
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。为使步行距离或时间标准化，热量消耗用于表示不同跑步机方案之间的差异，该差异由跑步机的速度和坡度计算得出。
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（ACD）。在研究结束时，与安慰剂相比，使用银杏叶治疗后ACD增加，总体效应量为3.57千卡（置信区间（CI）-0.10至7.23，P = 0.06）。这相当于在平均速度为3.2 km/h的平坦跑步机上仅增加64.5（CI -1.8至130.7）米。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。
