Brain Medical Center, The First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China , Department of Neurology, The First Affiliated Hospital of Zhejiang University, Hangzhou 310003, China.
Am J Chin Med. 2014;42(4):769-83. doi: 10.1142/S0192415X14500499.
Gingko biloba extract (EGB) has been used in traditional medicines for centuries, and although its application to cerebral ischemia has been of great interest in recent years, high quality evidence-based clinical trials have not been carried out. This systematic review and meta-analysis aimed to examine the neuroprotective effect of EGB on focal cerebral ischemia in animal models. A systematic literature search was performed using five databases spanning January 1980-July 2013. The outcome was assessed using the effect size, which was based on infarct size and/or neurological score. A total of 42 studies with 1,232 experimental animals matched our inclusion criteria. The results revealed that EGB improved the effect size by 34% compared to the control group. The animal species, the method and time to measure outcome, and the route and dosage of EGB administration affected the variability of the effect size. Mechanisms of EGB neuroprotection were reported as anti-apoptotic, anti-oxidative, and anti-inflammatory. In conclusion, EGB exerts a significant protective effect on experimental focal cerebral ischemia. However, possible experimental bias should be taken into account in future clinical studies.
银杏叶提取物（EGB）在传统医学中已经使用了几个世纪，尽管近年来其在脑缺血中的应用引起了极大的关注，但尚未进行高质量的基于证据的临床试验。本系统评价和荟萃分析旨在检查银杏叶提取物对动物模型局灶性脑缺血的神经保护作用。使用五个数据库进行了系统的文献检索，涵盖了 1980 年 1 月至 2013 年 7 月的文献。使用基于梗死面积和/或神经评分的效应大小来评估结果。共有 42 项研究，涉及 1232 只实验动物，符合我们的纳入标准。结果表明，银杏叶提取物与对照组相比，改善了 34%的效应大小。动物种类、测量结果的方法和时间以及银杏叶提取物给药的途径和剂量会影响效应大小的可变性。银杏叶提取物的神经保护机制被报道为抗细胞凋亡、抗氧化和抗炎作用。总之，银杏叶提取物对实验性局灶性脑缺血具有显著的保护作用。然而，未来的临床研究中应考虑可能存在的实验偏倚。
