Komishon A M, Shishtar E, Ha V, Sievenpiper J L, de Souza R J, Jovanovski E, Ho H V T, Duvnjak L S, Vuksan V
Clinical Nutrition and Risk Factor Modification Centre, St Michael's Hospital, Toronto, Ontario, Canada.
Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
J Hum Hypertens. 2016 Oct;30(10):619-26. doi: 10.1038/jhh.2016.18. Epub 2016 Apr 14.
Pre-clinical evidence indicates the potential for ginseng to reduce cardiovascular disease risk and acutely aid in blood pressure (BP) control. Clinical evidence evaluating repeated ginseng exposure, however, is controversial, triggering consumer and clinician concern. A systematic review and meta-analysis were conducted to assess whether ginseng has an effect on BP. MEDLINE, EMBASE, Cochrane and CINAHL were searched for relevant randomized controlled trials ⩾4 weeks that compared the effect of ginseng on systolic (SBP), diastolic (DBP) and/or mean arterial (MAP) BPs to control. Two independent reviewers extracted data and assessed methodological quality and risk of bias. Data were pooled using random-effects models and expressed as mean differences (MD) with 95% confidence intervals (CIs). Heterogeneity was assessed and quantified. Seventeen studies satisfied eligibility criteria (n=1381). No significant effect of ginseng on SBP, DBP and MAP was found. Stratified analysis, although not significant, appears to favour systolic BP improvement in diabetes, metabolic syndrome and obesity (MD=-2.76 mm Hg (95% CI=-6.40, 0.87); P=0.14). A priori subgroup analyses revealed significant association between body mass index and treatment differences (β=-0.95 mm Hg (95% CI=-1.56, -0.34); P=0.007). Ginseng appears to have neutral vascular affects; therefore, should not be discouraged for concern of increased BP. More high-quality, randomized, controlled trials assessing BP as a primary end point, and use of standardized ginseng root or extracts are warranted to limit evidence of heterogeneity in ginseng research and to better understand its cardiovascular health potential.
临床前证据表明人参具有降低心血管疾病风险以及急性辅助控制血压（BP）的潜力。然而，评估反复服用人参的临床证据存在争议，引发了消费者和临床医生的关注。我们进行了一项系统综述和荟萃分析，以评估人参对血压是否有影响。检索了MEDLINE、EMBASE、Cochrane和CINAHL数据库，查找比较人参对收缩压（SBP）、舒张压（DBP）和/或平均动脉压（MAP）控制效果的相关随机对照试验（≥4周）。两名独立评审员提取数据并评估方法学质量和偏倚风险。使用随机效应模型汇总数据，并以95%置信区间（CI）的平均差值（MD）表示。对异质性进行了评估和量化。17项研究符合纳入标准（n = 1381）。未发现人参对SBP、DBP和MAP有显著影响。分层分析虽无显著意义，但似乎有利于改善糖尿病、代谢综合征和肥胖患者的收缩压（MD = -2.76 mmHg（95%CI = -6.40，0.87）；P = 0.14）。先验亚组分析显示体重指数与治疗差异之间存在显著关联（β = -0.95 mmHg（95%CI = -1.56，-0.34）；P = 0.007）。人参似乎对血管有中性影响；因此，不应因担心血压升高而不鼓励使用。有必要进行更多以血压为主要终点的高质量、随机对照试验，并使用标准化的人参根或提取物，以限制人参研究中的异质性证据，并更好地了解其对心血管健康的潜在作用。
