PDR for Herbal Medicines

348 /GINSENG PDR FOR HERBAL MEDICINES

ginsenosides also reduce plasma ethanol by a delay in gastric

emptying time (Koo, 1999).

Hypolipidemic/Cardiac Effects

Ginseng saponins activate lipoprotein lipase, an enzyme that

reduces chylomicrons and very low-density lipoproteins, and

results in a decrease of triglycerides and cholesterol (Inoue,

1999). The ginsenosides demonstrate negative chronotropic

effects and positive and negative inotropic effects on the

heart (Wu, 1988). The anti-arrhythmic properties of Rgl

consist of prolonged ventricular refractoriness and repolari-

zation, and increased ventricular fibrillation threshold (Wu,

1995).

Miscellaneous Effects

Stimulation of corticotrophin secretion and increased hepatic

ribonucleic acid (RNA) and protein synthesis are effects of

the saponin glycosides in Ginseng. Panax ginseng is

comprised of at least 28 different saponin glycosides, which

contain nuclei resembling those of steroids (Punnonen,

1980). The ginsenosides also stimulate insulin release and

increase insulin receptors to exert a hypoglycemic effect

(Guodong, 1987). Ginseng also decreases blood sugar

through glucose metabolism related to adrenergic receptors.

Ginseng decreases lactic acid and stimulates other respira-

tory enzymes in the electron transport chain to promote

aerobic oxidation (Yao, 1990). The saponins have shown

enhancement of erectile capacity mediated by endothelium-

derived relaxing factor and peripheral neurophysiologic

enhancement (Choi, 1999; Choi, 1995).

CLINICAL TRIALS

Cognitive Function

A randomized, double-blind, placebo-controlled study was

conducted to evaluate the effect of Ginseng on cognitive

function over an 8-week period. There were 112 healthy

volunteers over 40 years of age. The primary outcome was

the change in score on each cognitive test, evaluated at

baseline, and again at 8 weeks. Oral standardized ginseng

400 mg daily was significantly better compared to placebo

with abstract thinking and a tendency toward faster simple

reaction times. There was no difference between the groups

with regard to concentration, memory, or subjective experi-

ence (Sorenson, 1996).

Hypoglycemic

The effect on blood glucose with Ginseng was demonstrated
in a double-blind, placebo-controlled study including 36
newly diagnosed Type 2 diabetic patients. Ginseng 200 mg
daily improved glycated hemoglobin, serum aminoterminal-
propetptide concentration and physical activity after 8 weeks
of therapy. Ginseng 100 mg and 200 mg daily dose elevated

mood, improved psychophysical performance, and reduced

fasting blood glucose and weight (Sotaniemi, 1995).

Antiviral

The properties of a standardized extract of ginseng root for

inducing a higher immune response in vaccination against

influenza were evaluated in 227 volunteers. The placebo-

controlled, randomized, double-blind study was conducted

over a 12-week period. Oral standardized ginseng extract

100 mg daily was given over the entire 12-week period, with

anti-influenza polyvalent vaccination given to all volunteers

at week 4. There were significantly fewer cases of influenza

or the common cold in the ginseng-treatment group, and

significantly higher antibody titers and natural killer cell

levels at 8 and 12 weeks in the ginseng treatment group

(Scaglione, 1996).

INDICATIONS AND USAGE

Approved by Commission E:

• Lack of stamina

Ginseng is used internally for fatigue and debility, and for a

decrease capacity for work and concentration.

Unproven Uses: In Folk medicine, Ginseng is used for loss

of appetite, cachexia, anxiety, impotence and sterility,

neuralgia and insomnia.

Chinese Medicine: In Chinese medicine, Ginseng is used for

hemoptysis, gastric disturbances, and vomiting.

Homeopathic Uses: Ginseng is used for rheumatism and

debility.

PRECAUTIONS AND ADVERSE REACTIONS

General: Caution should be taken in patients with cardiovas-

cular disease or diabetes. Hypertension resulting from

Ginseng Abuse Syndrome is associated with prolonged high

dose Ginseng with concomitant use of caffeine (Siegel,

1979; Siegel, 1980). General adverse effects include insom-

nia, epistaxis, headache, nervousness, and vomitting.

Mastalgia: Mastalgia with diffuse breast nodularity has been

reported with Ginseng use (Palmer, 1978).

Vaginal Bleeding: Oral Ginseng and Ginseng face cream

have been associated with post menopausal vaginal bleeding

(Greenspan, 1983; Hopkins, 1988).

Pregnancy/Lactation: Maternal use of Ginseng has been

associated with neonatal androgenization, thus it is not

recommended for use during pregnancy or lactation (Awang,

1991).

Drug Interactions:

Diabetic Agents/Insulin — Caution should be taken when

taking an antidiabetic agent or insulin to lower blood glucose