A systematic review of research investigating the physiological and psychological effects of combining Ginkgo biloba and Panax Ginseng into a single treatment in humans: implications for research design and analysis

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Abstract

Abstract
Introduction
The traditional herbal supplements Panax ginseng and Ginkgo biloba are self-medicated by members of the general public and prescribed by healthcare professionals in some EU countries for numerous health complaints. Clinical evidence is mixed and mechanisms of action are not fully understood. There is clinical interest into the synergistic effects of combining both herbs.
Methods
We systematically review the literature investigating the effects of combination treatments on physiological and psychological outcomes in humans. We identified all studies meeting inclusion criteria: (1) written in English; (2) peer-reviewed; (3) conducted in humans; (4) including either a proprietary Panax ginseng/Ginkgo biloba treatment or a study preparation containing both; (5) placebo-controlled; (6) utilising standardised extracts. We critically discuss each trial; calculate standardised effect sizes where possible and provide recommendations for research design and analysis.
Results
Eight studies were identified and all investigated a proprietary combination treatment, Gincosan®. Studies are high quality and robust; however, practice effects, choice of statistical model and reliance upon null-hypothesis significance testing hinder generalised estimates of effect. The most consistent result are benefits to aspects of the circulatory/cardiovascular system in patient populations and ‘secondary memory’ performance in patient and healthy populations. Two studies demonstrate synergy in healthy populations following a single dose; however, synergy in patient populations and following repeated dosing has not yet been directly tested.
Conclusions
A Panax ginseng and Ginkgo biloba combination treatment can improve aspects of physiological and cognitive function in humans; however, evidence for synergy requires further investigation and future research should directly investigate synergy following repeated dosing.
Original languageEnglish
Number of pages17
JournalBrain and Behavior
Publication statusPublished - 6 Feb 2019

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Ginkgo biloba
Panax
Research Design
Psychology
Cardiovascular System
Research
Population
Statistical Models
Therapeutics
Cognition
Placebos
Delivery of Health Care
Health

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@article{cd5a132735a641bc9d004413dcbec9d8,
title = "A systematic review of research investigating the physiological and psychological effects of combining Ginkgo biloba and Panax Ginseng into a single treatment in humans:: implications for research design and analysis",
abstract = "AbstractIntroductionThe traditional herbal supplements Panax ginseng and Ginkgo biloba are self-medicated by members of the general public and prescribed by healthcare professionals in some EU countries for numerous health complaints. Clinical evidence is mixed and mechanisms of action are not fully understood. There is clinical interest into the synergistic effects of combining both herbs. MethodsWe systematically review the literature investigating the effects of combination treatments on physiological and psychological outcomes in humans. We identified all studies meeting inclusion criteria: (1) written in English; (2) peer-reviewed; (3) conducted in humans; (4) including either a proprietary Panax ginseng/Ginkgo biloba treatment or a study preparation containing both; (5) placebo-controlled; (6) utilising standardised extracts. We critically discuss each trial; calculate standardised effect sizes where possible and provide recommendations for research design and analysis. Results Eight studies were identified and all investigated a proprietary combination treatment, Gincosan{\circledR}. Studies are high quality and robust; however, practice effects, choice of statistical model and reliance upon null-hypothesis significance testing hinder generalised estimates of effect. The most consistent result are benefits to aspects of the circulatory/cardiovascular system in patient populations and ‘secondary memory’ performance in patient and healthy populations. Two studies demonstrate synergy in healthy populations following a single dose; however, synergy in patient populations and following repeated dosing has not yet been directly tested. ConclusionsA Panax ginseng and Ginkgo biloba combination treatment can improve aspects of physiological and cognitive function in humans; however, evidence for synergy requires further investigation and future research should directly investigate synergy following repeated dosing.",
author = "Jonathon Reay and Christopher Wilson and {Van Schaik}, Paul",
year = "2019",
month = "2",
day = "6",
language = "English",
journal = "Brain and Behavior",
issn = "2157-9032",
publisher = "John Wiley and Sons Inc.",

}

TY - JOUR

T1 - A systematic review of research investigating the physiological and psychological effects of combining Ginkgo biloba and Panax Ginseng into a single treatment in humans:

T2 - implications for research design and analysis

AU - Reay, Jonathon

AU - Wilson, Christopher

AU - Van Schaik, Paul

PY - 2019/2/6

Y1 - 2019/2/6

N2 - AbstractIntroductionThe traditional herbal supplements Panax ginseng and Ginkgo biloba are self-medicated by members of the general public and prescribed by healthcare professionals in some EU countries for numerous health complaints. Clinical evidence is mixed and mechanisms of action are not fully understood. There is clinical interest into the synergistic effects of combining both herbs. MethodsWe systematically review the literature investigating the effects of combination treatments on physiological and psychological outcomes in humans. We identified all studies meeting inclusion criteria: (1) written in English; (2) peer-reviewed; (3) conducted in humans; (4) including either a proprietary Panax ginseng/Ginkgo biloba treatment or a study preparation containing both; (5) placebo-controlled; (6) utilising standardised extracts. We critically discuss each trial; calculate standardised effect sizes where possible and provide recommendations for research design and analysis. Results Eight studies were identified and all investigated a proprietary combination treatment, Gincosan®. Studies are high quality and robust; however, practice effects, choice of statistical model and reliance upon null-hypothesis significance testing hinder generalised estimates of effect. The most consistent result are benefits to aspects of the circulatory/cardiovascular system in patient populations and ‘secondary memory’ performance in patient and healthy populations. Two studies demonstrate synergy in healthy populations following a single dose; however, synergy in patient populations and following repeated dosing has not yet been directly tested. ConclusionsA Panax ginseng and Ginkgo biloba combination treatment can improve aspects of physiological and cognitive function in humans; however, evidence for synergy requires further investigation and future research should directly investigate synergy following repeated dosing.

AB - AbstractIntroductionThe traditional herbal supplements Panax ginseng and Ginkgo biloba are self-medicated by members of the general public and prescribed by healthcare professionals in some EU countries for numerous health complaints. Clinical evidence is mixed and mechanisms of action are not fully understood. There is clinical interest into the synergistic effects of combining both herbs. MethodsWe systematically review the literature investigating the effects of combination treatments on physiological and psychological outcomes in humans. We identified all studies meeting inclusion criteria: (1) written in English; (2) peer-reviewed; (3) conducted in humans; (4) including either a proprietary Panax ginseng/Ginkgo biloba treatment or a study preparation containing both; (5) placebo-controlled; (6) utilising standardised extracts. We critically discuss each trial; calculate standardised effect sizes where possible and provide recommendations for research design and analysis. Results Eight studies were identified and all investigated a proprietary combination treatment, Gincosan®. Studies are high quality and robust; however, practice effects, choice of statistical model and reliance upon null-hypothesis significance testing hinder generalised estimates of effect. The most consistent result are benefits to aspects of the circulatory/cardiovascular system in patient populations and ‘secondary memory’ performance in patient and healthy populations. Two studies demonstrate synergy in healthy populations following a single dose; however, synergy in patient populations and following repeated dosing has not yet been directly tested. ConclusionsA Panax ginseng and Ginkgo biloba combination treatment can improve aspects of physiological and cognitive function in humans; however, evidence for synergy requires further investigation and future research should directly investigate synergy following repeated dosing.

M3 - Review article

JO - Brain and Behavior

JF - Brain and Behavior

SN - 2157-9032

ER -