Finding evidence of efficacy and safety of ginseng in cognitive functions enhacement : "systematic" review : diploma thesis

Abstract

Cilj istraţivanja: Pronaći najbolje dostupne dokaze o sigurnosti i učinkovitosti primjene ginsenga u poboljšanju kognitivnih sposobnosti zdravih ispitanika, ispitanika s blagim kognitivnim oštećenjem ili demencijom. Materijal i metode: Temelj istraživanja je Cochrane sustavni pregled „Ginseng for cognition“. Pretraživanjem baza DARE, CENTRAL i MEDLINE pronaĎeni su novi randomizirani kontrolirani pokusi i sustavni pregledi objavljeni nakon Cochrane sustavnog pregleda, u skladu s ulaznim i izlaznim kriterijima Cochrane sustavnog pregleda. Procjena kvalitete Cochrane sustavnog pregleda i novih pronaĎenih pregleda je učinjena koristeći RAMSTAR kriterije. Rezultati: Uz Cochrane sustavni pregled, uključeno je šest novih randomiziranih kontroliranih pokusa i četiri sustavna pregleda. Četiri klinička ispitivanja te Cochrane i druga dva sustavna pregleda su pokazala poboljšanje nekih aspekata kognicije, ponajprije radnog pamćenja, ali i sekundarnog odnosno deklarativnog pamćenja i pozornosti. Jedina pronaĎena studija na pacijentima s blagim kognitivnim oštećenjem je pokazala poboljšanje pamćenja i učenja nakon 6 mjeseci terapije ginsengom. Dva sustavna pregleda nisu pronašla jasne dokaze djelotvornosti na pacijente s Alzheimerovom bolesti. Terapija ginsengom je dovela do pozitivnog učinka na faktore raspoloženje i kvalitete života zdravih ispitanika. Cochrane sustavni pregled je prema R-AMSTAR procjeni ocijenjen s 38 bodova. Preostala tri ocjenjena sustavna pregleda su dobili 18, 15 i 16 bodova. Zaključak: Dokazi o djelotvornosti ginsenga su vrlo ograničeni i neuvjerljivi zbog malog broja ispitanika, upitne metodološke kvalitete ispitivanja i nedosljednosti rezultata te se ne može dati pouzdan zaključak o djelovanju ginsenga na kognitivne sposobnosti zdravih ljudi i bolesnika s blagim kognitivnim oštećenjima ili demencijom ni o poboljšanju njihove kvalitete života i raspoloženja.Diploma Thesis Title: Finding evidence of efficacy and safety of ginseng in cognitive functions enhancement: systematic review Objectives: Finding the best available evidence of efficacy and safety of ginseng in cognitive performance enhancement in healthy participants, participants with mild cognitive impairment or dementia. Material and methods: The basis of this study was Cochrane systematic review "Ginseng for cognition". New randomised controlled trials and systematic reviews, published after that Cochrane systematic review, were found by searching MEDLINE, DARE and CENTRAL databases, following the inclusion and exclusion criteria used in Cochrane systematic review. Quality assessment of Cochrane and other reviews was made using R-AMSTAR tool. Results: Alongside Cochrane review, six new randomised controlled trials and four systematic reviews were included in this thesis. Four clinical trials as well as Cochrane and two other reviews had shown improvement of some cognitive aspects, particularly working memory, but also secondary or declarative memory and attention. The only study addressing participants with mild cognitive impairment had shown improved memory and learning after 6 months of ginseng treatment. Two systematic reviews found no clear evidence of efficacy on patients with Alzheimer's disease. Ginseng treatment had beneficial effects on some mood and quality of life factors in healthy participants. R-AMSTAR score for Cochrane systematic review was 38 points. Three other reviews were rated and scored 18, 15 and 16 points. Conclusion: Clinical evidence in support of ginseng efficacy is inadequate and inconclusive because of the small number of subjects, questionable methodological quality of trials and inconsistency of their results so a reliable conclusion about ginseng effects on cognition, mood and quality of life in healthy participants, participants with mild cognitive impairment or dementia cannot be made