PMID- 34474140
OWN - NLM
STAT- MEDLINE
DCOM- 20220127
LR  - 20220127
IS  - 1872-7573 (Electronic)
IS  - 0378-8741 (Linking)
VI  - 282
DP  - 2022 Jan 10
TI  - Efficacy and safety of standardized Ginkgo biloba L. leaves extract as an 
      adjuvant therapy for sudden sensorineural hearing loss: A systematic review and 
      meta-analysis.
PG  - 114587
LID - S0378-8741(21)00816-3 [pii]
LID - 10.1016/j.jep.2021.114587 [doi]
AB  - ETHNOPHARMACOLOGICAL RELEVANCE: Ginkgo biloba L. has been used for medical 
      purposes in China for centuries. Standardized Ginkgo biloba L. leaves extract 
      (GBE) is a widely used botanical drug which displays a variety of pharmacological 
      effects against sudden sensorineural hearing loss (SSNHL). AIM OF THE STUDY: To 
      evaluate the efficacy and safety of GBE as an adjuvant therapy, administered with 
      corticosteroids, for the initial management of patients with SSNHL. MATERIALS AND 
      METHODS: We searched seven databases for randomized clinical trials (RCTs) 
      comparing GBE plus corticosteroids with corticosteroids alone for SSNHL 
      treatment. Data analysis was carried out by Review Manager 5.4 and Stata 16.0 
      software. The study was conducted in accordance with Preferred Reporting Items 
      for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. We 
      subsequently evaluated the certainty of evidence using the GRADE (Grading of 
      Recommendation Assessment, Development and Evaluation) approach. RESULTS: A total 
      of 11 RCTs involving 1069 patients were included. Meta-analysis indicated that 
      the clinical cure rate (RR = 1.33, 95% CI = 1.12 to 1.58, P = 0.001) and total 
      effective rate (RR = 1.24, 95%CI = 1.17 to 1.31, P < 0.001) in SSNHL patients 
      receiving GBE plus corticosteroids was superior to patients receiving 
      corticosteroids alone. After treatment, pure tone average (PTA) improvement of 
      observation group was better than that in the control group (WMD = 10.33, 
      95%CI = 6.46 to 14.21, P < 0.001). The levels of whole blood high shear viscosity 
      (WMD = 0.93, 95%CI = 0.28 to 1.59, P = 0.005), whole blood medium shear viscosity 
      (WMD = 0.53, 95%CI = 0.11 to 0.95, P = 0.01), whole blood low shear viscosity 
      (WMD = 1.26, 95%CI = 0.80 to 1.72, P < 0.001), plasma viscosity (WMD = 0.19, 
      95%CI = 0.09 to 0.30, P < 0.001) and fibrinogen (WMD = 0.80, 95%CI = 0.25 to 
      1.35, P = 0.004) were lower than those in the control group. There was no 
      significant difference in the change of hematokrit between two groups 
      (WMD = 4.23, 95%CI = -0.54 to 8.99, P = 0.08). GBE was generally well tolerated, 
      and there was no significant difference in the incidence of adverse reactions 
      between two groups (RR = 1.01, 95%CI = 0.57 to 1.79, P = 0.97). CONCLUSION: The 
      results of the current study suggested that GBE might be effective and promising 
      as an adjuvant to corticosteroids in the initial treatment of moderate to 
      profound SSNHL. However, the GRADE assessment indicated that the overall strength 
      of evidence was not high. Further studies with high methodological quality and 
      low risk of bias are needed to confirm the positive results. PROSPERO 
      registration No. CRD 42020190113.
CI  - Copyright (c) 2021 Elsevier B.V. All rights reserved.
FAU - Si, Xia
AU  - Si X
AD  - Department of pharmacy, Peking University People's Hospital, Beijing, 100044, 
      China. Electronic address: sixia2012@126.com.
FAU - Yu, Zhiying
AU  - Yu Z
AD  - Department of pharmacy, Peking University People's Hospital, Beijing, 100044, 
      China. Electronic address: yzy9207@163.com.
FAU - Ren, Xiaolei
AU  - Ren X
AD  - Department of pharmacy, Peking University People's Hospital, Beijing, 100044, 
      China. Electronic address: renxiaolei83@126.com.
FAU - Huang, Lin
AU  - Huang L
AD  - Department of pharmacy, Peking University People's Hospital, Beijing, 100044, 
      China. Electronic address: huanglin@pkuph.edu.cn.
FAU - Feng, Yufei
AU  - Feng Y
AD  - Department of pharmacy, Peking University People's Hospital, Beijing, 100044, 
      China. Electronic address: fengyufei@126.com.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Systematic Review
DEP - 20210830
PL  - Ireland
TA  - J Ethnopharmacol
JT  - Journal of ethnopharmacology
JID - 7903310
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Drugs, Chinese Herbal)
RN  - 0 (Plant Extracts)
RN  - 19FUJ2C58T (Ginkgo biloba extract)
SB  - IM
MH  - Adrenal Cortex Hormones/*pharmacology
MH  - Chemotherapy, Adjuvant
MH  - Drugs, Chinese Herbal/pharmacology
MH  - Ginkgo biloba
MH  - Hearing Loss, Sensorineural/*drug therapy
MH  - Humans
MH  - Phytotherapy/*methods
MH  - Plant Extracts/*pharmacology
OTO - NOTNLM
OT  - Corticosteroids
OT  - GRADE
OT  - Ginkgo biloba L.
OT  - Meta-analysis
OT  - Randomized controlled trial
OT  - Sudden sensorineural hearing loss
EDAT- 2021/09/03 06:00
MHDA- 2022/01/28 06:00
CRDT- 2021/09/02 20:14
PHST- 2021/03/09 00:00 [received]
PHST- 2021/08/27 00:00 [revised]
PHST- 2021/08/28 00:00 [accepted]
PHST- 2021/09/03 06:00 [pubmed]
PHST- 2022/01/28 06:00 [medline]
PHST- 2021/09/02 20:14 [entrez]
AID - S0378-8741(21)00816-3 [pii]
AID - 10.1016/j.jep.2021.114587 [doi]
PST - ppublish
SO  - J Ethnopharmacol. 2022 Jan 10;282:114587. doi: 10.1016/j.jep.2021.114587. Epub 
      2021 Aug 30.