Dansk navn: Tempeltræ Engelsk navn: Maidenhair Tree Familie: Ginkgoaceae Droge: Blade
Beskrivelse
Ginkgo biloba er den eneste overlevende art af sin familie. Træet har overlevet uændret fra urtiden for 150 millioner år siden. I Asien var det kernen, der brugtes som medicin, men moderne undersøgelser har vist, at det er de vifteformede blade, der indeholder de helt enestående og interessante medicinske stoffer. Ginkgo biloba kan blive op til 1000 år og nå en højde af 30‑40 m. Frugten lugter for færdeligt og kan ikke spises. Ginkgo biloba har altid været et populært træ i de kinesiske tempelhaver.
Aktive indholdsstoffer
0,2‑0,5% ginkgoflavon glykosider (kaempferoglykosid, quercetinglykosid, isorhamnetinglykosid), ginkgolider (diterpener), bilobalid (sesquiterpen).(1, 2) Standardiseret Ginkgo biloba ekstrakt (Egb 761) indeholder 24% ginkgoflavon glykosider, 6% terpener (ginkgolider og bilobalider). Det er ginkgoterpenerne, der hæmmer PAF.(3)
Farmakologi
Ginkgo biloba hæmmer PAF:
PAFs patofysiologi.
(2) PAF er et fosforlipid, der kan udskilles af blodplader, monocytter, makrofager, eosinofile leukocytter, mastceller, endothelium og glat muskulatur. PAF har mange indvirkninger i kroppen: PAF øger blodpladesammenklumpning, bidrager muligvis til dannelsen af blodpropper. PAF skader blodkarvæggenes endothelium. Indsprøjtninger med PAF forårsager akut inflammation og er muligvis impliceret i blodkars-inflammation og LED. PAF forårsager sammentrækninger i luftvejene og tiltrækker eosinofile celler, som hos astmapatienter anses for at være de stærkeste inflammations-fremmende celler. PAF øger inflammation i glomerulonefritis forårsaget af immunkompleks aflejring. Endotoksiner og IgG komplekser danner symptomer via PAF. PAF fremmer dannelsen af mavesår forårsaget af endotoksiner. PAF er impliceret i hudsygdomme med inflammation, såsom psoriasis og nældefeber. PAF forgifter nerveceller og er muligvis ansvarlig for skaderne, der følger efter trauma og blodpropper. PAF kan også bidrage til panikfølelser hos visse patienter. PAF skader øjets retina. PAF øger risikoen for dannelse af kræftknuder.
Egenskaber
Antioxidant, fremmer cellernes udnyttelse af glukose og oxygen, stabiliserer cellemembraner, fremmer kalium/natrium-pumpen, fremmer kredsløbet og reducerer blodstase, udvider blodkar. Hæmmer fosfor diesterase (fremmer C-AMP koncentrationen inde i cellerne, hvilket medfører, at den glatte muskulatur i arterierne af spændes), fremmer tonus i venerne. Hæmmer platelet aggregating factor (PAF) Normaliserer produktionen og nedbrydelsen af kemiske substanser (dopamin, adrenalin, nor‑adrenalin og acetyl‑cholin) i nervesystemets synapser.(1, 2, 3, 4)
Indikationer
- Centrale kredsløb: Åreforkalkning kan forårsage iskæmi og blodpropper i hjernen, men det er ikke kun mangel på ilt og glukose, der forårsager destruktionen af hjerneceller. Forandringer i andre stofskifteprocesser kan ligeledes for årsage destruktion af nerveceller: ATP niveauet falder, kuldioxid og mælkesyre ophobes, lipidperoxydering øger niveauet af frie radikaler, og der opstår diffus ødem i hjernen.(1) Ginkgo biloba fremmer blodtilførslen til hjernen (uden af hæmme blodtilførslen til andre områder), hæmmer de nævnte stofskifteprocesser, hæmmer blodkar-forsnævring og dannelsen af blodpropper.(1, 4) Ginkgo bilobas krampeløsnende egenskaber anvendes i behandlingen af senilitet og Alzheimers sygdom, depression, dårlig hukommelse og koncentration forårsaget af åreforkalkning og dårligt blodomløb.(1, 4) Ginkgo biloba bruges også i akut og kronisk behandling af blodprop i hjernen, i behandlingen af iskæmiske hjertesygdomme og i kredsløbssygdomme forårsaget af sukkersyge.(1,4)
- Perifere kredsløb: Ginkgo biloba fremmer det perifere kredsløb og har vist sig effektiv i behandlingen af claudicatio intermittens (arteriosklerose i benenes pulsåre), Raynauds sygdom og hæmorroider.(1,3)
- Øjne, Øre, Næse og Hals: Ginkgo biloba har vist sig at være effektiv i behandlingen af tinnitus (specielt hvis susen kun er i det ene øre og af mindre end et års varighed), akut døvhed for årsaget af iskæmi, svimmelhed forårsaget af dårligt kredsløb og åreforkalkning. Senil makuladegeneration (åreforkalkning af øjehindens små arterier).(1,3,4)
- Inflammation: Ginkgo biloba hæmmer PAF og hæmmer derved inflammation. Bruges i behandlingen af gigt, astma og andre sygdomme, hvor der forekommer inflammation(2) og dissemineret sclerose.(3)
- Mentale processer: Fremmer hukommelsen og andre mentale processer både hos ældre, senile patienter og unge, raske forsøgspersoner.(4)
- Kvindelige kønsorganer:: Ginkgo biloba er effektiv i behandlingen af PMS (ømme bryster, ødemer, ængstelse, depression, hovedpine). Virkningen skyldes drogens inflammationshæmmende og anti-ødem effekt. Smertefuld menstruation. Kramper forårsaget af livmoderfibromer.(2)
Kontraindikationer
Ingen kendte.
Bivirkninger
Ingen bivirkninger ved anbefalet dosering.
Toksicitet
Ginkgo biloba har ingen giftvirkninger, hvis den rette dosis overholdes, men kan i visse tilfælde forårsage hovedpine og mavebesvær.(4) Blomsterne kan forårsage en alvorlig allergisk reaktion.
Dosering
Forsøg med Ginkgo biloba er blevet foretaget med 120 mg af en standardiseret ekstrakt indeholdende 22‑24% (27-30 mg) ginkgoflavonoide glykosider. Tørret droge: 9-10 g daglig. Standardiseret ekstrakt indeholdende 10 mg ginkgoflavonoide glykosider og 2,7 mg terpener per 1 ml i 50% alkohol: 20-25 ml ugentlig.(5)
Kombinationsforslag
Ginkgo biloba blandes ofte med Crataegus arter og andre urter med indvirkning på kredsløbet.
Referencer 1. Bone, K., MediHerb Professional Newsletter, April (1988) 2. Bone, K., MediHerb Professional Newsletter, August (1989) 3. Bone, K., MediHerb Monitor, No.11, Dec.(1994) 4. Mowray, D. B., Guaranteed Potency Herbs The Next Generation HerbalMedicine, Connecticut Keats Publishers (1990) s. 63-85 5. MediHerb, 31st May 1995 Dose Report, ikke udgivet
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