Ginseng and ginseng herbal formulas for symptomatic management of fatigue: A systematic review and meta-analysis Review


Authors: Li, X.; Yang, M.; Zhang, Y. L.; Hou, Y. N.; Smith, C. M.; Korenstein, D.; Mao, J. J.
Review Title: Ginseng and ginseng herbal formulas for symptomatic management of fatigue: A systematic review and meta-analysis
Abstract: Objectives: Ginseng has been widely used in fatigue management. However, its efficacy on fatigue remains unclear. This study aimed to assess the efficacy and safety of ginseng and ginseng herbal formulas for fatigue in randomized clinical trials (RCTs). Methods: The authors searched PubMed, Embase, Cochrane, Web of Science, and Allied and Complementary Medicine Database (AMED) databases from inception to July 6, 2022. Outcomes included fatigue severity, quality of life (QoL), and adverse events (AEs). Quality of evidence was assessed using the Cochrane Risk of Bias Tool. They pooled all included data and performed subgroup analysis by fatigue type, assessment instrument, and ginseng type. Results: The authors included 19 RCTs. Pooled analyses found no significant reduction in fatigue severity with ginseng versus controls (standardized mean difference [SMD]: -0.36, 95% confidence interval [CI]: -0.82 to 0.11, p = 0.13). In subgroup analysis, there was significant fatigue reduction with the ginseng herbal formula (SMD: -0.39, 95% CI: -0.66 to -0.13, p = 0.004) and chronic fatigue (CF) (SMD: -0.30, 95% CI: -0.56 to -0.03, p = 0.03) compared to controls. Ginseng produced significant reductions in general (i.e., non-disease-specific) fatigue compared to controls (SMD: -0.48, 95% CI: -0.71 to -0.25, p < 0.0001). Ginseng was associated with a trend toward QoL improvement (p = 0.05) and did not increase AEs compared with controls. Effect sizes were small. Conclusion: Ginseng herbal formulas improved fatigue severity compared to controls, especially among patients with CF, but with a small effect size. Rigorous RCTs as well as guidelines for standard ginseng usage are needed to further evaluate the effects of ginseng for fatigue and ensure proper use.
Keywords: fatigue; quality of life; randomized controlled trials as topic; safety; alternative medicine; complementary therapies; meta analysis; herbal medicine; efficacy; randomized controlled trial (topic); ginseng; panax; humans; human
Journal Title: Journal of Integrative and Complementary Medicine
Volume: 29
Issue: 8
ISSN: 2768-3605
Publisher: Mary Ann Liebert, Inc.  
Date Published: 2023-08-01
Start Page: 468
End Page: 482
Language: English
DOI: 10.1089/jicm.2022.0532
PUBMED: 36730693
PROVIDER: scopus
PMCID: PMC10457628
DOI/URL:
Notes: Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- MSK corresponding author is Jun J. Mao -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Jun J Mao
    243 Mao
  2. Yen Nien Hou
    8 Hou
  3. Yi Lily Zhang
    10 Zhang
  4. Mingxiao Yang
    17 Yang
  5. Colleen Mary Smith
    4 Smith
  6. Xiaotong Li
    12 Li