Efficacité de l'extrait der Ginkgo biloba dans le traitement des artériopathies oblitérantes chroniques des membres inférieurs au stade II de la classification de Fontaie

Author(s): Serise, J., Pillot, J. , et, al

Journal/Book: J des Malades Vasculaires. 1989; 14: 177-182.

Abstract: A controlled trial of ginkgo-biloba extract in injectable form (Tanakan 50 mg, a lyophilisate for parenteral use) was carried out versus a placebo as preoperative medical treatment of stage III (Fontaine classification) chronic occlusive arterial diseases of the lower limbs (with pain in decubitus). The 64 men and women patients in this multicenter study (32 in each group) were over 18 years of age and had a cultural and intellectual level as well as a physical condition allowing them to play an active role in the experiment (self-evaluation of pain). During 8 days they received two daily infusions of 500 cc of normal saline solution containing either 100 mg of ginkgo-biloba extract or a Placebo of identical appearance. During this period, anticoagulants were authorized ; hemodilution, vasoactive drugs and platelet antiaggregates were forbidden ; pentazocine (Fortal, 50-mg tablets)were allowed at the patient's request. Pain was rated according to a visual scale, with each patient marking a point between two extremes (« maximum imaginable pain » and « total absence of pain ») 100 mm apart. A questionnaire based an that of Melzack (McGill Pain Questionnaire) completed this qualitative as well as quantitative self-evaluation of pain. The results of these questionnaires were assessed an the basis of 4 scores each determined by the patient's choice among 3 evaluation figures. The chi square, Student and Wilcoxon tests were used for statistical analysis.Results : The two randomly-composed groupes with ginkgo-biloba extract and a placebo were comparable (Table I). Analysis was based an 55 observations (26 in the extract group and 29 in the placebo group). Comparison of the groups showed a statistically significant superiority (p = 0,04) of the extract.Analysis of the « patient's grade » score, the most sensitive of the 4 scores studied, showed a statistically significant reduction (p < 0.05) in the sensory component of the grade in the extract group. In the placebo group, the emotional-affective component of this score decreased significantly (p = 0.006) (Table II). If the mean use of pentazocine was not significantly different (p = 0.26) in the two groups, intake of pentazocine during the study decreased significantly in the extract group (p = 0.03) and not in the placebo group (p = 0.12).This placebo-controlled multicenter study demonstrates the advantage of using ginkgo-biloba extract in preoperative medical treatment of distal ischemia in stage III arterial diseases.

Keyword(s): Ginkgo biloba

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