Effectiveness Not Established

Ginseng

for Sleep-Wake Disturbances

The name ginseng applies to various herbs that have been used medicinally for many centuries. Asian ginseng (Panax ginseng) is one of several types of true ginseng; another is American ginseng (Panax quinquefolius). American ginseng is used for stress, to boost the immune system, and as a general tonic and stimulant. American ginseng contains chemicals called ginsenosides that seem to affect insulin levels in the body and lower blood sugar. Other chemicals in ginseng, polysaccharides, might affect the immune system.

Ginseng has been examined for use in anxiety and fatigue, and is considered as part of complementary and alternative medicine interventions in cognitive impairment. Not all types of ginseng have the same chemical contents, and so, not necessarily the same effectiveness.

Research Evidence Summaries

Yennurajalingam, S., Reddy, A., Tannir, N.M., Chisholm, G.B., Lee, R.T., Lopez, G., . . . Bruera, E. (2015). High-dose Asian Ginseng (Panax Ginseng) for cancer-related fatigue: A preliminary report. Integrative Cancer Therapies, 14, 419–427. 

Study Purpose

To assess the safety and efficacy of high-dose ginseng for cancer-related fatigue

Intervention Characteristics/Basic Study Process

Patients were given a supply of ginseng for 29 days and instructed to take two 400 mg tablets twice daily. Study measures were obtained at baseline, day 15, and day 29.

Sample Characteristics

  • N = 24
  • MEDIAN AGE = 58 years (range = 48–68 years)
  • MALES: 50%, FEMALES: 50%
  • KEY DISEASE CHARACTERISTICS: Genitourinary cancers were most common
  • OTHER KEY SAMPLE CHARACTERISTICS: 87% were currently receiving cancer treatment with either combination chemotherapy or targeted therapies; 33% also were receiving radiation therapy

Setting

  • SITE: Single site  
  • SETTING TYPE: Not specified  
  • LOCATION: Texas

Phase of Care and Clinical Applications

  • PHASE OF CARE: Multiple phases of care
  • APPLICATIONS: Palliative care

Study Design

Prospective observational

Measurement Instruments/Methods

  • Functional Assessment of Chronic Illness Therapy–Fatigue (FACIT-F)
  • Edmonton Symptom Assessment Scale (ESAS)
  • Hospital Anxiety and Depression Scale (HADS)

Results

There was an improvement in the FACIT fatigue subscale on day 15 (p = 0.004) and day 29 (p = 0.0006) although scores increased between day 15 and 29. Improvement was also seen in the ESAS fatigue scale at both time points (p < 0.001). Appetite improved on day 15 (p = 0.004) and day 29 (p = 0.0097). Sleep was improved on day 15 (p = 0.004) but not on day 29. ESAS scores for anxiety were improved on day 15 (p = 0.002). There were no significant adverse effects attributed to ginseng.

Conclusions

The findings of this study suggest that high-dose ginseng may be helpful in the management of multiple symptoms among patients with cancer.

Limitations

  • Small sample (< 30)
  • Risk of bias (no control group)
  • Risk of bias (no random assignment)
  • Other limitations/explanation: Patients were included and considered evaluable if they took only one dose of ginseng. The number of doses actually taken was not stated, so there is no way to know if symptoms changed over time due to ginseng or not, or in how many patients. For several symptoms, though statistically significant, actual changes in score were very small.

Nursing Implications

Ginseng appears to be safe and may be helpful in the management of multiple symptoms among patients with cancer. This study had multiple design limitations. Additional well-designed studies with larger patient samples are needed to provide sufficient evidence for the meaningful evaluation of efficacy.

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