Figure 29.14 • Structures of ginsenosides.

20 (R) Ginsenoside one herb can have opposing pharmacological effects.65 Ginsenoside Rb-1 acts as a CNS depressant, anticonvulsant, analgesic, and antipsychotic, prevents stress ulcers, and accelerates glycolysis and nuclear RNA synthesis. Ginsenoside Rg-1 stimulates the CNS, combats fatigue, is hypertensive, and aggravates stress ulcers. Additionally, ginsenosides Rg and Rg-1 enhance cardiac performance, whereas Rb depresses that function. Some of the other ginsenosides display antiarrhythmic activity similar to that of the calcium channel blocker verapamil and amiodarone.

Ginseng is popularly believed to enhance concentration, stamina, alertness, and the ability to do work. Longer-term use in elderly patients is claimed to enhance "well-being." There are few data from human studies. Clinical studies comparing ginseng with placebo on cognitive function tests showed statistically insignificant improvement. Nevertheless, ginseng is a popular herbal product recommended by the German Commission E.

Milk Thistle

Milk thistle (Silybum marianum) is a member of the Asteraceae, a family that includes daisies, asters, and thistles. The plant has a wide range around the world and is found in the Mediterranean, Europe, North America, South America, and Australia. The seeds of the milk thistle plant have been used for 2,000 years as a hepatoprotectant.66,67 This usage can be traced to the writings of Pliny the Elder (ad 23-79) in Rome, who reported that the juice of the plant could be used for "carrying off bile." Culpepper in England reported that milk thistle was useful in "removing obstructions of the liver and spleen and against jaundice."

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