Ginkgo Biloba for Peripheral Circulation
For peripheral circulation problems such as intermittent claudication, the best evidence shows ginkgo biloba does not produce a clinically meaningful improvement in pain-free walking distance. It is not a substitute for proven treatments like supervised exercise.
Why this grade7-layer evidence engine
The grade is driven by the strongest available study contradicting the supplement's reputation. The 2013 Cochrane review (PMID 23744597; 14 trials, n=739) found that any increase in walking distance with ginkgo was small and not statistically significant (P=0.06), concluding there was no clinically meaningful benefit. An earlier 2000 meta-analysis (PMID 11014719) reported a modest ~34 m gain, but its authors called the effect small and of uncertain clinical importance, and it has since been superseded by the Cochrane analysis.
Newer, more rigorous trials reinforce the null result. A double-blind RCT of standardized EGb 761 (PMID 18628657, n=62) found no significant effect on treadmill walking time in peripheral artery disease, and a second RCT (PMID 17702699) showed that adding ginkgo to a supervised exercise program offered no advantage over exercise alone. The signal weakens as study quality improves.
Regulators and clinics align with this caution. NIH/NCCIH states there is no conclusive evidence ginkgo helps any health condition; Mayo Clinic notes large studies have not shown benefit; Harvard calls the leg-pain evidence conflicting; and the 2024 AHA/ACC peripheral artery disease guideline does not mention or endorse ginkgo, recommending supervised exercise and cilostazol instead. Ginkgo also carries a meaningful bleeding-interaction risk with antiplatelet and anticoagulant drugs commonly used in these patients.
Scoring transparency
All scores computed by a 7-layer evidence engine — fully auditable▸View the full decision path (audit trail)
- compute_raw_score — 加權公式: L2×0.30 + L3×0.25 + L5×0.25 + L11×0.10 + L1×0.10 = 0.29
- tier_from_score — 依分數區間映射至 tier letter
- apply_hec_rules — 無高階證據可裁決
- tier_strict_requirement_check — Tier 條件達標，未降階
- detect_disputes — 偵測到 0 個 hard + 0 個 soft dispute
- decide_status — 依 tier + dispute 結果決定 status