Gan Jiang

Rhizoma Zingiberis; Zingiber officinale

Chemical Constituents

1-2% of rhizome contains essential oil which provides the distinctive smell and taste. The oil is comprised of borneol, camphene, cineol, zingerol, phellandrene, and zingerone, shagoal, bisabolene. [1] 

The essential oil contains zingiberene, ar-curcumene,beta-bisabolene, beta-sesquiphellandrene, camphene. [2][3] 

Dosage

3 to 9 grams of powdered herb. [1]

Pharmacology

Pre-clinical & Clinical

Traditional Use

Gan Jiang is acrid and hot, working through the stomach, spleen heart and lungs. It is used to revive ‘yang’ properties, to warm the spleen and unblock all channels through which it works. [9] Taste is also referred to as ‘pungent’. It is used for warming of the lung and as an anti-emetic when there is a faint pulse and low body temperatures. [1] 

General 

Anti-emetic activity: 

Several studies have been published which support Rhizoma Zingiberis’s antiemetic activity compared to drug or placebo therapy. [10][11][12][13] R. Zingiberis may also be of value in the treatment of hyperemesis gravidarum, a condition in morning sickness where severe dehydration and electrolyte disturbances may occur through excessive vomiting. [14] In addition, two double-blind, controlled clinical studies reported that the use of R. Zingiberis for treatment of nausea in pregnancy was found to decrease the number of events as well as lessening the severity of nausea. [15][16] A randomized, controlled equivalence trial found that women using R. Zingiberis in early pregnancy will reduce their symptoms. [17] The effectiveness of R. Zingiberis root pre-surgically as an antiemetic agent was comparable with metoclopramide in a double-blind, placebo controlled study. [18] R. Zingiberis root preparations may be useful in controlling nausea and vomiting after surgery with general anesthesia and in outpatient surgery. [19][20] However, there has been a report of dried R. Zingiberis root having no value in decreasing postoperative nausea, but product quality and lack of standardization may have contributed to this negative finding. [21] 

Shogaol is thought to give R. Zingiberis its antiemetic effect, and some authors report that this effect may be due to in part to R. Zingiberis’s increase in gastric emptying and its thromboxane synthetase activity. [22][23][24] A recent analysis of clinical studies on R. Zingiberis’s effectiveness in decreasing nausea reported that the studies collectively favored R. Zingiberis over placebo. [25] R. Zingiberis has also been reported to decrease the nausea associated with certain chemotherapy and radiation treatments. [26] 

Gastric Motility activity: 

R. Zingiberis is reported to stimulate gastric secretions and enhance gastric motility. [27][28] Whether or not R. Zingiberis works on the CNS or locally in the gut is debated, but research has reported both central and peripheral involvement. [29] A small human study did report however that a R. Zingiberis root powder preparation had no effect on gastric emptying. [30] R. Zingiberis’s structural phenols are similar to aspirin and may have an effect on prostaglandins, PGE2 and PGF2, as well as thromboxane, leading to its use as a platelet aggregation inhibitor. [6][31] 

Anti-inflammatory qctivity:

R. Zingiberis has reported anti-inflammatory properties and has been used in some inflammatory conditions such as arthritis. [32][33] R. Zingiberis was reported to be effective against pain and swelling in more than three-quarters of the 56 patients studied (28 with rheumatoid arthritis, 18 with osteoarthritis and 10 with muscular discomfort). [34] None of the patients reported adverse effects during the period of Rhizoma Zingiberis consumption which ranged from 3 months to 2.5 years. It has been suggested that at least one of the mechanisms by which Rhizoma Zingiberis has anti-inflammatory effects is the inhibition of prostaglandin and leukotriene biosynthesis. [35] 

Two-hundred and forty seven patients completed a randomized, double-blind, placebo-controlled, multicenter, parallel-group study lasting 6-weeks evaluating the safety and efficacy of 2 R. Zingiberis species (Zingiber officinale and Alpinia galanga) in osteoarthritis (OA) of the knee. The R. Zingiberis extract group had greater response in the primary endpoint of reduced knee pain upon standing as well as all the secondary endpoints evaluated. Less rescue medication (acetaminophen) was used by the R. Zingiberis group. More gastrointestinal adverse effects, most of them mild were experienced by the R. Zingiberis group. It is important to note that the change in the quality of life was equal between the R. Zingiberis and placebo group. [36] Another study found no significant advantage of using R. Zingiberis root over conventional anti-inflammatory agents such as ibuprofen. [37] However, the potential for side-effects of NSAID medications should be taken into consideration, as R. Zingiberis usage has reported fewer side-effects.

Clinical

Refer above

Interaction and Depletions

Interaction with other Herbs

Replace.

Interaction with Drugs

Based on pharmacology, constituents in Z. officinale may inhibit platelet aggregation which may alter the effects of medications used for this purpose. [5][6] 

Based on pharmacology, caution should be used in patients with bleeding disorders. [7] 

Precautions and Contraindications

Side effects

High doses may exacerbate hypertension. High doses may cause dry mouth, nosebleeds, sore throat and nephritis. [2]

Some instances of gastric upset have been reported. [8] 

Pregnancy

No documentation.

Age limitation

No documentation.

Adverse reaction

No documentation.

References

  1. Z. You-Ping. Chinese Materia Medica: Chemistry, Pharmacology and Applications. Florida:CRC Press;1998.352-353.
  2. D. Bensky, S. Clavey, E. Stoger, A. Gamble. Chinese Herbal Medicine Materia Medica, 3rd Edition. Seattle WA:Eastland Press;2004.30.
  3. H. Wohlmuth. Essential oil composition of diploid and tetraploid clones of ginger (Zingiber officinale Roscoe) grown in Australia. J Agric Food Chem. 22Feb2006;54(4):1414-1419.
  4. G. Singh. Studies on essential oils, Part 42: chemical, antifungal, antioxidant and sprout suppressant studies on ginger essential oil and its oleoresin. Flav Frag J. 2004;20(1):1-6.
  5. M. Suekawa. Pharmacological Studies on Gan Jiang, I. Pharmacological Actions of Pungent Constitutents, (6)-Gan Jiangol and (6)-shogaol. J Pharmacobiodyn. 1984;7(11):836-848.
  6. J.H. Guh, F.N. Ko, T.T. Jong, C.M. Teng. Antiplatelet Effect of Gan Jiangol Isolated from Zingiber officinale. J Pharm Pharmacol. 1995;47(4):329-332.
  7. A.M. Heck. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm. Jul2000;57(13): 1221-1227.
  8. H.G. Desai, R.H. Kalro, A.P. Choksi. Effect of Gan Jiang and garlic on DNA content of gastric aspirate. Ind J Med Res. Apr1990;92:139-141.
  9. D. Bensky, S. Clavey, E. Stoger, A. Gamble. Chinese Herbal Medicine Materia Medica, 3rd Edition. Seattle WA:Eastland Press,;2004.681-682.
  10. D.B. Mowry. Motion Sickness, Gan Jiang, and Psychophysics. Lancet. 1982;1(8273):655-667.
  11. A. Grontved. Gan Jiang Root Against Seasickness. A Controlled Trial on the Open Sea. Acta Otolaryngol. 1988;105:45-49.
  12. D.S. Qian. Pharmacologic Studies of Antimotion Sickness Actions of Gan Jiang. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih. 1992;12(2):95-98.
  13. J.J. Stewart. Effects of Gan Jiang on Motion Sickness Susceptibility and Gastric Function. Pharmacology. 1991;42(2):111-120.
  14. W. Fischer-Rasmussen. Gan Jiang Treatment of Hyperemesis Gravidarum. Eur J Obstet Gynecol Reprod Biol. 1991;38(1):19-24.
  15. T. Vutyavanich, T. Kraisarin, R. Ruangsri. Gan Jiang for nausea and vomiting in pregnancy: randomized, double-masked, placebo-controlled trial. Obstet Gynecol. Apr2001;97(4):577-582.
  16. M. Sripramote, N. Lekhyananda. A randomized comparison of Gan Jiang and vitamin B6 in the treatment of nausea and vomiting of pregnancy. J Med Assoc Thai. Sep2003;86(9):846-853.
  17. C. Smith, C. Crowther, K. Willson, N. Hotham, V. McMillian. A randomized controlled trial of Gan Jiang to treat nausea and vomiting in pregnancy. Obstet Gynecol. Apr2004;103(4):639-645.
  18. M.E. Bone. Gan Jiang Root--A New Antiemetic. The Effect of Gan Jiang Root on Postoperative Nausea and Vomiting After Major Gynaecological Surgery. Anaesthesia. Aug1990;45(8):669-671.
  19. S. Phillips. Zingiber officinale (Gan Jiang)--An Antiemetic for Day Case Surgery. Anaesthesia. Aug1993;48(8):715-717.
  20. D. Pongrojpaw, C. Chiamchanya. The efficacy of Gan Jiang in prevention of post-operative nausea and vomiting after outpatient gynecological laparoscopy. J Med Assoc Thai. Mar2003;86(3):244-250.
  21. Z. Arfeen, H. Owen, J.L. Plummer. A Double-blind Randomized Controlled Trial of Gan Jiang for the Prevention of Postoperative Nausea and Vomiting. Anaesth Intensive Care. Aug1995;23(4):449-452.
  22. G.H. Micklefield, Y. Redeker, V. Meister. Effects of Gan Jiang on Gastroduodenal Motility. Int J Clin Pharmacol Ther. Jul1999;37(7):341-346.
  23. J. Backon. Gan Jiang in Preventing Nausea and Vomiting of Pregnancy; A Caveat Due to Its Thromboxane Synthetase Activity and Effect on Testosterone Binding. Eur J Obstet Gynecol Reprod Biol. 26Nov1991;42(2):163-164.
  24. A.B. Lumb. Mechanism of Antiemetic Effect of Gan Jiang. Anaesthesia. 1993;48(12):1118.
  25. E. Ernst, M.H. Pittler. Efficacy of Gan Jiang for Nausea and Vomiting: A Systematic Review of Randomized Clinical Trials. Br J Anaesth. Mar2000;84(3):367-371.
  26. J. Yamahara, H.Q. Rong, Y. Naitoh. Inhibition of Cytotoxic Drug-induced Vomiting in Suncus by a Gan Jiang Constituent. J Ethnopharmacol. Dec1989;27(3):353-355.
  27. J. Yamahara, Q.R. Huang, Y.H. Li. Gastrointestinal Motility Enhancing Effect of Gan Jiang and Its Active Constituents. Chem Pharm Bull.Tokyo. Feb1990;38(2):430-431.
  28. J. Yamahara. Cholagogic Effect of Gan Jiang and Its Active Constituents. J Ethnopharmacology. 1985; 13(2):217.
  29. D.S. Qian. Pharmacologic Studies of Antimotion Sickness Actions of Gan Jiang. Chung Kuo Chung Hsi I Chieh Ho Tsa Chih. 1992;12(2):95-98.
  30. S. Phillips, S. Hutchinson, R. Ruggier. Zingiber officinale Does not Affect Gastric Emptying Rate. A Randomised, Placebo-controlled, Crossover Trial. Anaesthesia. May1993;48(5):393-395.
  31. S.K. Verma, J. Singh, R. Khamesra. Effect of Gan Jiang on Platelet Aggregation in Man. Indian J Med Res. Oct1993;98:240-242.
  32. J.N. Sharma, K.C. Srivastava, E.K. Gan. Suppressive Effects of Eugenol and Gan Jiang Oil on Arthritic Rats. Pharmacology. Nov1994;49(5):314-318.
  33. I. Wigler, I. Grotto, D. Caspi, M. Yaron. The effects of Zintona EC (a Gan Jiang extract) on symptomatic gonarthritis. Osteoarthritis Cartilage. Nov2003;11(11):783-789.
  34. K.C. Srivastava, T. Mustafa. Gan Jiang (Zingiber officinale) in Rheumatism and Musculoskeletal Disorders. Med Hypotheses. Dec1992;39(4):342-348.
  35. K.C. Srivastava, T. Mustafa. Gan Jiang (Zingiber officinale) and Rheumatic Disorders. Med Hypotheses. May1989;29(1):25-28.
  36. R.D. Altman, K.C. Marcussen. Effects of a Gan Jiang extract on knee pain in patients with osteoarthritis. Arthritis Rheum. Nov2001;44(11):2531-2538.
  37. H. Bliddal, A. Rosetzsky, P. Schlichting. A Randomized, Placebo-controlled, Cross-over Study of Gan Jiang Extracts and Ibuprofen in Osteoarthritis. Osteoarthritis Cartilage. Jan2000;8(1):9-12.