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Comparison Between the Efficacy of Ginger and Sumatriptan in the Ablative Treatment of the Common Migraine

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Frequency and torment caused by migraines direct patients toward a variety of remedies. Few studies to date have proposed ginger derivates for migraine relief. This study aims to evaluate the efficacy of ginger in the ablation of common migraine attack in comparison to sumatriptan therapy. In this double-blinded randomized clinical trial, 100 patients who had acute migraine without aura were randomly allocated to receive either ginger powder or sumatriptan. Time of headache onset, its severity, time interval from headache beginning to taking drug and patient self-estimation about response for five subsequent migraine attacks were recorded by patients. Patients(,) satisfaction from treatment efficacy and their willingness to continue it was also evaluated after 1 month following intervention. Two hours after using either drug, mean headaches severity decreased significantly. Efficacy of ginger powder and sumatriptan was similar. Clinical adverse effects of ginger powder were less than sumatriptan. Patients' satisfaction and willingness to continue did not differ. The effectiveness of ginger powder in the treatment of common migraine attacks is statistically comparable to sumatriptan. Ginger also poses a better side effect profile than sumatriptan. Copyright © 2013 John Wiley & Sons, Ltd.
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Comparison Between the Efficacy of Ginger and
Sumatriptan in the Ablative Treatment of the
Common Migraine
Mehdi Maghbooli,*Farhad Golipour, Alireza Moghimi Esfandabadi and Mehran Youse
Zanjan University Of Medical Sciences, VALI-e-ASR Hospital, Neurology Department, Zanjan, Iran
Frequency and torment caused by migraines direct patients toward a variety of remedies. Few studies to date
have proposed ginger derivates for migraine relief. This study aims to evaluate the efcacy of ginger in the
ablation of common migraine attack in comparison to sumatriptan therapy. In this double-blinded randomized
clinical trial, 100 patients who had acute migraine without aura were randomly allocated to receive either ginger
powder or sumatriptan. Time of headache onset, its severity, time interval from headache beginning to taking
drug and patient self-estimation about response for ve subsequent migraine attacks were recorded by patients.
Patients
,
satisfaction from treatment efcacy and their willingness to continue it was also evaluated after 1 month
following intervention. Two hours after using either drug, mean headaches severity decreased signicantly.
Efcacy of ginger powder and sumatriptan was similar. Clinical adverse effects of ginger powder were less than
sumatriptan. Patientssatisfaction and willingness to continue did not differ. The effectiveness of ginger powder
in the treatment of common migraine attacks is statistically comparable to sumatriptan. Ginger also poses a
better side effect prole than sumatriptan. Copyright © 2013 John Wiley & Sons, Ltd.
Keywords: common migraine; ginger; sumatriptan.
Supporting information may be found in the online version of this article.
INTRODUCTION
Migraine, a periodic chronic neurologic disorder, is one
of the most common causes of pain syndromes with a
prevalence rate of 12%. This disorder imposes exorbi-
tant expenditures and creates disadvantages on personal
function. These can vary from minimally disturbed
activities of daily living to complete, although temporary,
incapacitation requiring total rest. Unfortunately, the
wait-and-see approach often prolongs the symptoms
constituting the disease, while also decreasing the effec-
tiveness of the treatment.
Despite continuous improvements in the eld of
migraine treatment, which has provided further opportuni-
ties to select more specic and effective remedies, many
patients prefer to relieve headaches by nonchemical
(herbal) means or readily available over-the-counter
(OTC) products. A part of this trend is a result of fears
associated with adverse drug reactions and apprehensions
of dependency. Patients often experience a loss of satisfac-
tion from their usual medications which contributes to
their unmet needs. Even the general chronic relapsing
nature of migraine disease poses frustrations for sufferers
that lead them to seek out alternative remedies.
Ginger is a native plant of southeastern Asia that has
been widely cultivated in Jamaica, China, India, Nigeria,
Sierra Leone, Haiti and Australia. These thick rhizomes,
in dehydrated form, contain 4060% carbohydrate, 10%
protein, 10% fat, 5% ber, 6% minerals, 10% water,
14% essential oil, 58% resin and mucilage (Langner
et al., 1998; Shri, 2003; Mascolo et al., 1989; Mustafa
et al., 1993, Awang, 1992).
Ginger products have long been used in the manage-
ment of motion sickness, dyspepsia, articular pain, local
pains and vertigo (Grant and Lutz, 2000; Yarnell, 2002;
Holtmann et al., 1989; Riebenfeld and Borzone, 1999;
Mickleeld et al., 1999; Grøntved and Hentzer, 1986;
Altman and Marcussen, 2001).
One of the most favorable aspects of ginger is that there
are no serious or even frequent side effects reported with
its use. Anecdotal reports even indicate a therapeutic role
for ginger in vomiting, atulence and memory problems
(Ernst and Pittler, 2000; Yamahara et al., 1989). Pharma-
cologic studies have revealed its effectiveness in the
reduction of blood sugar, normalizing of blood pressure,
strengthening of the overall cardiovascular system, inhib-
itory effects on prostaglandins and platelet aggregation,
as well as lipid lowering properties and hyposecretion of
gastric acid (Bordia et al., 1997; Tjendraputra et al.,
2001; Guh et al., 1995).
In a study performed by Cady et al., Gelstat (an OTC
drug which contains ginger extract) alleviated migraine
headache completely in 48%, and partially in 34% of
patients within 2 h of taking the drug (Cady et al., 2005).
Aurora et al., performed a double-blinded placebo-
controlled study demonstrating that the Gelstat-treated
group also had a signicantly higher pain relief rate 2 h
following proper drug use, at 65% versus 36%, p = 0.038
(Aurora et al., 2006).
In a case report review, a 42year old woman with classic
migraine achieved headache subsidence within a 30 min
period of taking a 500600 mg water-soluble ginger
powder upon onset of visual aura. Patients, who continued
* Correspondence to: Maghbooli Mehdi, Zanjan University of Medical
Sciences, Vali-e-Asr University Hospital, Neurology ward, Zanjan, Iran.
E-mail: m.maghbooli@zums.ac.ir
PHYTOTHERAPY RESEARCH
Phytother. Res. 28: 412415 (2014)
Published online 9 May 2013 in Wiley Online Library
(wileyonlinelibrary.com) DOI: 10.1002/ptr.4996
Copyright © 2013 John Wiley & Sons, Ltd.
Received 09 September 2010
Revised 09 March 2013
Accepted 17 March 2013
consumption of ginger powder, every 4 h for a total of
four days, reported both diminished headache severity
and frequency (Mustafa and Srivastava, 1990).
Given the high frequency, the variability in treatment
options, along with the diverse inclinations and satisfaction
of the sufferer population, the purpose of this study is to
determine the therapeutic effects of ginger powder on
the attacks of migraine without aura and compare it with
standard sumatriptan treatment.
METHODS AND MATERIALS
This is a double-blinded randomized controlled clinical
trial comparing the efcacy of ginger to sumatriptan in
the treatment of the common migraine. One hundred
study participants who are sufferers of common migraine
were enrolled after admission to the Neurology Clinic of
Zanjan Vali-e-Asr Hospital. Participants were assigned
to two coequal groups by way of simple, random
nonprobability sampling; one group was blindly given
ginger powder, while the other was given sumatriptan.
Inclusion criteria used (International Headache Soci-
ety Classication ICHD-II, Migraine, nd): (i) Conrmed
diagnosis of migraine without aura by a neurologist,
based on IHS criteria (ICHD-II), (ii) Aged 18 years,
(iii) Education level high school diploma or higher,
(iv) Headache frequency between 2 and 10 days/month.
Exclusion criteria were: (i) History of biliary calculus or
peptic ulcer disease, (ii) Allergic reaction, (iii) Hemorrhagic
diathesis or using anticoagulants, (iv) History of ischemic
heart disease or Prinzmetals angina, (v) Pregnancy or
lactation, (vi) Headache after head trauma.
After completion of an introductory questionnaire,
one sealed box containing ve capsulets (sumatriptan
or ginger powder) was randomly delivered to each
subject. Subjects were instructed to take only one
capsulet upon headache onset. Each ginger capsulet
contained 250 mg powder of ginger rhizome, while each
Imegraz capsulet contained 50 mg of sumatriptan.
All patients were committed to keeping up with their
previous maintenance therapeutic regimens, and, with
each attack they were required to ll out a questionnaire
revealing: time of headache onset, headache severity
(rated on a visual analog scale), timing of drug taking,
response self-assessments following 30, 60, 90,120 min
and 24 h. Subjects also included any clinical adverse
drug reactions within the questionnaire. This study was
conducted for the duration of one month, at which point
patients evaluated their overall satisfaction with regards
to treatment efcacy as well as their willingness to con-
tinue their respective treatments. All statistical analysis
was performed by using SPSS for windows (version 16)
software. Means of quantitative variables were com-
pared by using student T-test between the two groups.
In the case of categorical variables, Chi-square test was
applied. Headache severity in the study groups, before
and after intervention, was assessed with a paired sam-
ples T-test analysis. All P-values were two-tailed and a
P-value <0.05 was considered signicant.
RESULTS
One hundred patients with common migraine were
selected to take either sumatriptan or ginger (groups
equally proportioned).
The mean age of patients was 35.1 6.2 years old in
the sumatriptan group and 33.9 8.3 years old in the
ginger group. Females comprised 68% (34 patients)
sumatriptan subjects versus 74% (37patients) ginger.
Average duration of migraine diagnosis was 7.3 4.5
years in sumatriptan and 7.2 4.6 years in ginger group.
Average number of headache attacks in sumatriptan
and ginger-treated groups were 5.8 3.1 and 4.9 2.7
attack/month, respectively. This frequency was 4.6 0.9
attack/month during trial period in both groups.
Average time interval from headache onset to drug
intake was 24 15 min (median: 21 min) for sumatriptan
and 20 11 min (median: 20 min) for ginger patients.
Figure 1 represents changes of mean headache severity
in subsequent time intervals following consumption of
either drug.
Before taking the medication, 22% of the sumatriptan
group and 20% of the ginger group had severe headaches
(VAS 8); mean values were 56% versus 48% for moder-
ate severity (5 VA S 7) in the two groups, respectively
(P = 0.527).
Frequency distribution of mean headache severity at
2 h after drug use demonstrated similar effectiveness
for sumatriptan and ginger groups (P = 0.116) (Table 1).
Comparing mean headache severity before and 2 h after
treatment revealed a 4.7 unit reduction (according to
VAS) in the sumatriptan group (P <0.0001) and a 4.6
unit reduction in the ginger group (P <0.0001).
In this study, 70% of sumatriptan-treated and 64% of
ginger-treated patients showed favorable relief (90%
decrease in headache severity) at 2 h following drug
Figure 1. Changes in mean headache severity after taking sumatriptan and Ginger during subsequent time intervals. This figure is available in
colour online at wileyonlinelibrary.com/journal/ptr.
413MIGRAINE ABLATION BY GINGER VERSUS SUMATRIPTAN
Copyright © 2013 John Wiley & Sons, Ltd. Phytother. Res. 28: 412415 (2014)
use. Frequency of favorable relief according to gender,
age group, duration of migraine history and maintenance
regimen was compared between the sumatriptan and
ginger groups and summarized in Table 2. These ndings
indicated that both the sumatriptan and ginger signi-
cantly impressed on pain relief and no signicant differ-
ences were demonstrated in the headache subsidence
between the sumatriptan- and ginger-treated groups.
Subjective side effectsarose from sumatriptan including
dizziness, a sedative effect, vertigo and heartburn.
The only reported clinical adverse effect of ginger was
dyspepsia. Prevalence rate of clinical complaints was
20% for sumatriptan in contrast with only 4% for ginger
(P = 0.028). 86% of subjects reported high or superior
satisfaction from the sumatriptan-treated group as com-
pared to 88% in ginger group (P = 0.736). Eighty-eight
percent of sumatriptan users and 72% of ginger recipients
were inclined to continue their randomly assigned drug
for the abortion of migraine attacks (P=0.139).
DISCUSSION
The current study reveals that both sumatriptan and
ginger powder decrease mean severity of common
migraine attacks in within 2 h of use. A comparison of
efcacy in headache alleviation and patients
content-
ment does not show any signicant difference amongst
the two drugs. However, subjective side effects due to
ginger powder were signicantly less than sumatriptan.
Despite availability of multiple drugs specically for
the abortion of migraine attacks (such as ergots and
triptans), as well as advances in pharmacologic and
alternative therapies, problems including poor satisfac-
tion of drug efcacy as well as varied side effects persist.
Challenges also include the chronic and recurrent
nature of the disease; these can cause patients to
constantly reevaluate their treatment needs, a delay or
interruption in self management, and a tendency to take
OTC and herbal medications.
Anecdotally, oral ginger has been used for migraine
headache, nausea and vomiting (Kemper, 1999). The es-
sential oil of ginger has also been used topically as an an-
algesic (Srivastava and Mustafa, 1989). For migraine,
500 mg ginger taken at onset, repeated every 4 h up to
1.52 g per day, for 34 days has been recommended
(Mustafa and Srivastava, 1990).
Researchers at the city of London Migraine Clinic
found that feverfew also eliminated about two-thirds
of migraines in a selected group of headache patients,
which is similar to the effectiveness of most migraine
drugs. While some people experience a pronounced
effect, others may have none at all (Hylands et al.,
1985; Murphy et al., 1988).
The amount that has been shown to prevent migraine
attacks in research studies ranges from 50 to 114 mg per
day. Though most practitioners use capsules containing
250 mg of a standardized potency feverfew.
Mustafa et al. reported a 42-year-old woman, with a
16 years history of migraines, experienced enormous
relief after supplementing her diet with 1.52 g of dried
ginger daily.
Table 1. Frequency of mean headache severity before each drug use and 2 h after its intake
Headache severity
Drug Free Mild
b
Moderate
c
Severe
d
Sum
Sumatriptan Before 0 22 (11) 56 (28) 22 (11) 100 (50)
After 44 (22)
a
48 (24) 8 (4) 0 100 (50)
Ginger powder Before 0 32 (16) 48 (24) 20 (10) 100 (50)
After 44 (22) 56 (28) 0 0 100 (50)
Sum Before 0 27 (27) 52 (52) 21 (21) 100 (100)
After 44 (44) 52 (52) 4 (4) 0 100 (100)
a
Digits outside and inside the brackets indicate percent and number of patients.
b
Headache severity as 1 VAS 4.
c
Headache severity as 5 VAS 7.
d
Headache severity as 8 VAS.
P = 0.116.
Table 2. Frequency of 90% reduction in headache severity after 2 h following each drug use compared based on some features of subjects
Drug
Variable Sumatriptan Ginger powder PV
Sex Male 68.8 (11)
a
69.2 (9) 0.978
Female 70.6 (24) 62.2 (23) 0.453
Age group <35 72 (18) 61.3 (19) 0.400
35 68 (17) 68.4 (13) 0.976
Duration of migraine history <5 73.3 (11) 62.5 (10) 0.519
5 68.6 (24) 64.7 (22) 0.733
Maintenance therapy With 78.1 (25) 78.6 (22) 0.967
Without 55.6 (10) 45.5 (10) 0.525
a
Digits outside and inside the brackets indicate percent and number of patients.
414 M. MAGHBOOLI ET AL.
Copyright © 2013 John Wiley & Sons, Ltd. Phytother. Res. 28: 412415 (2014)
In double-blinded placebo-controlled study of Aurora
et al., Gelstat (ginger extract) relieved migraine headache
more signicantly than placebo within 2 h of taking the
drug. There was no meaningful difference in relief rate
of headache by Gelstat and placebo (19% versus 7%
respectively).
In the present study, ginger powder reduced mean
headache severity up to 4.6 units in relation to before
taking drug.
Cady et al. performed an open-label study enrolling
30 patients that were treated in the mild pain phase with
Gelstat Migraine (a combination of ginger and fever-
few).Two hours after treatment, 48% were pain-free
with 34% reporting a headache of only mild severity.
Twenty-nine percent reported a recurrence within 24 h.
Side effects were minimal, and 59% of subjects were
satised. 41% preferred Gelstat Migraine or felt it was
equal to their pre-study medication. In our study, 2h
after ginger intake, 44% of subjects became pain free
with 56% reporting a headache of only mild severity.
Clinical adverse reactions occurred in 4% of ginger
group, and 88% of patients rated headache relief as
great or excellent, and 72% preferred this drug for
long-term therapy.
The present investigation demonstrated an overall
44% palliation in all headache attacks 2 h following
treatment with sumatriptan or ginger powder. In
conjunction with evidence from other studies, it is antici-
pated that increasing the total amount of ginger intake
per attack can greatly enhance migraine relief rate.
CONCLUSION
Consequently, ginger products are a favorable choice
for treatment of acute migraine without aura when com-
pared with sumatriptan. Therefore, it is recommended
for migrainous patients who are uneasy or poorly
responsive to other medications or in general simply
tend to use herbal remedies. It is suggested a more
extensive placebo-controlled study which can measure
the effectiveness of various doses of ginger-based
medications with differing types and severities of migraine
is examined.
Acknowledgements
We would like to thank all patients for participating in this study. We
are also very grateful to pharmacy companies Goldaru and Razak
for providing Zintoma and Imegraz. Thanks are also extended to
Mrs. Manizhe Asemani, Head nurse of Vali-e-Asr neuroclinic,
for her assistance in sample collection and patient follow-up.
This study was supported by a grant from Zanjan University of
Medical Sciences.
Conflict of Interest
The authors have declared that there is no conict of interest.
REFERENCES
Altman RD, Marcussen KC. 2001. Effects of a ginger extract
on knee pain in patients with osteoarthritis. Arthritis Rheum
44(11): 25312538.
Aurora SK, Vermaas A, Barrodale PM. 2006. Gelstat is Effective in
Relieving Migraine Pain in a Double-Blind, Placebo-Controlled
Study. 48th Annual Scientific Meeting, American Headache
Society; June 22-25; Los Angeles, CA.
Awang DVC. 1992. Ginger. Can Pharm J 125: 309311.
Bordia A, Verma SK, Srivastava KC. 1997.Effect of ginger (Zingiber
officinale Rosc.) and fenugreek (Trigonella foenum-graecum L.)
on blood lipids, blood sugar and platelet aggregation in patients
with coronary artery disease. PLEFA 56:379384.
Cady RK, Schreiber CP, Beach ME, Hart CC. 2005. Gelstat Migraine
(sublingually administered feverfew and ginger compound) for
acute treatment of migraine when administered during the mild
pain phase. Med Sci Monit 11(9): PI659.
Ernst E, Pittler MH. 2000.Efficacy of ginger for nausea and vomiting:
a systematic review of randomized clinical trials. B J Anaesthes
84:367371.
Grant KL, Lutz RB. 2000. Ginger. Am J Health Syst Pharm 57:
945947.
Grøntved A, Hentzer E. 1986.Vertigo-reducing effect of ginger
root: A controlled clinical study. ORL 48: 282286.
Guh JH, Ko FN, Jong TT, Teng CM, 1995. Antiplatelet effect of
gingerol isolated from Zingiber officinale.J Pharm Pharmacol
47: 329332.
Holtmann S, Clarke AH, Scherer H, Hohn M. 1989.The anti-motion
sickness mechanism of ginger. A comparative study with
placebo and dimenhydrinate. Acta Otolaryngol 108: 168174.
Hylands DM, Hylands PJ, Johnson ES, Kadam NP, MacRae KD.
1985. Efficacy of feverfew as prophylactic treatment of
migraine. Br Med J (Clin Res Ed) 291: 569573.
International Headache Society (IHS) Classification ICHD-II,
Migraine. (nd). Migraine without aura|1.1|G43.0. Available
from URL: http://ihs-classification.org/en/02_klassification/
02_teil/01.03.00_ migraine.html.
Kemper KJ. 1999. Ginger Clinical Information Summary.
Longwood Herbal Task Force: http://www.mcp.edu/herbal/
default.htm Revised November 3.
Langner E, Greifenberg S, Gruenwald J. 1998. Ginger: History and
use. Adv Ther 15: 25.
Mascolo N, Jain R, Jain SC, Capasso F, 1989. Ehtnopharmacologic
investigation of ginger (Zingiber officinale). J Ethnopharm 27:
129140.
Micklefield GH, Redeker Y, Meister V, et al. 1999. Effects of ginger
on gastroduodenal motility. Int J Clin Pharmacol Ther 37:
341346.
Murphy JJ, Heptinstall S, Mitchell JR. 1988. A Randomized
double-blind placebo-controlled trial of feverfew in migraine
prevention. Lancet 23: 18992.
Mustafa T, Srivastava KC. 1990. Ginger (Zingiber officinale) in
migraine headache. J Ethnopharmacol 29(3): 26773.
Mustafa T, Srivastava KC, Jensen KB. 1993. Drug Development
Report (9): Pharmacology of ginger, Zingiber officinale.J Drug
Dev 6: 24.
Riebenfeld D, Borzone L. 1999. Randomized double-blind study com-
paring ginger (Zintona
W
) and dimenhydrinate in motion sickness.
Healthnotes Rev Complementary Integrative Med 6:98101
Shri JNM. 2003. Ginger:Its role in xenobiotic metabolism. For the In-
dian Council of Medical Research, New Delhi at the ICMR offset
press, New Delhi-110 029, ICMR Bulletin Vol.33, No.6.
Srivastava KC, Mustafa T. 1989. Ginger (Zingiber officinale) and
rheumatic disorders. Med Hypoth 29:2528.
Tjendraputra E, Tran VH, Liu-Brennan D, Roufogalis BD, Duke CC,
2001. Effect of ginger constituents and synthetic analogues
on cyclooxygenase-2 enzyme in intact cells. Bioorg Chem
29: 156163.
Yamahara J, Rong HQ, Naitoh Y, Kitani T, Fujimura H, 1989. Inhibi-
tion of cytotoxic drug-induced vomiting in suncus by a ginger
constituent. J Ethnopharma 27: 353355.
Yarnell E. 2002. Phytotherapy for the Treatment of Pain. Modern
Phytotherapist 7(1): 112.
415MIGRAINE ABLATION BY GINGER VERSUS SUMATRIPTAN
Copyright © 2013 John Wiley & Sons, Ltd. Phytother. Res. 28: 412415 (2014)
... Although ginger extracts have been shown to inhibit arachidonic acid metabolism and have anti-inflammatory and/or anti-rheumatic properties, one of its traditional indications has been to treat rheumatic disorders [5]. One of the best things about ginger is that it hasn't been linked to any serious or even common side effects [19]. Most traditional and complementary systems of medicine such as Ayurveda, Siddha, Unani, Homeopathy, Tibetan, Chinese, etc. prescribe Z. officinale individually or as a combination in both infective and noncommunicable diseases. ...
... The essential oil of ginger has also been used topically as an analgesic [47]. Maghbooli et al., (2013) showed that the use of 250mg of ginger powder during migraine attacks was as effective as 50 mg of sumatriptan in relieving pain intensity 2 h after ginger intake [19]. Menon et al., (2021) reported that dried ginger powder is as effective as Ibuprofen in controlling pain and gingival inflammation that arises after open flap debridement. ...
... The essential oil of ginger has also been used topically as an analgesic [47]. Maghbooli et al., (2013) showed that the use of 250mg of ginger powder during migraine attacks was as effective as 50 mg of sumatriptan in relieving pain intensity 2 h after ginger intake [19]. Menon et al., (2021) reported that dried ginger powder is as effective as Ibuprofen in controlling pain and gingival inflammation that arises after open flap debridement. ...
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Sumatriptan (ST) is a commonly prescribed drug for treating migraine. The efficiency of several routes of ST administration has been investigated. Recently, the intranasal route with different delivery systems has gained interest owing to its fast-acting and effectiveness. The present study is aimed at reviewing the available studies on novel delivery systems for intranasal ST administration. The oral route of ST administration is common but complicated with some problems. Gastroparesis in patients with migraine may reduce the absorption and effectiveness of ST upon oral use. Furthermore, the gastrointestinal (GI) system and hepatic metabolism can alter the pharmacokinetics and clinical effects of ST. The bioavailability of conventional nasal liquids is low due to the deposition of a large fraction of the delivered dose of a drug in the nasal cavity. Several delivery systems have been utilized in a wide range of preclinical and clinical studies to enhance the bioavailability of ST. The beneficial effects of the dry nasal powder of ST (AVP-825) have been proven in clinical studies. Moreover, other delivery systems based on microemulsions, microspheres, and nanoparticles have been introduced, and their higher bioavailability and efficacy were demonstrated in preclinical studies. Based on the extant findings, harnessing novel delivery systems can improve the bioavailability of ST and enhance its effectiveness against migraine attacks. However, further clinical studies are needed to approve the safety and efficacy of employing such systems in humans.
... Furthermore, shogaols seem to modulate neuroinflammatory response through the down-regulation of inflammatory markers on microglial cells [51] , while gingerols may act as agonists of the capsaicin-activated vanilloid receptors [52] . To date, only a few uncontrolled studies and one case report have shown the analgesic effect of ginger in migraine [53,54,55] . ...
... Several studies that evaluate the effectiveness of ginger in patients suffering from osteoarthritis have controversial results. The study showed the extract of ginger has a significant effect on dropping osteoarthritis symptoms [22]. 6-Shogaol has potent anti-inflammatory and antioxidant effects used as a therapeutic agent in gout as a rheumatic disease of joints [23]. ...
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Ginger (Zingiber officinale) is a common kitchen spice that belongs to the family Zingiberaceae. It is rich in phytochemistry that is promoting health benefits. It is used as a home remedy to support the common cold, headaches, and pharmacological properties such as anti-inflammatory, antioxidant, antiemetic, antiulcer, and anti-cancer, antiplatelet, anti-diabetic and lipid-lowering activities. Gingerols are key ingredients found in ginger that convert into zingerone, shogaol, and parasols, giving flavor and odor. Zingerone and shogaol are present in limited quantities in fresh ginger and more in dried or extracted goods. Especially 6-gingerol and 6-shogaol are pharmacological properties that are effective in antipyretic, analgesic, and hypotensive. The present review is about different therapeutic properties of ginger, including antioxidant properties, anti-diabetic properties, anti-cancer properties etc.
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Background: Migraine sufferers seek a range of treatments according to the frequency and severity of their symptoms. Just a few research studies have shown the effectiveness of ginger derivatives for migraine treatment. Ginger has analgesic properties and is effective for the acute treatment of migraines, and there is anecdotal evidence of its effectiveness in migraine prevention. Objectives: The goal of this research was to see whether ginger may help prophylaxis of migraine episodes. Methods: This randomized, double-blind, placebo-controlled clinical study was done in the Neurology Clinic of Golestan Hospital (Ahvaz, Iran). This research enrolled 103 individuals with episodic migraine aged 18 to 50 years. Randomization was used to divide the participants into two groups: control and intervention. For three months, patients were given 500 mg dry extract of ginger (5% active component) or placebo (starch) tablets twice a day. At the baseline and end of the study, MIDAS score, the number and duration of migraine attacks, headache severity, demographic data, dietary intakes, and anthropometric indices were collected. The data were statistically analyzed using the SPSS (version 26). In all tests, a P < 0.05 was deemed statistically significant. Results: At the end of the study, MIDAS score, duration of migraine attacks, and headache severity decreased significantly in the ginger group compared to the placebo group (P < 0.05). Furthermore, there was no statistically significant difference in the number of migraine episodes between the two groups. Conclusions: Compared to the placebo, ginger has a stronger efficacy in the prevention of migraine.
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Objective The aim of this systematic review was to evaluate the efficacy of metamizole and triptans for the treatment of migraine. Methods Randomized controlled trials including people who received metamizole or triptan by multiple routes of administration and at all doses as treatment compared to subjects who received another treatment or placebo were included in the systematic review. The primary outcomes were freedom from pain at 2 hours; pain relief at 2 hours; sustained headache response at 24 hours; sustained freedom from pain at 24 hours. The statistical analysis of all interventions of interest were based on random effect models compared through a network meta-analysis. Results 209 studies meeting the inclusion and exclusion criteria were analyzed. Of these, 130 had data that could be analyzed statistically. Only 3.0% provided enough information and were judged to have a low overall risk of bias for all categories evaluated; approximately 50% of the studies presented a low risk of selection bias. More than 75% of the studies presented a low risk of performance bias, and around 75% showed a low risk of detection and attrition bias. Conclusion There is no evidence of a difference between dipyrone and any triptan for pain freedom after 2 hours of medication. Our study suggests that metamizole may be equally effective as triptans in acute migraine treatment.
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Ginger (Zingiber officinale) is well known for its anti-nausea and anti-inflammatory effects. It has been shown to have several gastrointestinal benefits in clinical research, as it improves digestion by stimulating salivary flow, gastric motility, gastric acid production, bile flow, and gall bladder kinesis. It may be beneficial for gingivitis, coronary artery disease, hyperlipidemia, nausea and vomiting of pregnancy, motion sickness, post-operative nausea, chemotherapy-induced nausea, gastroparesis, dysmenorrhea, menorrhagia, menopause, male infertility, osteoarthritis, muscle pain, migraine headache, and colorectal cancer prevention. In addition, ginger or its constituents have antiplatelet and antioxidant activity. This chapter examines some of the scientific research conducted on ginger, both alone and in combination formulas, for treating numerous health conditions. It summarizes results from several human studies of the ginger’s use in treating oral and dental, cardiometabolic, gastrointestinal, urogenital, neurological, and oncologic disorders. Finally, the chapter presents a list of ginger’s active constituents, different Commonly Used Preparations and Dosage, and a section on “Safety and Precaution” that examines side effects, toxicity, and disease and drug interactions.
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Ginger (Zingiber officinale) is often advocated as beneficial for nausea and vomiting. Whether the herb is truly efficacious for this condition is, however, still a matter of debate. We have performed a systematic review of the evidence from randomized controlled trials for or against the efficacy of ginger for nausea and vomiting. Six studies met all inclusion criteria and were reviewed. Three on postoperative nausea and vomiting were identified and two of these suggested that ginger was superior to placebo and equally effective as metoclopramide. The pooled absolute risk reduction for the incidence of postoperative nausea, however, indicated a non-significant difference between the ginger and placebo groups for ginger 1 g taken before operation (absolute risk reduction 0.052 (95% confidence interval -0.082 to 0.186)). One study was found for each of the following conditions: seasickness, morning sickness and chemotherapy-induced nausea. These studies collectively favoured ginger over placebo.
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Seventeen patients who ate fresh leaves of feverfew daily as prophylaxis against migraine participated in a double blind placebo controlled trial of the herb: eight patients received capsules containing freeze dried feverfew powder and nine placebo. Those who received placebo had a significant increase in the frequency and severity of headache, nausea, and vomiting with the emergence of untoward effects during the early months of treatment. The group given capsules of feverfew showed no change in the frequency or severity of symptoms of migraine. This provides evidence that feverfew taken prophylactically prevents attacks of migraine, and confirmatory studies are now indicated, preferably with a formulation controlled for sesquiterpene lactone content, in migraine sufferers who have never treated themselves with this herb.
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In traditional medicine the rhizome of ginger was held to possess medicinal properties. The scientific investigations relating to consumption of fresh or powdered rhizome by humans and in vitro effects of aqueous and organic extracts and of volatile oils are reviewed. Pungent components of ginger inhibit cyclooxygenase and lipoxygenase activity in the arachidonic acid metabolic pathway and thereby probably reduce inflammation and relieve pain in rheumatic disorders and migraine headache. Consumption of ginger reduces plasma thromboxane B2 (TXB2) levels in humans. Ginger is reported to reduce nausea vertigo and vomiting for which the mechanism of action is however not yet understood. Effects on the gastrointestinal system include increase in bile secretion and anti-emetic action. An acetone extract of ginger and (6)-shogaol given orally, accelerate gastroinstestinal movement in mice while given i.v. (6)-shogaol inhibits such movement. Galanolactone antagonises 5-HT3 receptors which may explain the anti-emetic and gastrointestinal movement enhancing effects. Zingiberone and(6)-gingerol are reported to protect against gastric mucosal lesions. (6)-Shogaol is known to reduce blood pressure by both a central and a peripheral action. (8)-Gingerol has a cardiotonic action via enhancement of the Ca-ATPase in the sarcoplasmic reticulum. Ginger contains mutagenic (gingerol and shogaol) and anti-mutagenic (zingiberone) compounds. Ginger extract exhibits cytotoxic effects in cultured plant cells but it is not known whether ginger can suppress tumour growth in experimental animals or humans. Some of the chemical compounds from ginger may prove to have anti-inflammatory, anti-emetic, cardiotonic and gastroprotective properties in humans without side effects.
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Ginger is well known in the form of ginger sticks or ginger ale. If these are consumed during travel, the traveler imbibes, albeit subconsciously, a healing plant for motion sickness. The efficacy of ginger rhizome for the prevention of nausea, dizziness, and vomiting as symptoms of motion sickness (kinetosis), as well as for postoperative vomiting and vomiting of pregnancy, has been well documented and proved beyond doubt in numerous high-quality clinical studies. The use of this ancient medicine for gastrointestinal problems (stimulation of digestion) has been given scientific approval. Today, medicinal ginger is used mainly for prevention of the symptoms of travel sickness.
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The effect of powdered ginger root (Zingiber officinale) upon vertigo and nystagmus following caloric stimulation of the vestibular system was studied in 8 healthy volunteers in a double-blind crossover placebo trial. The results reported are based upon 48 vertigo scores and 48 electronystagmograms. Ginger root reduced the induced vertigo significantly better than did placebo. There was no statistically significant action upon the duration or the maximum slow phase velocity of nystagmus.
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Clinical criteria for the classification of patients with hip pain associated with osteoarthritis (OA) were developed through a multicenter study. Data from 201 patients who had experienced hip pain for most days of the prior month were analyzed. The comparison group of patients had other causes of hip pain, such as rheumatoid arthritis or spondylarthropathy. Variables from the medical history, physical examination, laboratory tests, and radiographs were used to develop different sets of criteria to serve different investigative purposes. Multivariate methods included the traditional "number of criteria present" format and "classification tree" techniques. Clinical criteria: A classification tree was developed, without radiographs, for clinical and laboratory criteria or for clinical criteria alone. A patient was classified as having hip OA if pain was present in combination with either 1) hip internal rotation greater than or equal to 15 degrees, pain present on internal rotation of the hip, morning stiffness of the hip for less than or equal to 60 minutes, and age greater than 50 years, or 2) hip internal rotation less than 15 degrees and an erythrocyte sedimentation rate (ESR) less than or equal to 45 mm/hour; if no ESR was obtained, hip flexion less than or equal to 115 degrees was substituted (sensitivity 86%; specificity 75%). Clinical plus radiographic criteria: The traditional format combined pain with at least 2 of the following 3 criteria: osteophytes (femoral or acetabular), joint space narrowing (superior, axial, and/or medial), and ESR less than 20 mm/hour (sensitivity 89%; specificity 91%). The radiographic presence of osteophytes best separated OA patients and controls by the classification tree method (sensitivity 89%; specificity 91%). The "number of criteria present" format yielded criteria and levels of sensitivity and specificity similar to those of the classification tree for the combined clinical and radiographic criteria set. For the clinical criteria set, the classification tree provided much greater specificity. The value of the radiographic presence of an osteophyte in separating patients with OA of the hip from those with hip pain of other causes is emphasized.
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Migraine is considered as a neurological disorder with little convincing evidence of the involvement of some vascular phenomenon. Recent understanding of the mechanisms behind migraine pain generation and perception have considerably helped the development of modern migraine drugs. Most migraine drugs in use, i.e., ergotamine and dihydroergotamine, iprazochrome, pizotifen and diazepam; and non-steroidal antiinflammatory drugs (i.e. aspirin, paracetamol, persantin, etc.) have side-effects and are prescribed with caution for a limited duration. Ginger is reported in Ayurvedic and Tibb systems of medicine to be useful in neurological disorders. It is proposed that administration of ginger may exert abortive and prophylactic effects in migraine headache without any side-effects.