Effects of Ginger Intake on Chemotherapy-Induced Nausea and Vomiting: A Systematic Review of Randomized Clinical Trials

Abstract

Nausea and vomiting are the most common side effects of chemotherapy. They must be managed because they can increase the risk of malnutrition in patients, which can adversely affect treatment. The objective of this study was to evaluate the effect of ginger supplementation as an adjuvant treatment for alleviating chemo We checked. therapy-induced nausea and vomiting (CINV). This study searched for randomized controlled trials (RCTs) related to ginger supplement intake for CINV in three electronic databases (i.e., Medline (PubMed), Embase, and Web of Science). The search period ranged from each database’s first date of service to 5 November 2021. Two investigators independently performed abstract screenings, full-text screenings, data extraction, and risk of bias analyses (ROB). The Cochrane ROB tool was used for the assessment of ROB. This study systematically reviewed 23 RCTs. The effects of ginger supplementation were compared to those of placebo or antiemetic agents. This study conducted a meta-analysis after classifying the effects of ginger supplementation on acute and delayed CINV into subgroups due to the clinical heterogeneity between these RCTs. The results showed that the incidence of acute nausea (p = 0.53), the incidence of delayed nausea (p = 0.31), the incidence of acute vomiting (p = 0.09), and the incidence of delayed vomiting (p = 0.89) were not significantly different between the ginger supplement intake group and the control group. However, it was found that the ginger supplement intake group, which took not more than 1 g of ginger supplementation per day for above four days, had significantly less acute vomiting than the control group (OR 0.30; 95% CI 0.12 to 0.79; p = 0.02; I2 = 36%). Ginger supplementation may reduce the incidence of acute chemotherapy-induced vomiting. However, this study could not confirm the effects of ginger supplementation on the incidence of chemotherapy-induced nausea and delayed vomiting. Therefore, it will be necessary to conduct additional studies with sufficient sample sizes using high-quality RCTs to evaluate the effects of ginger supplementations based on the results of this study.

Renoprotective Glycoside Derivatives from Zingiber officinale (Ginger) Peels

“…The Molecular Formula of Metabolite 11 (Zingterpeneoside D) Was Assigned Based on the HRESIMS Peak at m/z 355.1722 [M + Na] + (calcd for C 16 H 28 O 7 Na, 355.1727). 1 H NMR data (Table 4) indicate that 11 possesses two olefinic protons at δ H 5.91 (1H, dd, J = 10.5 1.3 Hz, H-3) and 5.63 (1H, dd, J = 10.5, 1.3 Hz, H-2), an oxygenated methylene at δ H 3.54 (2H, s, H-7), two methyl groups at δ H 0.91 (3H, d, J = 6.8 Hz, H-10) and 0.88 (3H, d, J = 6.8 Hz, H-9), and a β-D-glucose moiety associated with signals at δ H 4.45 (1H, d, J = 7.8 Hz, H-1′) and 3.22−3.81 (6H, H-2′−6′). The 13 C NMR spectrum (Table 4) of 11 contains signals for 16 carbons including two methyls at δ C 19.6 (C-9) and 20.0 (C-10), three methylenes at δ C 24.3 (C-5), 30.6 (C-6), and 68.5 (C-7), four methines at δ C 129.9 (C-2), 137.4 (C-3), 137.4 (C-4), and 33.0 (C-8), a quaternary carbon at δ C 80.9 (C-1), together with those for the β-Dglucose moiety at δ C 99.1 (C-1′), 75.2 (C-2′), 77.9 (C-3′), 71.6 (C-4′), 77.8 (C-5′), and 62.7 (C-6′).…”

“…The absolute configuration at these centers was determined to be (1S, 2R, 3S, 5R) by the close match of the experimental and calculated ECD curves (Figure 4). 1 H and 13 C NMR data (Table 3) shows that 8 contains three methyls, six methylenes, two olefinic C�C bonds, an ester group, and a glucose moiety. The data were similar to those of callicapene M3, 26 configuration of the glucose moiety was established by using the same method that was applied to 6.…”

Ginger Update

“…Although various antiemetic drugs were developed to alleviate this, a substantial proportion of patients nonetheless experience episodes of NV 69 . The effectiveness of ginger as a potential adjunct to suppress CINV was examined in several meta-analyses and reviews 10,12,13,39–42,69–72 . Determining any benefit of ginger is complex because patient NV episodes are classified as acute, delayed, anticipatory, breakthrough, and refractory, and generally ginger's effects on only the acute and delayed phases have been assessed.…”

“…Future clinical trials are needed that address other factors contributing to heterogeneity in trial outcomes and that provide more detailed treatment analyses. For example, variability among trials may be lessened by administering low and high doses of standardized ginger formulations that are provided during each of the acute and delayed phases for both short and long durations, an approach that was specifically adopted in the meta-analysis by Choi et al 72 Examining the effects of ginger on CINV associated with specific cancer treatment strategies may yield additional insights into variability of outcomes 42,71 . Well-designed RCTs are also needed that address additional issues such as the effects of ginger on overall quality of life and fatigue for those with CINV 10,41,70 .…”

“…69 The effectiveness of ginger as a potential adjunct to suppress CINV was examined in several meta-analyses and reviews. 10,12,13,[39][40][41][42][69][70][71][72] Determining any benefit of ginger is complex because patient NV episodes are classified as acute, delayed, anticipatory, breakthrough, and refractory, and generally ginger's effects on only the acute and delayed phases have been assessed. The uses of different cancer chemotherapy regimens possess variable emetogenicities, and prescribed antiemetic agents can exhibit distinct mechanisms of action.…”