Efficacy of ginkgo biloba extract in the treatment of idiopathic pulmonary fibrosis: A systematic review and meta-analysis of randomized controlled trials

Xuxin Sun ¹ Ling Peng ¹ Wenchao Xiao ¹ Keying Li ¹ Sheng Chen ^2*

• ¹ The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, China
• ² Shenzhen Traditional Chinese Medicine Hospital, Shenzhen ，Guangdong, China

This systematic review and meta-analysis aims to assess the efficacy of GBE in the treatment of IPF by evaluating its impact on total effective rate, blood gas analysis, pulmonary function tests, and markers of inflammation and fibrosis. Methods: We conducted a comprehensive search across seven databases, including PubMed, EMBASE, Web of Science, CNKI, Wanfang DATA, VIP, and CBM, without restrictions on publication date. Randomized controlled trials (RCTs) that investigated the effects of GBE on IPF patients were eligible for inclusion. Relevant literature was screened, and the data in the included studies were extracted for quality assessment according to the Risk of bias tool. Results: A total of 14 RCTs involving 1043 patients were included in the analysis. GBE significantly improved the total effective rate, arterial oxygen partial pressure, arterial oxygen saturation, forced vital capacity, forced expiratory volume in one second, maximum voluntary ventilation, and sixminute walk test compared to the control group. Additionally, there was a significant reduction in arterial carbon dioxide partial pressure, interleukin-4, hyaluronan, and laminin levels. Conclusion: GBE may offer therapeutic benefits in IPF by improving respiratory function, modulating inflammation, and affecting fibrosis markers. These findings support the potential use of GBE as an adjunct therapy in IPF and suggest that further large-scale, multicenter trials are warranted to confirm its efficacy and safety. 1 Introduction Idiopathic Pulmonary Fibrosis (IPF) is a devastating interstitial lung disease characterized by the progressive replacement of functional lung tissue with fibrotic scar tissue, leading to impaired gas exchange and ultimately respiratory failure (1). The etiology of IPF remains obscure, and despite recent advances in understanding its pathogenesis, the disease continues to carry a poor prognosis, with a median survival time of only three to five years following diagnosis (2). The complexity of IPF's pathogenesis, which encompasses chronic inflammation, dysregulated wound healing, and microenvironmental changes that drive fibroblast proliferation and extracellular matrix deposition, poses significant challenges for disease management(3).