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Efficacy and indication optimization of Chinese medicine (Tiao-Chang Ke-Min granules) for diarrhea-predominant irritable bowel syndrome: study protocol for a randomized controlled trial.
Trials. 2018 Jul 11; 19(1):367.T

Abstract

BACKGROUND

Irritable bowel syndrome (IBS) is a chronic, recurring condition, prevalent in the general population. Current medication treatments usually leave patients undertreated. Nowadays, Chinese medicine (CM) is being considered as a promising treatment approach for IBS. However, due to methodological limitations, there is no strong evidence to support CM. Although IBS relapses are common, the relapse assessment has always been neglected in CM study designs. Meanwhile, in clinical practice and studies, it has been found that certain CM formulas can only benefit certain kinds of patients. Discovering what population and illness characteristics likely respond to outcomes may help improve the effectiveness of CM. The aims of this study are to evaluate the efficacy and safety of Tiao-Chang Ke-Min (TCKM) granules for IBS, especially in reducing IBS symptoms' relapse, by a high-quality randomized controlled trial and then to optimize the indication of the TCKM granules.

METHODS/DESIGN

This is a parallel-group, randomized, double-blind, placebo-controlled trial embedded with outcome predictive factors. Eligible patients with diarrhea-predominant IBS will be randomized into either a TCKM granule group or a placebo group. Patients from both groups will receive health education. The treatment duration is 4 weeks and the follow-up is 12 weeks. The primary outcome is global improvement measured with adequate relief (AR). The second outcome measures include time until relief, time until first relapse, total relapse times, long-term effectiveness, individual symptoms, IBS-Symptom Severity Score (IBS-SSS), IBS-Quality of Life Questionnaire (IBS-QOL), and Hospital Anxiety and Depression Scale (HADS). Predictive factors associated with patient and illness characteristics have been widely collected. These factors will be embedded in this trial for further identification.

DISCUSSION

This trial may provide high-quality evidence on the efficacy and safety of TCKM granules for IBS and a more accurate indication. Importantly, this trial will provide a new research method for improving the therapeutic effects of CM for clinicians and researchers. To address IBS relapse assessment, a series of special definitions of relapse incidents has been made for this trial.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, ID: ChiCTR-IOR-17010600 . Registered on 9 February 2017.

Authors+Show Affiliations

Chinese Medicine Syndrome Research Team, Guangdong Provincial Hospital of Chinese Medicine, No. 111, DaDe Road, Guangzhou, 510120, China. The Second Clinical College of Guangzhou University of Chinese Medicine, No. 12, JiChang Road, Guangzhou, 510405, China.Department of Gastroenterology, Guangdong Provincial Hospital of Chinese Medicine, No. 111, DaDe Road, Guangzhou, 510120, China.Department of Gastroenterology, Guangdong Provincial Hospital of Chinese Medicine, No. 111, DaDe Road, Guangzhou, 510120, China.Key Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, No. 111, Dade Road, Guangzhou, 510120, China.Chinese Medicine Syndrome Research Team, Guangdong Provincial Hospital of Chinese Medicine, No. 111, DaDe Road, Guangzhou, 510120, China.Key Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, No. 111, Dade Road, Guangzhou, 510120, China.Chinese Medicine Syndrome Research Team, Guangdong Provincial Hospital of Chinese Medicine, No. 111, DaDe Road, Guangzhou, 510120, China. yangxiaobomd@163.com.

Pub Type(s)

Clinical Trial Protocol
Journal Article

Language

eng

PubMed ID

29996882

Citation

Li, Qian, et al. "Efficacy and Indication Optimization of Chinese Medicine (Tiao-Chang Ke-Min Granules) for Diarrhea-predominant Irritable Bowel Syndrome: Study Protocol for a Randomized Controlled Trial." Trials, vol. 19, no. 1, 2018, p. 367.
Li Q, Zhang BP, Huang SG, et al. Efficacy and indication optimization of Chinese medicine (Tiao-Chang Ke-Min granules) for diarrhea-predominant irritable bowel syndrome: study protocol for a randomized controlled trial. Trials. 2018;19(1):367.
Li, Q., Zhang, B. P., Huang, S. G., Ouyang, W. W., Xie, J. H., Wen, Z. H., & Yang, X. B. (2018). Efficacy and indication optimization of Chinese medicine (Tiao-Chang Ke-Min granules) for diarrhea-predominant irritable bowel syndrome: study protocol for a randomized controlled trial. Trials, 19(1), 367. https://doi.org/10.1186/s13063-018-2754-9
Li Q, et al. Efficacy and Indication Optimization of Chinese Medicine (Tiao-Chang Ke-Min Granules) for Diarrhea-predominant Irritable Bowel Syndrome: Study Protocol for a Randomized Controlled Trial. Trials. 2018 Jul 11;19(1):367. PubMed PMID: 29996882.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and indication optimization of Chinese medicine (Tiao-Chang Ke-Min granules) for diarrhea-predominant irritable bowel syndrome: study protocol for a randomized controlled trial. AU - Li,Qian, AU - Zhang,Bei-Ping, AU - Huang,Shao-Gang, AU - Ouyang,Wen-Wei, AU - Xie,Jian-Hui, AU - Wen,Ze-Huai, AU - Yang,Xiao-Bo, Y1 - 2018/07/11/ PY - 2017/05/26/received PY - 2018/06/20/accepted PY - 2018/7/13/entrez PY - 2018/7/13/pubmed PY - 2019/3/23/medline KW - Chinese medicine KW - Diarrhea-predominant KW - Indication KW - Irritable bowel syndrome KW - Prediction of the treatment outcome KW - Randomized controlled trial KW - Tiao-Chang Ke-Min granules SP - 367 EP - 367 JF - Trials JO - Trials VL - 19 IS - 1 N2 - BACKGROUND: Irritable bowel syndrome (IBS) is a chronic, recurring condition, prevalent in the general population. Current medication treatments usually leave patients undertreated. Nowadays, Chinese medicine (CM) is being considered as a promising treatment approach for IBS. However, due to methodological limitations, there is no strong evidence to support CM. Although IBS relapses are common, the relapse assessment has always been neglected in CM study designs. Meanwhile, in clinical practice and studies, it has been found that certain CM formulas can only benefit certain kinds of patients. Discovering what population and illness characteristics likely respond to outcomes may help improve the effectiveness of CM. The aims of this study are to evaluate the efficacy and safety of Tiao-Chang Ke-Min (TCKM) granules for IBS, especially in reducing IBS symptoms' relapse, by a high-quality randomized controlled trial and then to optimize the indication of the TCKM granules. METHODS/DESIGN: This is a parallel-group, randomized, double-blind, placebo-controlled trial embedded with outcome predictive factors. Eligible patients with diarrhea-predominant IBS will be randomized into either a TCKM granule group or a placebo group. Patients from both groups will receive health education. The treatment duration is 4 weeks and the follow-up is 12 weeks. The primary outcome is global improvement measured with adequate relief (AR). The second outcome measures include time until relief, time until first relapse, total relapse times, long-term effectiveness, individual symptoms, IBS-Symptom Severity Score (IBS-SSS), IBS-Quality of Life Questionnaire (IBS-QOL), and Hospital Anxiety and Depression Scale (HADS). Predictive factors associated with patient and illness characteristics have been widely collected. These factors will be embedded in this trial for further identification. DISCUSSION: This trial may provide high-quality evidence on the efficacy and safety of TCKM granules for IBS and a more accurate indication. Importantly, this trial will provide a new research method for improving the therapeutic effects of CM for clinicians and researchers. To address IBS relapse assessment, a series of special definitions of relapse incidents has been made for this trial. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ID: ChiCTR-IOR-17010600 . Registered on 9 February 2017. SN - 1745-6215 UR - https://www.unboundmedicine.com/medline/citation/29996882/Efficacy_and_indication_optimization_of_Chinese_medicine__Tiao_Chang_Ke_Min_granules__for_diarrhea_predominant_irritable_bowel_syndrome:_study_protocol_for_a_randomized_controlled_trial_ L2 - https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-018-2754-9 DB - PRIME DP - Unbound Medicine ER -