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

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...

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Main Authors: Qian Li, Bei-ping Zhang, Shao-gang Huang, Wen-wei Ouyang, Jian-hui Xie, Ze-huai Wen, Xiao-bo Yang
Format: Article
Language:English
Published: BMC 2018-07-01
Series:Trials
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13063-018-2754-9
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author Qian Li
Bei-ping Zhang
Shao-gang Huang
Wen-wei Ouyang
Jian-hui Xie
Ze-huai Wen
Xiao-bo Yang
author_facet Qian Li
Bei-ping Zhang
Shao-gang Huang
Wen-wei Ouyang
Jian-hui Xie
Ze-huai Wen
Xiao-bo Yang
author_sort Qian Li
collection DOAJ
description 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.
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spelling doaj.art-f54144491bd4475eb72153ae55efec482022-12-22T00:48:05ZengBMCTrials1745-62152018-07-011911910.1186/s13063-018-2754-9Efficacy and indication optimization of Chinese medicine (Tiao-Chang Ke-Min granules) for diarrhea-predominant irritable bowel syndrome: study protocol for a randomized controlled trialQian Li0Bei-ping Zhang1Shao-gang Huang2Wen-wei Ouyang3Jian-hui Xie4Ze-huai Wen5Xiao-bo Yang6Chinese Medicine Syndrome Research Team, Guangdong Provincial Hospital of Chinese MedicineDepartment of Gastroenterology, Guangdong Provincial Hospital of Chinese MedicineDepartment of Gastroenterology, Guangdong Provincial Hospital of Chinese MedicineKey Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of Chinese MedicineChinese Medicine Syndrome Research Team, Guangdong Provincial Hospital of Chinese MedicineKey Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of Chinese MedicineChinese Medicine Syndrome Research Team, Guangdong Provincial Hospital of Chinese MedicineAbstract 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.http://link.springer.com/article/10.1186/s13063-018-2754-9Irritable bowel syndromeDiarrhea-predominantRandomized controlled trialPrediction of the treatment outcomeIndicationTiao-Chang Ke-Min granules
spellingShingle Qian Li
Bei-ping Zhang
Shao-gang Huang
Wen-wei Ouyang
Jian-hui Xie
Ze-huai Wen
Xiao-bo Yang
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
Irritable bowel syndrome
Diarrhea-predominant
Randomized controlled trial
Prediction of the treatment outcome
Indication
Tiao-Chang Ke-Min granules
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
topic Irritable bowel syndrome
Diarrhea-predominant
Randomized controlled trial
Prediction of the treatment outcome
Indication
Tiao-Chang Ke-Min granules
url http://link.springer.com/article/10.1186/s13063-018-2754-9
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