The Efficacy of Tradition Chinese Medicine in Patients With Irritable Bowel Syndrome (TCM-IBS)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00676975
Recruitment Status : Completed
First Posted : May 13, 2008
Last Update Posted : April 25, 2017
University of Maryland
National Center for Complementary and Integrative Health (NCCIH)
Information provided by (Responsible Party):
Francis KL Chan, Chinese University of Hong Kong

Brief Summary:
To test the efficacy of Traditional Chinese Medicine in relieving symptoms and change of quality of life of patients with Irritable Bowel Syndrome.

Condition or disease Intervention/treatment Phase
Irritable Bowel Syndrome Drug: Traditional Chinese Medicine Drug: Traditional Chinese Medicine Placebo Phase 2

Detailed Description:

Irritable bowel syndrome (IBS), characterized by abdominal pain/discomfort and disturbed bowel frequency, is a common functional bowel disorder that accounts for a substantial proportion of patients seen in primary care and secondary referral centers. The impact on patients' quality of life and the economic burden on the community are considerable. However, the outcome of conventional Western medicine in treating IBS has been disappointing. Several potential new therapeutic agents have been withdrawn because of serious adverse events. Traditional Chinese medicine (TCM) has been used in the treatment of IBS for centuries in Asian countries but scientific evaluation of its therapeutic function is scarce. A methodologically strong trial of a 20-herb formula has shown significant benefit for IBS patients. However, the herbal formulation was inadequately characterized and defined for repeated clinical studies.

Subsequent to complete chemical characterization, a randomized, placebo-controlled, double-blind, phase II dose-escalation clinical trial will be conducted to find an optimally safe and efficacious dosage of this standardized 20-herb preparation in 104 patients aged 18 to 75 with all types of IBS. At each of two dosage levels, 52 participants will be randomized to treatment for 8 weeks with the herbal formula or placebo in a 1:1 allocation ratio, and will be assessed at baseline, weeks 0, 2, 4, 8, and 12 for the clinically important and reliable outcome of patient reported global symptom improvement. At the conclusion of the 1st dosage level, safety will be assessed prior to using the higher dosage in a new cohort of participants. We also will assess individual IBS symptoms, nature, severity, duration, and frequency of adverse events, quality of life, concurrent IBS medications and health care utilization, and will perform blood tests for safety purposes. Adherence to study medication will be verified by dose counts. Results of this dose-ranging study will help to identify the optimal dosage of the herbal formula to be used in future randomized placebo-controlled trials and in head-to-head comparisons with conventional pharmaceuticals.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 104 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Dose Escalation Trial of Traditional Chinese Medicine for Irritable Bowel Syndrome(TCM- IBS)
Actual Study Start Date : May 26, 2008
Actual Primary Completion Date : December 30, 2010
Actual Study Completion Date : August 30, 2011

Arm Intervention/treatment
Active Comparator: Traditional Chinese Medicine
Traditional Chinese Medicine 17g herbal extract
Drug: Traditional Chinese Medicine

A herbal extract 17g once daily for 8 weeks for lower dosage, and 34g for higher dosage.

The 20-herb formulation are Agastache rugosa,Fraxinus rhynchophylla, Angelica dahurica,Glycyrrhiza uralensis, Artemisia capillaris, Magnolia officinalis, Atractylodes macrocephala,Paeonia lactiflora, Aucklandia lappa, Plantago asiatica,Bupleurum chinense, Phellodendron amurense, Citrus reticulate, Poria cocos, Codonopsis pilosula, Saposhnikovia diraricata, Coix lacryma-jobi, Schisandra chinensis, Coptis chinensis, Zingiber officinale

Placebo Comparator: Traditional Chinese Medicine Placebo
Drug: Traditional Chinese Medicine Placebo
Placebo once daily for 8 weeks

Primary Outcome Measures :
  1. Patient reported global symptom improvement, based on this question: "Have you had adequate relief of your symptoms over the last two weeks"? (yes/no) [ Time Frame: 12 weeks ]

Secondary Outcome Measures :
  1. Bowel Symptom Scale (BSS): to assess changes in individual IBS and global IBS symptoms. QoL assessment:one disease-specific (IBS-QoL) and one generic (SF-36), will be used. [ Time Frame: 12 weeks ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes

Inclusion Criteria:

  • All IBS patients attending the Gastroenterology Clinic of the Prince of Wales Hospital of Hong Kong.
  • Age 18-75 inclusive
  • IBS diagnosed by Rome III criteria:

    • Recurrent abdominal pain or discomfort at least three days per month in the previous three months
    • Symptom onset at least six months prior to diagnosis
    • Pain or discomfort associated with two or more of the following:

      1. Improvement with defecation
      2. Onset associated with a change in frequency of stool
      3. Onset associated with a change in form (appearance) of stool
  • Normal colonic evaluation (colonoscopy or barium enema) in past 5 years
  • No "global symptom improvement" as rated by patients (see below) at baseline and during the two-week run-in period
  • Normal full blood count, liver function test and renal function test.
  • Informed written consent for participation into study.
  • Ethical approval will be obtained from the Joint CUHK-NTEC Clinical Research Ethics Committee as well as the IRB of UMB.

Exclusion Criteria:

  • Past or present history of organic disease of gastrointestinal tract (e.g. colorectal cancer, advanced colonic polyp, celiac disease, inflammatory bowel disease, peptic ulcer and previous gastrointestinal surgery). (Note: those with polyps removed during colonoscopy can be included, as long as no known polyps remained).
  • Systemic diseases that cause diarrhea or constipation (e.g. thyroid disease, diabetic neuropathy)
  • Lactose intolerance
  • Severe liver diseases (e.g. cirrhosis, chronic active hepatitis)
  • Renal impairment (serum creatinine level > 150mmol/L)
  • Women who are pregnant, lactating or not practicing proper contraception
  • Known hypersensitivity to herbal medicine
  • Concommitant use of prescription antidepressant medication.
  • Current alcoholism and drug abuse
  • Current psychiatric illness or dementia
  • Fever or severe illness at baseline (week 0).

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00676975

Li Ka Shing Specialist Clinic, Prince of Wales Hospital
Hong Kong (SAR), China, 852
Sponsors and Collaborators
Chinese University of Hong Kong
University of Maryland
National Center for Complementary and Integrative Health (NCCIH)
Principal Investigator: Francis KL Chan, MD Chinese University of Hong Kong

Responsible Party: Francis KL Chan, professor, Chinese University of Hong Kong Identifier: NCT00676975     History of Changes
Other Study ID Numbers: TCM-IBS
1U19AT003266-01 ( U.S. NIH Grant/Contract )
First Posted: May 13, 2008    Key Record Dates
Last Update Posted: April 25, 2017
Last Verified: April 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

Keywords provided by Francis KL Chan, Chinese University of Hong Kong:
Irritable Bowel disease
Traditional Chinese Medicine

Additional relevant MeSH terms:
Irritable Bowel Syndrome
Pathologic Processes
Colonic Diseases, Functional
Colonic Diseases
Intestinal Diseases
Gastrointestinal Diseases
Digestive System Diseases