Journal of Traditional Chinese Medicine >
Efficacy and safety of a sequential treatment with clearing heat and eliminating phlegm and tonifying Qi and activating blood circulation in treating acute ischemic stroke: study protocol for a randomized controlled trial
Received date: 2021-04-19
Accepted date: 2021-07-20
Online published: 2022-07-12
Supported by
National Key Research and Development Program of China (Evidence-based Evaluation of TCM Key Syndrome Differentiation and Treatment for Acute Ischemic Stroke)(2018YFC1705002)
OBJECTIVE: To investigate the short-term efficacy and safety outcomes following a sequential treatment with clearing heat and eliminating phlegm (CHEP) formula and tonifying Qi and activating blood circulation (TQABC) formula in patients with acute ischemic stroke (AIS) within a 72 h time window. METHODS: In this randomized, multicenter, double-blinded, placebo-controlled trial, 500 participants will be randomly assigned in a ratio of 1∶1 to the CHEP+ TQABC group or control group. In addition to guideline-based standard medical care, participants in the treatment group will receive the CHEP formula for the first 5 consecutive days followed by the TQABC formula for another 10 consecutive days, while those in the control group will receive CHEP formula placebo and TQABC formula placebo consecutively. The primary outcome measure will be the comparison of the change in the National Institutes of Health Stroke Scale score from baseline to 15 days after randomization. The secondary outcome measures will include the scores on the modified Rankin Scale, Barthel Index, Patient-Reported Outcomes, TCM symptom pattern (Zheng-hou) evaluation Scale, and the incidence of in-hospital complications. Safety assessment will include the physical examination, laboratory detection, any adverse events or serious adverse events, and the proportion of any complications during hospitalization. DISCUSSION: The results of this study will provide objective and scientific data with which to assess the efficacy and safety of a sequential treatment based on “integrating disease and symptom pattern” for patients with AIS.
Ziyi ZHOU , Can WAN , Yuanqi ZHAO , Xiangzhe LIU , Ying GAO , Hongwei AN , Lejun LI , Huili ZHANG , Xiaofei YU , Xinchun ZHANG , Huijuan WANG , Qing SHI , Chunhua WEI , Jie CHEN , Wenguo HUANG , Junbin CHEN , Ying GAO , Mingzhe HU , Yefeng CAI . Efficacy and safety of a sequential treatment with clearing heat and eliminating phlegm and tonifying Qi and activating blood circulation in treating acute ischemic stroke: study protocol for a randomized controlled trial[J]. Journal of Traditional Chinese Medicine, 2022 , 42(4) : 604 -610 . DOI: 10.19852/j.cnki.jtcm.20220617.003
| 1 | Wang WZ, Jiang B, Sun HX, et al. Prevalence, incidence, and mortality of stroke in China: results from a nationwide population-based survey of 480 687 adults. Circulation 2017; 135: 759-71. |
| 2 | Li ZX, Jiang Y, Li H, Xian Y, Wang YJ. China's response to the rising stroke burden. BMJ 2019; 364: 1897. |
| 3 | Jiang M, Lu C, Zhang C, et al. Syndrome differentiation in modern research of traditional Chinese medicine. J Ethnopharmacol 2012; 140: 634-42. |
| 4 | Yang W, Li MQ, Li Y, et al. Exploring Chinese medicine and Western Medicine group modules in acute phase of ischemic stroke disease. Zhong Guo Zhong Yao Za Zhi 2018; 43: 618-26. |
| 5 | Yeh ML, Chiu WL, Wang YJ, Lo C. An investigation of the use of Traditional Chinese Medicine and complementary and alternative medicine in stroke patients. Holist Nurs Pract 2017; 31: 400-7. |
| 6 | Han XX, Gao YH, Ma B, et al. The clinical relevance of serum NDKA, NMDA, PARK7, and UFDP levels with phlegm-heat syndrome and treatment efficacy evaluation of Traditional Chinese Medicine in acute ischemic stroke. Evid Based Complement Alternat Med 2015; 2015: 270498. |
| 7 | Xin XY, Chang JL, Cao KG, Gao Y, Li S. Investigation on the relationship between each period of syndrome characteristics and short-term prognosis in early ischemic stroke based on decision tree analysis. Zhong Hua Zhong Yi Yao Za Zhi 2014; 29: 2647-50. |
| 8 | Xin XY, Chang JL, Gao Y. Use of generalized rule induction to study the evolution rules of syndrome of acute ischemic stroke. Zhong Hua Zhong Yi Yao Za Zhi 2016; 31: 3985-8. |
| 9 | Chen P, Zhang Y, Ling LL, et al. Efficacy and safety of Xinglouchengqi decoction for acute ischemic stroke with constipation: study protocol for a randomized controlled trial. J Tradit Chin Med 2017; 37: 810-8. |
| 10 | Wang YY, Xie YZ. Origin and development of therapy of resolving phlegm and relaxing bowels for treating syndrome of phlegm heat and bowel excess of stroke (III): spring-up features of syndrome of phlegm heat and bowel excess of stroke under imagery therapeutic mode. Beijing Zhong Yi Yao Da Xue Xue Bao 2013; 20: 1-4. |
| 11 | Xie YZ, Ren JT, Wang ZY, Wang YY. Influence of therapy of resolving phlegm and relaxing bowels on consciousness in patients with stroke. Beijing Zhong Yi Yao Da Xue Xue Bao 2009; 16: 17-9. |
| 12 | Cheng YS, Wang PL, Zhao YC. Clinical effect of retention enema with Jiaweixinglouchengqi decoction for acute ischemic stroke sthenia. Zhong Guo Zhong Yi Ji Zheng 2014; 23: 444-64. |
| 13 | Yang XY, Zhang GM. Curative effect of Xinglouchengqi decoction on ischemic stroke. Beijing Zhong Yi Yao Da Xue Xue Bao 2009; 16: 14-6. |
| 14 | Gao Q, Zhang DD, Wang YH. Preliminary study on the theory of Qi deficiency and blood stasis syndrome during the recovery period of stroke. Zhong Guo Zhong Xi Yi Jie He Xin Nao Xue Guan Bing Za Zhi 2019; 17: 1106-7. |
| 15 | Cheng SC, Lin CH, Chang YJ, et al. Fire-heat and Qi deficiency syndromes as predictors of short-term prognosis of acute ischemic stroke. J Altern Complement Med 2013; 19: 721-8. |
| 16 | Li NF, Chen YB, Liu QH, Zou L, Huang XW. Research development on the treatment of ischemic stroke with supplementing Qi and activating blood circulation. Shi Jie Zhong Xi Yi Jie He Za Zhi 2020; 15: 974-80. |
| 17 | Cheng CW, Wu TX, Shang HC, et al. CONSORT extension for Chinese herbal medicine formulas 2017: recommendations, explanation, and elaboration. Ann Intern Med 2017; 167: 112-21. |
| 18 | Peng B, Liu M, Cui LY. Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018. Zhong Hua Shen Jing Ke Za Zhi 2018; 51: 666-82. |
| 19 | Gao Y, Ma B, Liu Q, Wang YY. Methodological study and establishment of the diagnostic scale for TCM syndromes of ischemic stroke. J Tradit Chin Med 2011; 52: 2097-101. |
| 20 | Meyer BC, Lyden PD. The modified National Institutes of Health Stroke Scale: its time has come. Int J Stroke 2009; 4: 267-73. |
| 21 | Ghabaee M, Zandieh A, Mohebbi S, et al. Predictive ability of C-reactive protein for early mortality after ischemic stroke: com-parison with NIHSS score. Acta Neurol Belg 2014; 114: 41-5. |
| 22 | Weisscher N, Vermeulen M, Roos YB, et al. What should be defined as good outcome in stroke trials;a modified Rankin score of 0-1 or 0-2? J Neurol 2008; 255: 867-74. |
| 23 | Quinn TJ, Dawson J, Walters MR, et al. Exploring the reliability of the modified rankin scale. Stroke 2009; 40: 762-6. |
| 24 | Cabañero-Martínez MJ, Cabrero-García J, Richart-Martínez M, et al. The Spanish versions of the Barthel index (BI) and the Katz index (KI) of activities of daily living (ADL): a structured review. Arch Gerontol Geriatr 2009; 49: e77-84. |
| 25 | Zhao L, Chen JQ. Patient-reported outcomes (PROs): an approach to evaluate treatment efficacy of Chinese medicine or integrative medicine. Chin J Integr Med 2005; 11: 151-3. |
| 26 | Santoro E, Tinazzi A. Clinical trials data management. Atlanta: American Cancer Society, 2010: 101-6. |
| 27 | Bruland P, Breil B, Fritz F, Dugas M. Interoperability in clinical research: from metadata registries to semantically annotated CDISC ODM. Stud Health Technol Inform 2012; 180: 8. |
/
| 〈 |
|
〉 |