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The purpose of this study is to test the onset of action, offset of action, efficacy, and safety of pinaverium and an herbal medication for irritable bowel syndrome (IBS) for a long term (over one year). Pinaverium has been in many countries, but there is no randomized, double-blind, large sample size, and placebo-controlled study on this medication yet. Tong Xie Yao Fang (Formula for pain and diarrhea) is a historically and contemporarily used traditional Chinese medicine that can be used for IBS. The hypothesis is that the two remedies are effective and safe for IBS treatment with no significant different onset and offset of actions when tested by modern clinical standards and criteria.
Pinaverium bromide (pinaverium), an antispasmodics, is one of the most commonly used IBS medication worldwide. However, original clinical studies on pinaverium are scarce. Only five original clinical studies from Europe, one from Latin America, and one from Asian were found. These studies were single-centered and small sample sized (19 - 53 IBS patients) studies.
Tong Xie Yao Fang has long been used in China. Its efficacy and safety has not been evaluated by modern scientific method.
Effectiveness, onset and offset of actions are the most considered factors when physicians choose medications for IBS. Yet, to our knowledge, there are no clinical studies studied the onset and offset of actions of pinaverium, which remains one of the most transcribed IBS medications, and herbs, which are becoming more popular for treating IBS.
This study is designed to evaluate onset and offset of actions, efficacy, and safety over a long term (>1 year) of pinaverium and Tong Xie Yao Fang for IBS treatment in a double-blind, randomized, and large sample size clinical trial using placebo as a control.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TCM (Traditional Chinese medicine) | Active Comparator | Formula for pain and diarrhea, Atractylodes (~10-15g), Paeonia Lactiflora (~15-30g), Tangerine Peel (~10g), Ledebouriella Root (~10g), Radix codonopsitis (~10-15g), Radix curcumae (~10g), Fingered citron (~10g), Tuckahoe (~15g), etc. |
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| Pinaverium | Active Comparator |
| |
| Placebo | Placebo Comparator | Placebo is blindly given to patients |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pinaverium | Drug | To test the effectiveness and safety of the formula for pain and diarrhea, we will randomly assign patients into one 3 groups: Pinaverium, TCM (Formula for pain and diarrhea) group, and placebo group, and treat them accordingly. |
| Measure | Description | Time Frame |
|---|---|---|
| Abdominal pain | 0 = no pain, 10 worst pain | 2 years |
| Primary endpoint --- vi) Form (appearance) of stool | Use Bristol stool scale. | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| Frequency of the pain | 0 = no pain; 1 = 1 pain/day; 2 = 2 pains/day; 3 = 3 pains/day; ................... 9 = 9 pains/day; 10 = ≥ 10 pains/day. | 2 year |
| # of stools per day | 0 = no stool; 1 = 1 stool/day; 2 = 2 stools/day; 3 = 3 stools/day; ............... 9 = 9 stools/day; 10 = ≥ 10 stools/day. |
| Measure | Description | Time Frame |
|---|---|---|
| IBS global symptom relief | IBS global symptom relief was evaluated by each patient at the end of the therapy as "improved", "stayed the same", or "worsened" | 2 years |
| Treatment-emergent adverse effect (TEAE) profiles. |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Baiwen Li, MD | Department of Gastroenterology, Shanghai First People's Hospital, Shanghai Jiao Tong University, 100 Haining Rd. Hongkou, Shanghai 200280, China. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Second Jiangsu Provincial Hospital of Traditional Chinese Medicine affiliated to Nanjing University of Traditional Chinese Medicine | Nanjing | Jiangsu | 210017 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34230526 | Derived | Zheng L, Lu W, Xiao Q, Lai Y, Fan H, Sun Y, Huang D, Wang Y, Li Z, Jiang Z, Liu X, Zhang L, Zuo D, Shou Z, Tang Q, Huang H, Yang Y, Tang Z, Xiao J. Assessing the post-treatment therapeutic effect of pinaverium in irritable bowel syndrome: a randomized controlled trial. Sci Rep. 2021 Jul 6;11(1):13894. doi: 10.1038/s41598-021-92990-7. |
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| Atractylodes | Device | Atractylodes (~10-15g) |
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| Paeonia Lactiflora | Device | Paeonia Lactiflora (~15-30g) |
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| Tangerine Peel | Device | Tangerine Peel (~10g) |
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| Ledebouriella Root | Drug | Ledebouriella Root (~10g) |
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| Radix codonopsitis | Drug | Radix codonopsitis (~10-15g) |
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| Radix curcumae | Drug | Radix curcumae (~10g) |
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| Fingered citron | Drug | Fingered citron (~10g) |
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| Tuckahoe | Drug | Tuckahoe (15g) |
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| Placebo | Drug | Placebo is blindly given to patients. |
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| 2 years |
| Abdominal discomfort | 0 = no discomfort...... 10 = Worst possible, unbearable unbearable discomfort | 2 years |
| Frequency of discomfort | 0 = no discomfort; 1 = 1 discomfort/day; 2 = 2 discomforts/day; 3 = 3 discomforts /day; ................... 9 = 9 discomforts/day; 10 = ≥ 10 discomforts/day. | 2 years |
| 2 years |
| Jiangsu Provincial Hospital of Traditional Chinese Medicine affiliated to Nanjing University of Traditional Chinese Medicine | Nanjing | Jiangsu | 210029 | China |
| Beijing Xuanwu Hospital of Traditional Chinese Medicine affiliated to Capital Medical University. | Beijing | 100050 | China |
| Shanghai First People's Hospital affiliated to Shanghai Tiao Tong University | Shanghai | 200240 | China |
| ID | Term |
|---|---|
| D043183 | Irritable Bowel Syndrome |
| D003967 | Diarrhea |
| ID | Term |
|---|---|
| D003109 | Colonic Diseases, Functional |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D012817 | Signs and Symptoms, Digestive |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| C013199 | pinaverium |
| C585952 | diterpenoid C, Radix curcumae |
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