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Gastric CancerNCT03025152

Efficacy and Safety of Hou Gu Mi Xi in Patients With Spleen Qi Deficiency and Radical Gastrectomy for Gastric Cancer

A study testing Hou Gu Mi Xi in people with Gastric Cancer and Gastrointestinal Disease, run by Jiangxi University of Traditional Chinese Medicine at 1 site in China.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This trial aims to determine whether Hou Gu Mi Xi is an effective treatment for improving symptoms and indicators in patients with spleen qi deficiency and radical gastrectomy for gastric cancer. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Gastric Cancer, Gastrointestinal Disease
What is being tested?
Hou Gu Mi Xi
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
130 participants
Where
1 siteChina
Study dates
11 Nov 2016to 20 Jul 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patient should be diagnosed as gastric cancer by pathology and have received radical gastrectomy. They should finish the following radiotherapy and chemotherapy and the treatment for surgical complications (such as leak, stricture, and marginal ulcer).
  • Patient should be constitution of spleen qi deficiency, that is, meet two primary symptoms of spleen deficiency + two primary symptoms of qi deficiency, or meet two primary symptoms of spleen deficiency + one primary symptoms of qi deficiency + one auxiliary symptoms, or meet one primary symptoms of spleen deficiency + one primary symptoms of qi deficiency + two secondary symptoms + one auxiliary symptoms as follow:
  • Main symptoms of spleen deficiency: a) poor appetite; b) abnormal stool (loose, diarrhea); c) abdominal distention after meal or afternoon
  • Main symptoms of qi deficiency: a) fatigue; b) tired mind and taciturnity
  • Secondary symptoms: a) tastelessness, hypodipsia, like hot drink, polysialia; b) abdominal pain, as a result either patients like warm or press, or remit after meal, or occur when work; c) nausea and vomiting; d) fullness in stomach; e) abnormal bowel sounds; f) lean or puffiness; g) sallow complexion; h) powerless defecation weakness; i) edema
  • Auxiliary symptoms: pale or swollen or teeth-printed tongue with thin and white fur
Show all 9Show fewer
  • Age ranges from 18 to 70 years; both male and female
  • Patient should be in fair performance status, indicated by a score of Eastern Cooperative Oncology Group (ECOG) Performance Status ≤ 1
  • Sign the informed consent

Who cannot join

  • Stage IV gastric cancer according to the Japanese classification criteria [16]
  • Impaired liver function (total bilirubin > 2 × upper limit of normal (ULN), alanine transaminase > 2 × ULN, or aspartate aminotransferase > 2 × ULN), kidney function (serum creatinine > 2 × ULN), or hematopoiesis (neutrophil counts < 0.5×109/L or, thrombocyte counts < 20×109/L or, absolute reticulocyte counts < 15×109/L)
  • Obviously abnormal electrocardiogram
  • Severe mental disorders
  • Other severe diseases (e.g. multiple organ failure, HIV infection)
  • Pregnant or breast-feeding women
  • Allergic to the test sample
  • Unwilling to provider personal information and sign the informed consent

Trial locations and contacts

1 site in 1 country.

China1 site
  • Jiangxi University of Traditional Chinese Medicine

    Nanchang, Jiangxi, 330004

Other trials in China

About this study

Official title: Efficacy and Safety of Hou Gu Mi Xi in Patients With Spleen Qi Deficiency and Radical Gastrectomy for Gastric Cancer: A Multicenter, Randomized, Double-blinded, Parallel-group, Placebo-controlled Trial

This trial aims to determine whether Hou Gu Mi Xi is an effective treatment for improving symptoms and indicators in patients with spleen qi deficiency and radical gastrectomy for gastric cancer.

Read the detailed description

The incidence of gastric cancer ranks high in many countries around the world. Although along with the development of economy and medical condition the incidence of gastric cancer appears a trend of decrease in developed countries, it is still one of most common cancers in Asia. There are more new gastric cancer cases in China compared with other countries every year. According to an epidemiological survey by World Health Organization, 5-year prevalence of gastric cancer was 53.7/10,000 in China - it is only lower than Japan. For the early gastric cancer, radical gastrectomy, is the most important treatment, which could significantly prolong disease-free survival and overall survival. However, the severe damage of surgery and following radiation and chemotherapy in intestinal tract usually leads patients to be a constitution of spleen qi deficiency, a concept of traditional Chinese medicine (TCM) that mainly involves digestive symptoms, such as poor appetite, abnormal stool (loose, diarrhea) and abdominal distention. Therefore, how to resolve and protect the function of intestinal tract, and change the constitution of spleen qi deficiency postoperatively is important for improving quality of life and reducing the recurrence rate of cancer.

Shen Ling Bai Zhu San, a classic Chinese medicinal formulae originally described in Tai Ping Hui Min He Ji Ju Fang in the Song Dynasty (1102 AD), is composed of ginseng, tuckahoe, atractylodes, baked licorice, coixenolide, Chinese yam, lotus seed, shrinkage fructus amomi, platycodon grandiflorum, white hyacinth bean, and dried orange peel. It has effects of replenishing qi and invigorating spleen (spleen is a TCM conception that differs from western medicine), as well as penetrating wet and antidiarrheal. It is mainly used for treating the syndrome of spleen qi deficiency, including dyspepsia, chest and stomach distress, borborygmus and diarrhea, limb weakness, thin body, sallow complexion, pale tongue with white and greasy coating, and weak and slow pulse, etc. In the theory of TCM, spleen is the source for producing qi and blood and thus is the root of life. Shen Ling Bai Zhu San could invigorate spleen by supplying spleen and remove wet, and finally nourish the stomach and intestine. Previous pharmacologic studies also revealed that Shen Ling Bai Zhu San could adjust function of anaerobic and aerobic bacteria in gastrointestinal tract; specifically, it could improve the proliferation of probiotics (such as bifidobacterium) and inhibit the main resistance strains (such as enterococcus) and thus has an effect to improve gastrointestinal symptoms.

According to the experience of TCM, the constitution of patients who are undergoing radiation and chemotherapy is usually yin deficiency, but changes to spleen qi deficiency due to digestive disorders after those treatment. Therefore, Shen Ling Bai Zhu San is expected to improve symptoms in patients who underwent gastrectomy and following radiation and chemotherapy.

Hou Gu Mi Xi is a dietary therapy form of Shen Ling Bai Zhu San, which removes atractylodes and platycodon grandiflorum (two herbs that could not be used as food) from Shen Ling Bai Zhu San, and adds perilla leaf for adapting a dietary therapy for a long-term use. Hou Gu Mi Xi uses the main formula of Shen Ling Bai Zhu San, so that it could theoretically maintain the treatment effects. Although the reliable health effects of Shen Ling Bai Zhu San has been proved in previous studies, Hou Gu Mi Xi is optimized in formula and its preparations changed from electuary to rice paste, so that its functional mechanism and efficacy may be different. Therefore, the investigators plan to perform a hospital-based randomized controlled trial, enroll patients from three hospitals in Nanchang City of Jiangxi Province in China, for assessing efficacy and safety of Hou Gu Mi Xi on digestive symptoms in patients with spleen qi deficiency and radical gastrectomy for gastric cancer.

Being tested
Hou Gu Mi Xi, placebo
Keywords
Hou Gu Mi Xi, Shen Ling Bai Zhu San, radical gastrectomy, gastric cancer, traditional Chinese medicine, randomized controlled trial
Medical subject headings
Stomach Neoplasms, Gastrointestinal Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Hou Gu Mi XiDietary supplement

    Hou Gu Mi Xi is a dietary therapy form of Shen Ling Bai Zhu San, which removes atractylodes and platycodon grandiflorum, adds perilla leaf for adapting a dietary therapy.

  • placeboOther

    The placebo has same appearance, taste and smell as Hou Gu Mi Xi.

Study groups in NCT03025152
Study groupRoleWhat they receive
Hou Gu Mi XiExperimentalPatients in this arm receive Hou Gu Mi Xi, with an oral dose of 10 g/day during entire follow up period (2 years).
Receives: Dietary Supplement: Hou Gu Mi Xi
placeboPlacebo comparatorPatients in this arm receive placebo, with an oral dose of 10 g/day during entire follow up period (2 years).
Receives: Other: placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Changes from baseline in total scores of Spleen Qi Deficiency Symptoms Grading and Quantifying Scale (Units on a scale)

    Higher score indicates severer symptoms of Spleen Qi Deficiency. Units of measure (Units on a scale)

    Measured: At baseline and 2, 4, 8, 26, 52, 78 and 104 weeks

Secondary outcomes (14)
  1. Qualitative assessment of changes in total scores of SQD scale from baseline

    1. completely remission: reduction in scores is ≥ 95% compared with baseline; 2) markedly effective: reduction in scores is 70% to 94% compared with baseline; 3) effective: reduction in scores is 30% to 69% compared with baseline; 4) not effective: reduction in scores is < 30% compared with baseline

    Measured: At baseline and 2, 4, 8, 26, 52, 78 and 104 weeks

  2. Changes in scores of each item of SQD scale from baseline

    1. Stomach distension*, 2) Abdominal distension*, 3) Fatigue and weakness*, 4) Tired mind and taciturnity*, 5) Inappetence*, 6) Stomach pain, 7) Stomach tightness, 8) Abdominal pain, 9) Acid reflux, 10) Belching, 11) Nausea and vomiting, 12) Abnormal stools, 13) Abnormal bowel sounds, 14) Powerless defecation, 15) Sallow complexion, 16) Tastelessness and hypodipsia, and 17) Face and limbs edema.

    Measured: At baseline and 2, 4, 8, 26, 52, 78 and 104 weeks

  3. Changes from baseline in total scores of Short Form 36 (SF-36) (Units on a scale)

    To assess quality of life

    Measured: At baseline and 2, 4, 8, 26, 52, 78 and 104 weeks

  4. Changes from baseline in scores of subitems in Short Form 36 (SF-36) (Units on a scale)

    Physical Component Summary (PCS) and Mental Component Summary (MCS)

    Measured: At baseline and 2, 4, 8, 26, 52, 78 and 104 weeks

  5. Changes from baseline in scores of Eastern Cooperative Oncology Group (ECOG) Performance Status (Units on a scale)

    To assess performance status

    Measured: At baseline and 2, 4, 8, 26, 52, 78 and 104 weeks

  6. Progression free survival (month)

    assessed by evidence of pathological examination, computed tomography and/or magnetic resonance imaging

    Measured: From the first dose of intervention up to 104 weeks

  7. Changes from baseline in systolic blood pressure (mmHg)

    To determine whether the interventions improve systolic blood pressure

    Measured: At baseline and 2, 4, 8, 26, 52, 78 and 104 weeks

  8. Changes from baseline in diastolic blood pressure (mmHg)

    To determine whether the interventions improve diastolic blood pressure

    Measured: At baseline and 2, 4, 8, 26, 52, 78 and 104 weeks

  9. Changes from baseline in body weight (kg)

    To determine whether the interventions improve body weight

    Measured: At baseline and 2, 4, 8, 26, 52, 78 and 104 weeks

  10. Changes from baseline in body mass index (kg/m2)

    To determine whether the interventions improve body mass index

    Measured: At baseline and 2, 4, 8, 26, 52, 78 and 104 weeks

  11. Incidence of any adverse events

    abnormal results (indicated by more or less than 2 × normal reference interval) in the routine blood, urine, and stool tests, liver function tests (alanine transaminase [ALT], aspartate aminotransferase [AST], total bilirubin [TBIL], direct bilirubin [DBIL], indirect bilirubin [IBIL]), kidney function tests (serum creatinine [SCr] and urea nitrogen [BUN]), coagulation function (prothrombin time [PT], activated partial thromboplastin time [APTT], thrombin time [TT], fibrinogen [FIB]), and electrocardiogram as well as any other new-onset symptoms or diseases related or unrelated to the intervention

    Measured: From the first dose of intervention up to 104 weeks

  12. Incidence of severe adverse events

    AEs that lead to new or prolonged hospitalization, disability, admission to intensive care unit, life danger, and death

    Measured: From the first dose of intervention up to 104 weeks

  13. Incidence of drug-related adverse events

    This outcome is assessed by blinded clinicians in each research center

    Measured: From the first dose of intervention up to 104 weeks

  14. Incidence of withdrawn due to adverse events

    Measured: From the first dose of intervention up to 104 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Jan 2017 (estimated)
  2. Study start11 Nov 2016
  3. Primary completion20 Jul 2019
  4. Study completion20 Jul 2019

Why it stopped: High attrition rate up to 37.7% at one year's follow-up

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
130 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03025152
Sponsor's protocol ID
JXUTCM-EBM-02
Status last verified
Apr 2021
First submitted
17 Jan 2017
Last updated
26 Apr 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: The investigators do not plan to share individual participant data.

Publications

  • Oh SY, Lee HJ, Yang HK. Pylorus-Preserving Gastrectomy for Gastric Cancer. J Gastric Cancer. 2016 Jun;16(2):63-71. doi: 10.5230/jgc.2016.16.2.63. Epub 2016 Jun 24.

    PubMed 27433390
  • Yang L. Incidence and mortality of gastric cancer in China. World J Gastroenterol. 2006 Jan 7;12(1):17-20. doi: 10.3748/wjg.v12.i1.17.

    PubMed 16440411
  • Wu TH, Chen IC, Chen LC. Antacid effects of Chinese herbal prescriptions assessed by a modified artificial stomach model. World J Gastroenterol. 2010 Sep 21;16(35):4455-9. doi: 10.3748/wjg.v16.i35.4455.

    PubMed 20845514
  • Yin GY, Chen Y, Shen XJ, He XF, Zhang WN. Study on the pathophysiologic basis of classification of 'spleen' deficiency in chronic gastritis. Chin Med J (Engl). 2005 Mar 20;118(6):468-73.

    PubMed 15788127
  • Yin GY, Zhang WN, Shen XJ, He XF, Chen Y. Study on the pathological basis of classification of spleen deficiency in chronic gastritis. Chin Med J (Engl). 2004 Aug;117(8):1246-52.

    PubMed 15361303
  • Zhou X, Yan DM, Zhu WF, Liu WJ, Nie HY, Xu S, Jiang YP, Zhang KH, Fu Y, Wan YY, Yu XY, Li H, Sun X, Chen XF. Efficacy and safety of Hou Gu Mi Xi in patients with spleen qi deficiency syndrome who underwent radical gastrectomy for gastric cancer: protocol for a multicenter, randomized, double-blind, placebo-controlled trial. Trials. 2019 Jun 10;20(1):343. doi: 10.1186/s13063-019-3429-x.

    PubMed 31182140

Questions about this trial

What is this clinical trial studying?

A study testing Hou Gu Mi Xi in people with Gastric Cancer and Gastrointestinal Disease, run by Jiangxi University of Traditional Chinese Medicine at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 9 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 26 Apr 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study was stopped early (reason given: High attrition rate up to 37.7% at one year's follow-up). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes from baseline in total scores of Spleen Qi Deficiency Symptoms Grading and Quantifying Scale (Units on a scale) (time frame: At baseline and 2, 4, 8, 26, 52, 78 and 104 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03025152, which also lists 6 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Apr 2021.

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