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Effectiveness and Clinical Mechanism of Huanglian-Jiedu Decoction in Patients With Intense-exuberant Stomach Fire Syndrome

Primary Purpose

Intense-exuberant Stomach Fire Syndrom, Acute Pericoronitis, Recurrent Aphthous Stomatitis

Status
Unknown status
Phase
Phase 1
Locations
China
Study Type
Interventional
Intervention
Huanglian-Jiedu Decoction
Sponsored by
China Academy of Chinese Medical Sciences
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Intense-exuberant Stomach Fire Syndrom

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • General inclusion criteria:

    1. Female or male patients.
    2. Age: 18 - 60 years.
    3. Meeting the diagnostic criteria of Intense-Exuberant Stomach Fire Syndrome according to the traditional Chinese medicine.
    4. Patient is willing to participate voluntarily and to sign a written patient informed consent.
  • Disease-specific inclusion criteria for patients with acute pericoronitis:

    1. Patients with clinical diagnosis of acute pericoronitis and without treatment before the study began.

  • Disease-specific inclusion criteria for patients with minor recurrent aphthous stomatitis:

    1. Patients with clinical diagnosis of minor recurrent aphthous stomatitis(MiRAS).
    2. A history of MiRAS for more than 6 months and an expectation that the ulcers normally take 5 or more days to resolve without treatment.
    3. Ulcer occurred less than 48h hours' duration without treatment.
  • Disease-specific inclusion criteria for recurrent herpes simplex labialis

    1. Patients with clinical diagnosis of recurrent herpes simplex labialis.
    2. History of recurrent herpes labialis averaging 1 or more episodes per year.
    3. Onset of prodrome, erythema or vesicle within 48 hours without treatment.

Exclusion Criteria:

  • General exclusion criteria:

    1. Patients with severe cardiac dysfunction on the grade of heart function over Ⅲ grade and/or liver function impairment with the value of ALT over 1.5-fold of normal value and/or renal dysfunction with the value over 133μmol/L.
    2. Patients who have serious, unstable, or clinically significant medical or psychological conditions, which, in the opinion of the investigator(s), would compromise the subject's participation in the study (including but not limited to arrhythmia, uncontrolled hypertension, diabetes, hepatitis, kidney failure, AIDS, cancer, etc.
    3. Women during pregnancy, lactation , breastfeeding or having child bearing potential without use an adequate method of birth control.
    4. Patients who known allergy to the study drug or the Huanglian (Rhizoma Coptidis), Huangbo (Cortex Phellodendri), Huangqin (Scutellaria baicalensis) and Zhizi (Scutellaria baicalensis ( Patients who are insufficiency of the spleen-yang according to the TCM should be exclude ).
    5. Patients participating in or having participated in other clinical studies in the 3 months prior to this clinical trial.
    6. Patients who are considered unreliable as to medication compliance or adherence to scheduled appointments.
  • Disease-specific exclusion criteria for acute pericoronitis:

    1. Patients who smoked at least 20 cigarettes per day(heavy smokers).
    2. Patients with fascial space infection of maxillofacial region or/and chronic periodontitis.
    3. Patients with periodontal disease in the region of the acute pericoronitis.
    4. Patients who had systemic administration of antibiotics within the past 4 weeks
  • Disease-specific exclusion criteria for minor recurrent aphthous stomatitis(MiRAS):

    1. Patients with history of drug abuse within the past 6 months.
    2. Patients who smoked at least 20 cigarettes per day(heavy smokers).
    3. Patients with ulcers as a manifestation of a systemic disease process such as ulcerative colitis, Behcet's syndrome, Reiter' s syndrome or immune deficiency.
    4. Patients who had systemic administration of antibiotics within the past 4 weeks or/ and had treatment with systemic steroid or immunomodulatory within 3 month before the study entry.
    5. Patients who had orthodontic braces or retainer that might contact with the ulcer.
  • Disease-specific exclusion criteria for recurrent herpes simplex labialis:

    1. Patients with fever > 38.5℃, and / or blood WBC>11.0x109/L, and / or neutrophil >85%.
    2. Patients who had systemic administration of antibiotics within the past 4 weeks or/ and had treatment with immunomodulatory within 3 month before the study entry.

Sites / Locations

  • Third affiliated hospital of Beijing University of traditional Chinese medicineRecruiting
  • Dongfang Hospital Affiliated to Beijing University of traditional Chinese medicineRecruiting
  • Affiliated Hospital to Chengdu University of traditional Chinese medicineRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Huanglian-Jiedu Decoction in acute pericoronitis

Huanglian-Jiedu Decoction in recurrent aphthous stomatitis

Huanglian-Jiedu Decoction in recurrent herpes simplex labialis

Arm Description

All eligible patients entering this group will receive Huanglian-Jiedu Decoction(prepared as granule). 1 bag per time and twice a day for 5 days.

All eligible patients entering this group will receive Huanglian-Jiedu Decoction(prepared as granule). 1 bag per time and twice a day for 5 days.

All eligible patients entering this group will receive Huanglian-Jiedu Decoction(prepared as granule). 1 bag per time and twice a day for 5 days.

Outcomes

Primary Outcome Measures

Change from baseline in the Intense-Exuberant Stomach Fire Syndrome scores
Intense-Exuberant Stomach Fire Syndrome scores were questionnaires that consists of basic symptoms and disease-specific symptoms that described in traditional Chinese medicine. The basic symptoms included feverish sensation, thirst that preferring cold drink, bad breath, flushed face, bound stool, scanty yellowish urine, red tongue with dry and yellowish fur, and the forceful or rapid pulse. The disease-specific symptoms included tooth or/and gums for acute pericoronitis, ulcer for recurrent aphthous stomatitis and herpes for recurrent herpes simplex labialis. Each symptom was assessed by the Visual Analogue Scale(VAS),where a higher score meant higher severity.

Secondary Outcome Measures

Change from baseline of each symptom in Intense-Exuberant Stomach Fire Syndrome scores
The proportion of patients whose Intense-Exuberant Stomach Fire Syndrome were disappeared
The definition of "disappeared" is the scores of all the symptoms in Intense-Exuberant Stomach Fire Syndrome were 0 or the reduction in rate of Intense-Exuberant Stomach Fire Syndrome scores more than 90%
The proportion of patients who gain 50% reduction of Intense-Exuberant Stomach Fire Syndrome scores
Reduction in rate of Intense-Exuberant Stomach Fire Syndrome scores =(The score of Intense-Exuberant Stomach Fire Syndrome before treatment - the score of Intense-Exuberant Stomach Fire Syndrome after treatment)/ The score of Intense-Exuberant Stomach Fire Syndrome before treatment×100%.
Change from baseline on toothache based on visual analogue scale(VAS)for acute pericoronitis
Patients were asked to record the VAS each morning for 5 consecutive days prior to taking their medication.
Change from baseline on maximum mouth opening (MMO) for acute pericoronitis
To measure the amount of MMO, the inter-incisal distance between maxillary and mandibular right central incisors was recorded using a caliper.
Number of patients with trismu for acute pericoronitis
Patients were recorded to have trismus if the MMO was less than 40 mm.
Change from baseline on OHIP-14 measures for acute pericoronitis
Using the OHIP measures, the patients were asked to rate the impact of their oral health on 14 key areas of OHRQoL: "What effects do your teeth, gums, and/or mouth have on each of the 14 key areas of life quality (i.e., your comfort, your speech)?" These 14 items were subdivided into seven domains (subscales): functional limitation, physical discomfort, psychological discomfort, physical disability, psychological disability, social disability, and handicap. For the OHIP-14, the response categories were recorded on a five-point Likert scale: 0, never; 1, hardly ever; 2, occasionally; 3, fairly often; 4, very often. Higher scores in the OHIP-14 questionnaire indicated a poorer OHQoL.
Change from baseline of VAS on the pain of ulcer for minor recurrent aphthous stomatitis
Patients were asked to record the VAS each morning for 5 consecutive days prior to taking their medication.
The proportion of patients with ulcer healing for minor recurrent aphthous stomatitis
The sizes of ulcer for minor recurrent aphthous stomatitis
The investigators chose one of the largest ulcer and measured the maximum diameters and its vertical using a calibrated dental probe with millimeter markings. The two measurements were then multiplied to represent the size of the ulcer.
The number of days that the lesion was present (until loss of crust)for recurrent herpes simplex labialis
The proportion of patients with lesion healing for recurrent herpes simplex labialis
Change from baseline of VAS on the pain of lesions for recurrent herpes simplex labialis
Patients were asked to record the VAS each morning for 5 consecutive days prior to taking their medication.

Full Information

First Posted
February 28, 2018
Last Updated
April 8, 2018
Sponsor
China Academy of Chinese Medical Sciences
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1. Study Identification

Unique Protocol Identification Number
NCT03469232
Brief Title
Effectiveness and Clinical Mechanism of Huanglian-Jiedu Decoction in Patients With Intense-exuberant Stomach Fire Syndrome
Official Title
Effectiveness and Clinical Mechanism of Huanglian-Jiedu Decoction in Patients With Intense-exuberant Stomach Fire Syndrome (Acute Pericoronitis, Minor Recurrent Aphthous Stomatitis and Recurrent Herpes Simplex Labialis)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2018
Overall Recruitment Status
Unknown status
Study Start Date
April 4, 2018 (Actual)
Primary Completion Date
September 1, 2018 (Anticipated)
Study Completion Date
November 1, 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
China Academy of Chinese Medical Sciences

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This clinical research focus on evaluating the effectiveness of Huanglian-Jiedu Decoction in patients with intense-exuberant stomach fire syndrome (one of the common TCM syndrome)of acute pericoronitis,minor recurrent aphthous stomatitis and recurrent herpes simplex labialis,meanwhile, exploring the pharmacological mechanism and potential biomarkers of this traditional formula.
Detailed Description
Huanglian-Jiedu Decoction, as a traditional Chinese medicine formula,includes 4 kinds of Chinese herbs as following: Huanglian (Rhizoma Coptidis), Huangbo (Cortex Phellodendri), Huangqin (Scutellaria baicalensis) and Zhizi (Scutellaria baicalensis). Huanglian-Jiedu Decoction has been recorded to be effective in many diseases that belong to the syndrome of intense-exuberant stomach fire from thousands years of clinical practice, just like acute pericoronitis, minor recurrent aphthous stomatitis and recurrent herpes simplex labialis,etc. While its clinical pharmacological mechanism has not been clearly illustrated. In this study, the investigators focus on evaluating the effectiveness of Huanglian-Jiedu Decoction in patients with intense-exuberant stomach fire syndrome (including three disease: acute pericoronitis, minor recurrent aphthous stomatitis and recurrent herpes simplex labialis), and exploring the pharmacological mechanism and potential biomarkers of this traditional formula.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Intense-exuberant Stomach Fire Syndrom, Acute Pericoronitis, Recurrent Aphthous Stomatitis, Recurrent Herpes Simplex Labialis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
240 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Huanglian-Jiedu Decoction in acute pericoronitis
Arm Type
Experimental
Arm Description
All eligible patients entering this group will receive Huanglian-Jiedu Decoction(prepared as granule). 1 bag per time and twice a day for 5 days.
Arm Title
Huanglian-Jiedu Decoction in recurrent aphthous stomatitis
Arm Type
Experimental
Arm Description
All eligible patients entering this group will receive Huanglian-Jiedu Decoction(prepared as granule). 1 bag per time and twice a day for 5 days.
Arm Title
Huanglian-Jiedu Decoction in recurrent herpes simplex labialis
Arm Type
Experimental
Arm Description
All eligible patients entering this group will receive Huanglian-Jiedu Decoction(prepared as granule). 1 bag per time and twice a day for 5 days.
Intervention Type
Drug
Intervention Name(s)
Huanglian-Jiedu Decoction
Intervention Description
Huanglian-Jiedu Decoction includes 4 kinds of Chinese herbs as following: Huanglian (Rhizoma Coptidis), Huangbo (Cortex Phellodendri), Huangqin (Scutellaria baicalensis) and Zhizi (Scutellaria baicalensis). All of them were prepared as granule.
Primary Outcome Measure Information:
Title
Change from baseline in the Intense-Exuberant Stomach Fire Syndrome scores
Description
Intense-Exuberant Stomach Fire Syndrome scores were questionnaires that consists of basic symptoms and disease-specific symptoms that described in traditional Chinese medicine. The basic symptoms included feverish sensation, thirst that preferring cold drink, bad breath, flushed face, bound stool, scanty yellowish urine, red tongue with dry and yellowish fur, and the forceful or rapid pulse. The disease-specific symptoms included tooth or/and gums for acute pericoronitis, ulcer for recurrent aphthous stomatitis and herpes for recurrent herpes simplex labialis. Each symptom was assessed by the Visual Analogue Scale(VAS),where a higher score meant higher severity.
Time Frame
Day 0,Day 3,Day 5
Secondary Outcome Measure Information:
Title
Change from baseline of each symptom in Intense-Exuberant Stomach Fire Syndrome scores
Time Frame
Day 0,Day 3,Day 5
Title
The proportion of patients whose Intense-Exuberant Stomach Fire Syndrome were disappeared
Description
The definition of "disappeared" is the scores of all the symptoms in Intense-Exuberant Stomach Fire Syndrome were 0 or the reduction in rate of Intense-Exuberant Stomach Fire Syndrome scores more than 90%
Time Frame
Day 0,Day 5
Title
The proportion of patients who gain 50% reduction of Intense-Exuberant Stomach Fire Syndrome scores
Description
Reduction in rate of Intense-Exuberant Stomach Fire Syndrome scores =(The score of Intense-Exuberant Stomach Fire Syndrome before treatment - the score of Intense-Exuberant Stomach Fire Syndrome after treatment)/ The score of Intense-Exuberant Stomach Fire Syndrome before treatment×100%.
Time Frame
Day 0,Day 5
Title
Change from baseline on toothache based on visual analogue scale(VAS)for acute pericoronitis
Description
Patients were asked to record the VAS each morning for 5 consecutive days prior to taking their medication.
Time Frame
Day 0,Day 1,Day 2,Day 3,Day 4,Day 5
Title
Change from baseline on maximum mouth opening (MMO) for acute pericoronitis
Description
To measure the amount of MMO, the inter-incisal distance between maxillary and mandibular right central incisors was recorded using a caliper.
Time Frame
Day 0,Day 3,Day 5
Title
Number of patients with trismu for acute pericoronitis
Description
Patients were recorded to have trismus if the MMO was less than 40 mm.
Time Frame
Day 0,Day 3,Day 5
Title
Change from baseline on OHIP-14 measures for acute pericoronitis
Description
Using the OHIP measures, the patients were asked to rate the impact of their oral health on 14 key areas of OHRQoL: "What effects do your teeth, gums, and/or mouth have on each of the 14 key areas of life quality (i.e., your comfort, your speech)?" These 14 items were subdivided into seven domains (subscales): functional limitation, physical discomfort, psychological discomfort, physical disability, psychological disability, social disability, and handicap. For the OHIP-14, the response categories were recorded on a five-point Likert scale: 0, never; 1, hardly ever; 2, occasionally; 3, fairly often; 4, very often. Higher scores in the OHIP-14 questionnaire indicated a poorer OHQoL.
Time Frame
Day 0,Day 3,Day 5
Title
Change from baseline of VAS on the pain of ulcer for minor recurrent aphthous stomatitis
Description
Patients were asked to record the VAS each morning for 5 consecutive days prior to taking their medication.
Time Frame
Day 0,Day 1,Day 2,Day 3,Day 4,Day 5
Title
The proportion of patients with ulcer healing for minor recurrent aphthous stomatitis
Time Frame
Day 0,Day 3,Day 5
Title
The sizes of ulcer for minor recurrent aphthous stomatitis
Description
The investigators chose one of the largest ulcer and measured the maximum diameters and its vertical using a calibrated dental probe with millimeter markings. The two measurements were then multiplied to represent the size of the ulcer.
Time Frame
Day 0,Day 3,Day 5
Title
The number of days that the lesion was present (until loss of crust)for recurrent herpes simplex labialis
Time Frame
From the date of lesion or premonitory symptom present until the date of crust lose, which up to 28 days.
Title
The proportion of patients with lesion healing for recurrent herpes simplex labialis
Time Frame
Day 3,Day 5
Title
Change from baseline of VAS on the pain of lesions for recurrent herpes simplex labialis
Description
Patients were asked to record the VAS each morning for 5 consecutive days prior to taking their medication.
Time Frame
Day 0,Day 1,Day 2,Day 3,Day 4,Day 5
Other Pre-specified Outcome Measures:
Title
High-sensitivity C-reactive protein(hs-CRP)
Time Frame
Day 0,Day 5
Title
Evaluation of inflammatory cytokines
Description
The evaluation of inflammatory cytokines include IL-1α, IL-1β, IL-4, IL-6, IL-8, IL-10, IL-13, MIP-2, MCP-1, IFNγand TNF-α
Time Frame
Day 0,Day 5
Title
Activity of sirtuins (SIRTs)
Description
Detection by qRT-PCR
Time Frame
Day 0,Day 5
Title
GSH/GSSG ratios in plasma
Time Frame
Day 0,Day 5
Title
Evaluation of oxidative stress parameters:SOD
Time Frame
Day 0,Day 5
Title
Evaluation of oxidative stress parameters:MDA
Time Frame
Day 0,Day 5
Title
Pyruvate Acid / Uric Acid ratios in plasma
Time Frame
Day 0,Day 5
Title
Mass Spectrometry analyses for urine sample
Description
Mass Spectrometry analyses for urine sample include hypoxanthine, 1.7 - diphosphate sedoheptose, -5- riboflavin phosphate, urobilin, D - Ribose, ubiquinone, urinary lactate / pyruvate urine
Time Frame
Day 0,Day 5
Title
Proteomic analyses for blood sample
Time Frame
Day 0,Day 5
Title
Proteomic analyses for urine sample
Time Frame
Day 0,Day 5

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: General inclusion criteria: Female or male patients. Age: 18 - 60 years. Meeting the diagnostic criteria of Intense-Exuberant Stomach Fire Syndrome according to the traditional Chinese medicine. Patient is willing to participate voluntarily and to sign a written patient informed consent. Disease-specific inclusion criteria for patients with acute pericoronitis: 1. Patients with clinical diagnosis of acute pericoronitis and without treatment before the study began. Disease-specific inclusion criteria for patients with minor recurrent aphthous stomatitis: Patients with clinical diagnosis of minor recurrent aphthous stomatitis(MiRAS). A history of MiRAS for more than 6 months and an expectation that the ulcers normally take 5 or more days to resolve without treatment. Ulcer occurred less than 48h hours' duration without treatment. Disease-specific inclusion criteria for recurrent herpes simplex labialis Patients with clinical diagnosis of recurrent herpes simplex labialis. History of recurrent herpes labialis averaging 1 or more episodes per year. Onset of prodrome, erythema or vesicle within 48 hours without treatment. Exclusion Criteria: General exclusion criteria: Patients with severe cardiac dysfunction on the grade of heart function over Ⅲ grade and/or liver function impairment with the value of ALT over 1.5-fold of normal value and/or renal dysfunction with the value over 133μmol/L. Patients who have serious, unstable, or clinically significant medical or psychological conditions, which, in the opinion of the investigator(s), would compromise the subject's participation in the study (including but not limited to arrhythmia, uncontrolled hypertension, diabetes, hepatitis, kidney failure, AIDS, cancer, etc. Women during pregnancy, lactation , breastfeeding or having child bearing potential without use an adequate method of birth control. Patients who known allergy to the study drug or the Huanglian (Rhizoma Coptidis), Huangbo (Cortex Phellodendri), Huangqin (Scutellaria baicalensis) and Zhizi (Scutellaria baicalensis ( Patients who are insufficiency of the spleen-yang according to the TCM should be exclude ). Patients participating in or having participated in other clinical studies in the 3 months prior to this clinical trial. Patients who are considered unreliable as to medication compliance or adherence to scheduled appointments. Disease-specific exclusion criteria for acute pericoronitis: Patients who smoked at least 20 cigarettes per day(heavy smokers). Patients with fascial space infection of maxillofacial region or/and chronic periodontitis. Patients with periodontal disease in the region of the acute pericoronitis. Patients who had systemic administration of antibiotics within the past 4 weeks Disease-specific exclusion criteria for minor recurrent aphthous stomatitis(MiRAS): Patients with history of drug abuse within the past 6 months. Patients who smoked at least 20 cigarettes per day(heavy smokers). Patients with ulcers as a manifestation of a systemic disease process such as ulcerative colitis, Behcet's syndrome, Reiter' s syndrome or immune deficiency. Patients who had systemic administration of antibiotics within the past 4 weeks or/ and had treatment with systemic steroid or immunomodulatory within 3 month before the study entry. Patients who had orthodontic braces or retainer that might contact with the ulcer. Disease-specific exclusion criteria for recurrent herpes simplex labialis: Patients with fever > 38.5℃, and / or blood WBC>11.0x109/L, and / or neutrophil >85%. Patients who had systemic administration of antibiotics within the past 4 weeks or/ and had treatment with immunomodulatory within 3 month before the study entry.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yanan Yu, Ph.D
Phone
8610-64093140
Email
pumpkinnaicha@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Zhong Wang, Professor
Phone
8610-64093140
Email
zhonw@vip.sina.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Zhong Wang
Organizational Affiliation
Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences
Official's Role
Principal Investigator
Facility Information:
Facility Name
Third affiliated hospital of Beijing University of traditional Chinese medicine
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100029
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lu Qiang, Professor
Phone
8610-52075325
First Name & Middle Initial & Last Name & Degree
Lu Qiang, Professor
Facility Name
Dongfang Hospital Affiliated to Beijing University of traditional Chinese medicine
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100078
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hong Mu, Professor
Phone
010-67618333
First Name & Middle Initial & Last Name & Degree
Hong Mu, Professor
Facility Name
Affiliated Hospital to Chengdu University of traditional Chinese medicine
City
Chengdu
State/Province
Sichuan
ZIP/Postal Code
610075
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yuling Zuo, Professor
Phone
028-87769902
First Name & Middle Initial & Last Name & Degree
Yuling Zuo, Professor

12. IPD Sharing Statement

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Effectiveness and Clinical Mechanism of Huanglian-Jiedu Decoction in Patients With Intense-exuberant Stomach Fire Syndrome

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