Immune Dysfunction Clinical Trial
Participants and study design:
Subjects were recruited and selected for uremic patients on maintenance hemodialysis (HD)
who informed us of their interest in the investigators study and were mentally capable to
give an informed written consent and willing to comply with study requirements. The
inclusion criteria were 18 years or older, with at least 3 months maintenance HD. The
exclusion criteria were malignancy, acute infection, gastrointestinal bleeding, pregnancy,
and inability to comply with the requirements of study.
69 respondents were enrolled in this trial. A single-center quasi-randomized controlled
clinical trial was designed based on the patients in the care of one attending physician.
Eligible subjects were allocated to study and control group, and the basic characteristics
between the experimental group and control group were matched. There was no significant
difference regarding gender, aged, education level, comorbidities between these two groups.
The experimental group was treated with Ren Shen Yang Rong Tang (R-S-Y-R-T) combined routine
western medicine, and the control group was treated with WM alone. The experimental group
had 32 respondents and the control group had 37 respondents. The duration of use of
R-S-Y-R-T was 6 months. Finally, there were 27 patients in the experimental group and 32
patients in the control group completed the study. Blood investigation, including
biochemical profiles and inflammatory markers were checked at intervals 0, 2, 4 and 6 months
form routine HD. The questionnaire, for the assessment of quality of life (QOL) was
evaluated at interval 0, and 6 months.
Study medication and dosage:
For this study, the investigators used herbal granules prepared according to the formula of
R-S-Y-R-T. The investigators purchased the study products from a manufacturer with a Good
Manufacturing Practice (Si Wu Tang) certification in Taiwan. This was a concentrated
decoction made by water extraction in 1:13 ratio from single batched roots of the 14 plants
in proportions: Radix Paeoniae alba (Bai Sau) (90 g), Radix Angelicae sinensis (Dang Guay)
(30 g), Pericarpium Citri Reticulatae (Chenpi) (30 g), Radix Astragali (Huangqi) (30 g),
Cortex Cinnamomi (Rougui) (30 g), Radix Ginseng (Renshen) (30 g), Rhizoma Atractylodis
Macrocephalae (Baizhu) (30 g), Radix Glycyrrhizae (Gancao) (30 g), Radix Rehmanniae
praeparata (Soe Dee Huang) (20 g), Fructus Schisandrae (Wuweizi) (20 g), Poria cocos
(Fuling) (20 g), Cortex et Radix Polygalae (Yuanzhi) (15 g), Zingiber officinale Roscoe
(Jiang) (30 g),Fructus Jujubae (Dazao) (10 g) as prepared according to the original
pharmacopoeia. The plant origins in China were known to the buyer of the pharmaceutical
company and the final product was free of E. coli, Salmonella and pesticide residues. The
levels of heavy metals were 1.238 ppm for lead, 0.228 ppm for arsenic,0.10 ppm for cadmium,
and <0.0022 ppm for mercury, all within regulated limits (5, 5, 0.5, and 0.5 ppm,
respectively). Each pack weighed approximately 500 mg in aluminum packets.
The investigators determined the dosage of 1 pack a time for 3 times a day with warm water
for 6 months. The exact number of packs taken was recorded in clinic visits and any
unfinished packs were brought back to the study nurse at the next clinic visit.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care
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