Use of Traditional Chinese Medicine (Ren Shen Yang Rong Tang) Against Microinflammation in Hemodialysis Patients: A Quasi-randomized Controlled Trial

Immune Dysfunction Clinical Trial

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT02053740
• Other study ID #: TSGH 2012-1
• Status: Completed
• Phase: Phase 4
• First received: January 30, 2014
• Last updated: January 31, 2014
• Start date: January 2013

Study information

• Verified date: January 2014
• Source: Tri-Service General Hospital
• Contact: n/a
• Is FDA regulated: No
• Health authority: Taiwan: Food and Drug Administration, Ministry of Health and Welfare
• Study type: Interventional

Clinical Trial Summary

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.

Description:

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 59
• Est. primary completion date: August 2013
• Accepts healthy volunteers: No
• Gender: Both
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• More than 18 years or older

• With maintenance HD for at least 3 months

Exclusion Criteria:

• Malignancy

• Acute infection

• Gastrointestinal bleeding

• Pregnancy

• Inability to comply with the requirements of study

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Supportive Care

Related Conditions & MeSH terms

• Immune Dysfunction
• Immune System Diseases

Intervention

Drug:
• Add R-S-Y-R-T (500 mg 3 times per day) for 6 months

• Routine western medicine

Locations

Country	Name	City	State
Taiwan	Tri-service general hospital	Taipei

Sponsors (1)

Lead Sponsor	Collaborator
Tri-Service General Hospital

Country where clinical trial is conducted

Taiwan, 

References & Publications (3)

Aoki T, Kojima T, Kameda N, Yoshijima S, Ono A, Kobayashi Y. [Anti-inflammatory effect of a traditional Chinese medicine, ren-shen-yang-rong-tang (Japanese name: ninjin-youei-to), on alveolar macrophages stimulated by RANTES or TNF-alpha]. Arerugi. 1994 May;43(5):663-7. Japanese. — View Citation

Harigai E, Nakai S, Kawakita T, Nomoto K. Combined treatment with ren-shen-yang-rong-tang (Japanese name: ninjin-youei-to) plus prednisolone on adjuvant-induced arthritis in Lewis rat. Int J Immunopharmacol. 1995 May;17(5):411-8. — View Citation

Nakai S, Kawakita T, Nagasawa H, Himeno K, Nomoto K. Thymus-dependent effects of a traditional Chinese medicine, ren-shen-yang-rong-tang (Japanese name; Ninjin-youei-to), in autoimmune MRI/MP-lpr/lpr mice. Int J Immunopharmacol. 1996 Apr;18(4):271-9. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Inflammatory markers	These inflammatory markers include c-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-a (TNF-a). We use the xMAP serum assay for the 3 cytokines.	Average 26 weeks (6 months)	Yes
Secondary	Quality of life	We use the Taiwan version of the WHOQOL-BREF (WHOQOL-BREF [TW]).	Average 26 weeks (6 months)	Yes