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Irritable Bowel SyndromeNCT01342718

Effect of Herbal Extract Granules Combined With Probiotics on Irritable Bowel Syndrome With Diarrhea

A study testing Herbal extract granule and probiotics in people with Irritable Bowel Syndrome, run by Kyunghee University Medical Center at 1 site in South Korea.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The aims of this study are to investigate the effect of famous herbal formula extract and probiotics on irritable bowel syndrome with diarrhea, and to determine whether these two experimental items affect intestinal permeability and the composition of intestinal microbiota. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Irritable Bowel Syndrome
What is being tested?
Herbal extract granule and probiotics
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
48 participants
Where
1 siteSouth Korea
Study dates
Apr 2011to Apr 2012
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 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age of 18 - 75, with a elementary-school diploma or higher, must be literate
  • One who meet Rome Ⅲ IBS-D criteria
  • One who agree on not taking other therapies during experimental period
  • During the past 5 yrs, no history of organic lesion proven by colonoscopy
  • One who agree on consent form

Who cannot join

  • Patients who have abdominal operation in the past(exception: appendectomy, caesarean section, tubal ligation, laparoscopic cholecystectomy, hysterectomy and abdominal wall hernia repair)
  • No history of non-functional bowel disease(cholangitis, pancreatitis, enteritis, ulcer, bleeding, cancer, etc.)
  • Before participation clinical trial, one who took over-the-count medication affecting GI motility
  • One who takes antibiotics during run-in period (2 wks)
  • One who takes probiotics within 2 wks before experiment
  • Pregnant woman
  • One who disagree on the consent form

Trial locations and contacts

1 site in 1 country.

South Korea1 site
  • Kyung Hee University Hospital at Gangdong

    Seoul, Gangdong-gu, 130-701

Other trials in South Korea

About this study

The aims of this study are to investigate the effect of famous herbal formula extract and probiotics on irritable bowel syndrome with diarrhea, and to determine whether these two experimental items affect intestinal permeability and the composition of intestinal microbiota.

Read the detailed description

Irritable bowel syndrome (IBS), a common chronic gastrointestinal disorder characterized by abdominal pain and alteration of bowel habits in the absence of structural abnormality, has a prevalence of approximately 15% in western populations1,2. Patients with IBS can be classified by their predominant bowel habits: diarrhea-predominant IBS (D-IBS), constipation-predominant IBS, or IBS with alternating bowel movements3. Although smooth-muscle relaxants, bulking agents, and anti-diarrheal agents are commonly used as conventional IBS treatments, many IBS patients turn to alternative treatments because of the lack of therapeutic advantages of these treatments4. Therefore, the development of a new therapy is necessary for IBS patients.

Gwakhyangjeonggisan (GJS; Kkako-shoki-san in Kampo Medicine; Huoxiang-zhengqi-san in Traditional Chinese Medicine), which was recorded originally in the famous ancient herbal formula literature "Formularies of the Bureau of people's Welfare Pharmacies", consists of 13 common crude herbs. GJS contains the chemical ingredients naringin, hesperidin, thymol, honokiol and magnolol5. GJS has been shown to protect intestinal barrier function6, contract the colonic muscle7, and regulate infectious diarrhea8 in vivo. In traditional Korean medicine, this herbal formula has long been used for relieving abdominal pain, diarrhea, and vomiting as an over-the-counter or prescribed medicine9-11. However, there have been no clinical trials to investigate the efficacy of GJS in IBS.

Probiotics are defined as viable microorganisms, which confer potential health benefits on the host when taken in proper amounts12. They are easily available, do not require a prescription, and are administered extensively for the relief of abdominal symptoms13. According to a recent systematic review and meta-analysis study, probiotics caused a modest improvement in the overall IBS symptoms14. The rationale for using probiotics for IBS is based on the assumption that they modify the composition of the intestinal microflora15 and regulate intestinal permeability by modulating the epithelial tight junctions16. Duolac7S (DUO), a probiotic mixture, contains 7 bacterial species including Bifidobacterium, Lactobacillus, and Streptococcus. Each of these bacterial species is reportedly beneficial for IBS17. DUO has been approved by the Korean Food and Drug Administration for restoring the ecological balance of intestinal microflora and improving intestinal symptoms18. Although DUO has been widely used as an over-the-counter product for IBS-related symptoms, no clinical trials have investigated the efficacy of DUO on IBS.

Recently, several herbal formulas and probiotics have been simultaneously administered to IBS patients for relieving abdominal symptoms19. In addition to lack of clinical evidence for the use of GJS or DUO, the efficacy of their combined treatment for IBS has not been elucidated. Thus, there is a need to evaluate the safety and efficacy of administration of GJS, DUO, or a combination therapy as a frequently used treatment for IBS. In the current trial, we identified the safety and efficacy of GJS, DUO, or a combination therapy on D-IBS by evaluating IBS symptoms and quality of life. To investigate their mechanisms in humans, intestinal permeability and composition of intestinal microbiota were assessed.

Being tested
Herbal extract granule and probiotics, Herbal extract granule and placebo probiotics, Placebo herbal extract granule and probiotics, Placebo herbal extract granule and placebo probiotics
Keywords
Irritable bowel syndrome, Herbal medicine, Probiotics
Medical subject headings
Irritable Bowel Syndrome

What participants receive

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

  • Herbal extract granule and probioticsDietary supplement

    Also called Gwakhyangjeonggisan granule and Duolac7S

    The herbal extract granule, Gwakhyangjeonggisan granule, consists of 11 herbs. Ingredients: Agastachis, Perillae Folium, Angelicae Radix, Arecae Pericarpium, Hoelen, Magnoliae officinalis Cortex, Atractylis Rhizoma, Aurantii nobilis Percarpium, Pinelliae Rhizoma, Platycodi Radix, Glychrrhizae Radix. Dosage and frequency: 1 pack (3g), 3 packs per day (2 hours after morning, afternoon and evening meal)

    The probiotics, Duolac7S, consist of 7 bacteria. Ingredients: Lactobacillus acidophilus, L. plantarum, L. rhamnosus, Bifidobacterium breve, B. lactis, B. longum, Streptococcus thermophilus. Dosage and frequency: 1 capsule (5✕1,000,000,000 bacteria/capsule [7✕100,000,000 viable cells/strain]), 2 capsules per day (2 hours after morning and evening meal)

  • Herbal extract granule and placebo probioticsDietary supplement

    Also called Gwakhyangjeonggisan granule and placebo Duolac7S

    The herbal extract granule, Gwakhyangjeonggisan granule, consists of 11 herbs. Ingredients: Agastachis, Perillae Folium, Angelicae Radix, Arecae Pericarpium, Hoelen, Magnoliae officinalis Cortex, Atractylis Rhizoma, Aurantii nobilis Percarpium, Pinelliae Rhizoma, Platycodi Radix, Glychrrhizae Radix. Dosage and frequency: 1 pack (3g), 3 packs per day (2 hours after morning, afternoon and evening meal).

    Duolac7S placebo has the same form, color and flavor as experimental intervention (Duolac7S). The dosage, frequency and duration is also the same as experimental intervention (Duolac7S).

  • Placebo herbal extract granule and probioticsDietary supplement

    Also called Placebo Gwakhyangjeonggisan granule and Duolac7S

    The Gwakhyangjeonggisan placebo has the same form, color and flavor as experimental intervention (Gwakhyangjeonggisan). The dosage, frequency and duration is also the same as experimental intervention (Gwakhyangjeonggisan).

    The probiotics, Duolac7S, consist of 7 bacteria. Ingredients: Lactobacillus acidophilus, L. plantarum, L. rhamnosus, Bifidobacterium breve, B. lactis, B. longum, Streptococcus thermophilus. Dosage and frequency: 1 capsule (5✕1,000,000,000 bacteria/capsule [7✕100,000,000 viable cells/strain]), 2 capsules per day (2 hours after morning and evening meal)

  • Placebo herbal extract granule and placebo probioticsDietary supplement

    Also called Placebo Gwakhyangjeonggisan granule and placebo Duolac7S

    The Gwakhyangjeonggisan placebo has the same form, color and flavor as experimental intervention (Gwakhyangjeonggisan). The dosage, frequency and duration is also the same as experimental intervention (Gwakhyangjeonggisan).

    Duolac7S placebo has the same form, color and flavor as experimental intervention (Duolac7S). The dosage, frequency and duration is also the same as experimental intervention (Duolac7S).

Study groups in NCT01342718
Study groupRoleWhat they receive
GJS/Duolac7SExperimentalGJS: Real herbal extract granule/Duolac7S: Real probiotics
Receives: Dietary Supplement: Herbal extract granule and probiotics
GJS-P/Duolac7SPlacebo comparatorGJS-P: Placebo herbal extract granule/Duolac7S: Real probiotics
Receives: Dietary Supplement: Placebo herbal extract granule and probiotics
GJS/Duolac7S-PPlacebo comparatorGJS: Real herbal extract granule/Duolac7S-P: Placebo probiotics
Receives: Dietary Supplement: Herbal extract granule and placebo probiotics
GJS-P/Duolac7S-PPlacebo comparatorGJS-P: Placebo herbal extract granule/Duolac7S-P: Placebo probiotics
Receives: Dietary Supplement: Placebo herbal extract granule and placebo probiotics

What is being measured

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

  1. Adequate relief (AR) of IBS pain & discomfort

    As the participants answer the question "in the past seven days have you had adequate relief of your irritable bowel syndrome pain and discomfort?" in the form of "Yes" or "No", the effect can be assessed.

    Measured: Weekly (during run-period [2 wks], administarion period [8 wks] and follow-up period [2 wks])

  2. Proportion of responders

    The proportion of responders who answer "Yes" to more than half of AR questions in each period (>50%)

    Measured: Once in each period (run-period [2 wks], administarion period [8 wks] and follow-up period [2 wks])

Secondary outcomes (4)
  1. Daily assessment of bowel function scores

    1. The patients should write diaries of stool's frequency, consistency and ease of passage
    2. Frequency (number of defecation in a day)
    3. Consistency (judged by Bristol scale)
    4. Ease of passage

    Measured: Daily (during run-period [2 wks], administarion period [8 wks] and follow-up period [2 wks])

  2. Daily assessment of severity of individual symptoms related to defecation

    Abdominal pain, abdominal discomfort, bloating, flatulence, urgency, mucus in stool and overall symptom would be evaluated through visual analog scale (100mm)

    Measured: Daily (during run-period [2 wks], administarion period [8 wks] and follow-up period [2 wks])

  3. Changes on population of intestinal microbes

    1. To investigate the changes of intestinal microbes before and after experiment, feces should be collected.
    2. The feces will be analyzed by the method of DGGE (denaturing gradient gel electrophoresis - PCR of DNA).

    Measured: Two times in administration period (0 and 8 wks)

  4. Intestinal permeability test

    In order to evaluate intesinal permeability, the urine should be collected after orally administration of lactulose and mannitol.

    Measured: Two times in administration period (0 and 8 wks)

Timeline

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

  1. First posted27 Apr 2011 (estimated)
  2. Study startApr 2011
  3. Primary completionApr 2012
  4. Study completionApr 2012

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
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
48 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01342718
Sponsor's protocol ID
KHNMC-OH-IRB 2010-011
Status last verified
Jun 2012
First submitted
25 Apr 2011
Last updated
5 Jun 2012
Results posted
No
Data monitoring committee
Yes

Publications

  • Ko SJ, Ryu B, Kim J, Hong BG, Yeo I, Lee BJ, Lee JM, Park JW. Effect of herbal extract granules combined with probiotic mixture on irritable bowel syndrome with diarrhea: study protocol for a randomized controlled trial. Trials. 2011 Oct 6;12:219. doi: 10.1186/1745-6215-12-219.

    PubMed 21978382

Questions about this trial

What is this clinical trial studying?

A study testing Herbal extract granule and probiotics in people with Irritable Bowel Syndrome, run by Kyunghee University Medical Center at 1 site in South Korea.

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 5 inclusion and 7 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: finished, as of the sponsor's last update on 5 Jun 2012. 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 South Korea. 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 is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Adequate relief (AR) of IBS pain & discomfort (time frame: Weekly (during run-period [2 wks], administarion period [8 wks] and follow-up period [2 wks])). The study lists 2 primary outcomes in all. 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 NCT01342718, which also lists 1 linked publication.

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 5 Jun 2012.

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