Efficacy of the Supplementation With a Symbiotic, a Prebiotic and a Probiotic to Produce a Beneficial Effect on the Intestinal Microbiota and on the Characteristics of Feces in Children With Cerebral Palsy (CP) and Chronic Constipation
试验速览
- 阶段
- 4 期
- 状态
- 已完成
- 发起方
- 入组人数
- 40
- 试验地点
- 1
- 主要终点
- Change in the composition of the microbiota (firmicutes, bifidobacteria and lactobacilli)
研究概览
简要总结
Randomized double blind controlled clinical trial. Participants will be enrolled at the New Civil Hospital of Guadalajara "Dr. Juan I. Menchaca" during the period from May 2017 to July 2018, from six to 59 months of either sex. The duration of each participant in the study will be of four weeks. Each participant will be randomized assigned to any of the different study groups: synbiotic, prebiotic, probiotic or placebo. Hypothesis: The efficacy of supplementation with a symbiotic, a prebiotic and a probiotic differs in its beneficial effect on the intestinal microbiota and the characteristics of feces in children with CP and chronic constipation.
详细描述
All the data registered in the case report forms will be monitored by the responsible party. This person will be monitoring each procedure during the study.
All the data in the case report forms will be obtained from the information obtained from the legal caregiver or the parents of the child and/or from the medical and electronic records and calls to the parents or legal caregivers and will be introduced daily in the Statistical Package for the Social Scienses (SPSS) program version 21. The responsible party will have access to this database and will verify the information.
Plan for missing data. In case that we have some missing variables, we will call the parents or legal caregiver of the children if it is about the data of the child. In case of missing data, unavailable or non-reported variable and it is not possible to compare the initial vs final phases, the subject will be excluded from the study. In case of finding an out-of-range laboratory results we will repeat the test. If we have some missing data from the subject but we can analyze other results from the same subject, it will not be excluded.
Standard Operating Procedures to address registry operations and analysis activities, such as patient recruitment, data collection, data management, data analysis, reporting for adverse events, and change management. Patients will be recruited from the nutrition and neurology outpatient at the New Hospital Civil of Guadalajara. We will apply a standardized questionnaire to the parents or legal caregivers to assure that the subject could be eligible to the study. Once all the inclusion criteria are fulfilled then another questionnaire or case report form will be filled. The informed consent will be explained and given to the parents or legal caregivers of the child for sign. An external person will be chose to assign randomly (by envelops) the subjects to each group. This person will provide the study product and the diaries to the parents or legal caregivers. Data from the case reports forms will be captured by the principal investigator and monitored by the responsible party. Te adverse events will be reported by phone calls during the four weeks (two to three phone calls in a week). To analyze the information, the SPSS program version 21 will be used.
Sample size. The sample size was calculated according to the next formula:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Factorial
- 主要目的
- Treatment
- 盲法
- Triple (Participant, Care Provider, Investigator)
盲法说明
pediatric neurologist and laboratory staff.
入排标准
- 年龄范围
- 6 Months 至 60 Months(Child)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Participants attending the outpatient of nutrition and/or pediatric neurology with cerebral palsy diagnosed and confirmed by a pediatric neurologist, and that belong to levels IV or V of the Gross Motor Function Classification System (GMFCS).
- •Participants with constipation according to the Rome IV criteria.
- •Signed informed consent by one of the child's parents or legal guardians
排除标准
- •Refusal to continue in the study
- •Use of antibiotics during the study, consumption of laxatives, food fibers, lactulose, magnesia or products containing probiotics, prebiotics or both as infant formulas (NOTE: Glycerin suppositories will only be allowed when there is no evacuation for more than five days).
- •Omission of administration of the required dose of symbiotic, prebiotic, probiotic or placebo and/or administered with an unspecified frequency (compliance <95%)
- •Adverse effects not related to the agent of study.
研究组 & 干预措施
Placebo
maltodextrin (4 g) in powder and an oil mix (sunflower oil and medium chain triglyceride oil) in 5 drops daily, once a day for four weeks.
干预措施: Oil mix (medium chain triglycerides and sunflower oil) (Other)
Synbiotic
Each participant will receive the next:
- agave inulin (4 g) in powder
- Lactobacillus reuteri DSM 17938 (1 x 10^8 cfu) in 5 drops daily, once a day for four weeks.
干预措施: agave inulin (Biological)
Synbiotic
Each participant will receive the next:
- agave inulin (4 g) in powder
- Lactobacillus reuteri DSM 17938 (1 x 10^8 cfu) in 5 drops daily, once a day for four weeks.
干预措施: Lactobacillus reuteri DSM 17938 (Biological)
Probiotic
Lactobacillus reuteri DSM 17938 (1 x 10^8 cfu) in 5 drops and maltodextrin (4 g) in powder daily, once a day for four weeks.
干预措施: Lactobacillus reuteri DSM 17938 (Biological)
Prebiotic
agave inulin (4 g) in powder and an oil mix (sunflower oil and medium chain triglyceride oil) in 5 drops daily, once a day for four weeks.
干预措施: agave inulin (Biological)
Prebiotic
agave inulin (4 g) in powder and an oil mix (sunflower oil and medium chain triglyceride oil) in 5 drops daily, once a day for four weeks.
干预措施: Oil mix (medium chain triglycerides and sunflower oil) (Other)
Probiotic
Lactobacillus reuteri DSM 17938 (1 x 10^8 cfu) in 5 drops and maltodextrin (4 g) in powder daily, once a day for four weeks.
干预措施: maltodextrin (Other)
Placebo
maltodextrin (4 g) in powder and an oil mix (sunflower oil and medium chain triglyceride oil) in 5 drops daily, once a day for four weeks.
干预措施: maltodextrin (Other)
结局指标
主要结局
Change in the composition of the microbiota (firmicutes, bifidobacteria and lactobacilli)
时间窗: change from baseline bacteria composition at four weeks
species/g
change in consistency of feces
时间窗: change from baseline consistency at four weeks
Bristol scale
change in potential of hydrogen (pH) of feces
时间窗: Change from baseline pH at four weeks
pH scale
change in frequency of evacuations
时间窗: change from baseline frequency at four weeks
evacuations per week
次要结局
- change in the concentration of short chain fatty acids in feces(Change from baseline concentration at four weeks)
研究者
Andrea Garcia Contreras
Principal investigator
Hospital Civil Juan I. Menchaca
