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The Study of Chinese Medicine for the Treatment of Chronic Atrophic Gastritis

Not Applicable
Completed
Conditions
Chronic Atrophic Gastritis
Interventions
Drug: Chinese medicine prescription
Drug: Placebo
Drug: Compound Azimtamide Entieric-coated Tablets
Registration Number
NCT02955134
Lead Sponsor
Wangjing Hospital, China Academy of Chinese Medical Sciences
Brief Summary

The purpose of this study is to evaluate efficacy of Chinese medicine treatment for chronic atrophic gastritis. It is a multi-center, randomized, placebo-controlled trial.

Detailed Description

A prospective, double-blind, randomized, placebo-controlled, multi-center trial is carried out in this study.The sample size is 468 patients ( 312 in treatment group, 156 in control group). The investigators will screen the patients for inclusion according to the inclusion and exclusion criteria. All patients detect of H.pylori, undergo upper digestive endoscopy and biopsies for histological investigation. Patients infected of H.pylori must receive H.pylori eradication therapy under the guidance of Kyoto global consensus report on H.pylori gastritis. Then they are assigned to treatment group or control group with an allocation ratio of 2:1. Patients intreatment group take the traditional Chinese medicine prescription, while the control group take simulate granule of the prescription. Both two groups are under symptomatic treatment. Treatment duration lasts 24 weeks. Investigators also follow up another 24 weeks. Histological changes are used as the primary outcome index. Endoscopy findings, symptoms are assessed. Serum level of pepsinogen and patient-reported outcome instrument are also administered during the study. All biopsy specimens are collected to build the biological specimen bank. Central blinded histological assessment (Histological diagnosis is determined independently by three experienced pathologists who are blinded to the information of the patients.) are used to insure the accuracy and consistency. Tele-medicine and information management system is established to help achieve follow-up interviews.

Random numbers are generated by SAS 9.4 software. The subjects, caregivers, investigators and outcomes assessors in this study are all blinded.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
468
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Chinese medicine prescriptionChinese medicine prescriptionOn the basis of symptomatic treatment of Talcid® and Compound Azimtamide Entieric-coated Tablets,patients in experimental group use the traditional Chinese medicine application prescription.
Chinese medicine prescriptionCompound Azimtamide Entieric-coated TabletsOn the basis of symptomatic treatment of Talcid® and Compound Azimtamide Entieric-coated Tablets,patients in experimental group use the traditional Chinese medicine application prescription.
placeboTalcid®On the basis of symptomatic treatment of Talcid® and Compound Azimtamide Entieric-coated Tablets,patients in placebo group use the simulate granule of traditional Chinese medicine application prescription.
placeboPlaceboOn the basis of symptomatic treatment of Talcid® and Compound Azimtamide Entieric-coated Tablets,patients in placebo group use the simulate granule of traditional Chinese medicine application prescription.
placeboCompound Azimtamide Entieric-coated TabletsOn the basis of symptomatic treatment of Talcid® and Compound Azimtamide Entieric-coated Tablets,patients in placebo group use the simulate granule of traditional Chinese medicine application prescription.
Chinese medicine prescriptionTalcid®On the basis of symptomatic treatment of Talcid® and Compound Azimtamide Entieric-coated Tablets,patients in experimental group use the traditional Chinese medicine application prescription.
Primary Outcome Measures
NameTimeMethod
Change of histological scoreChange from baseline histological score at 6 months and 1 year

Gastric mucosa samples are subsequently evaluated according to updated Sydney system with the degree of H.pylori density, polymorphonuclear neutrophil activity, chronic inflammation, glandular atrophy, and intestinal metaplasia classified as: 0,'absent'; 2, 'mild'; 4, 'moderate'; and 6, 'marked'. Grade of histological gastritis is evaluated with this score 0, 2, 4, and 6. Dysplasia was assessed according to the revised Vienna classification, scored as 0 (absent), 2 (mild), 4 (moderate), or 6 (marked).

Change of symptoms scoreChange from baseline symptoms score at 6 months and 1 year

Symptoms of dyspepsia, regurgitation and defecation are assessed for severity and frequency at enrollment in every interview during the study.For each symptom, the scores are calculated by multiplying frequency by severity.

All symptom scores are added to define the total symptom score.

Secondary Outcome Measures
NameTimeMethod
Change of endoscopic atrophyChange from baseline endoscopic atrophy at 6 months and 1 year

Endoscopic atrophy are defined using an endoscopicatrophic border scale previously reported by Kimura and Takemoto. This scale correlates with histological results and includes the following classifications: 1 close-type, when the atrophic border remains on the lesser curvature of the stomach; 2 open-type, when the atrophic border extends along the anterior and posterior walls of the stomach and is not associated with the lesser curvature of the stomach. Close-type and open-type atrophy are further classified as none (C0), mild (C1, 2),moderate (C3, O1), and severe (O2, 3) atrophy. In this study, atrophy grade are also scored as C0: 0, C1: 1, C2: 2, C3:3, O1: 4, O2: 5, and O3: 6 respectively, with 0 representing an absence of atrophy and 6 indicating severe atrophy.

Change of OLGA stages.Change from baseline at 6 months and 1 year

Three expert GI pathologists, who are blinded for the endoscopic findings, independently assessed all biopsy specimens of the surveillance endoscopy. The type and grade of the different stages of changes are classified according to the updated Sydney system and scored as 0 (absent), 1 (mild), 2(moderate), or 3 (marked) by using the Sydney system visual analog scale. On the basis of the standardized sites, the gastritis stages areassess according to the OLGA.

Change of OLGIM stages.Change from baseline endoscopic atrophy at 6 months and 1 year

Three expert GI pathologists, who are blinded for the endoscopic findings, independently assessed all biopsy specimens of the surveillance endoscopy. The type and grade of the different stages of changes are classified according to the updated Sydney system and scored as 0 (absent), 1 (mild), 2(moderate), or 3 (marked) by using the Sydney system visual analog scale. On the basis of the standardized sites, the gastritis stages areassess according to the OLGA.

Trial Locations

Locations (13)

Liaoning Hospital of TCM

🇨🇳

Shenyang, China

Guangdong Provincial TCM Hospital

🇨🇳

Guangzhou, China

The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine

🇨🇳

Guangzhou, China

GanSu Provincial Hospital of Traditional Chinese Medicine

🇨🇳

Lanzhou, China

Yueyang Hospital of Integrated Traditional Chinese Medicine and Western Medicine, Affiliated Hospital of Shanghai University of Traditional Chinese Medicine

🇨🇳

Shanghai, China

Hebei Hospital of TCM

🇨🇳

Shijiazhuang, China

Shanxi province hospital of traditional Chinese medicine

🇨🇳

Taiyuan, China

Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital

🇨🇳

Tianjin, China

Tianjin Nankai Hospital

🇨🇳

Tianjin, China

Shanxi Traditional Chinese Medicine Hospital

🇨🇳

Xi'an, China

Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University

🇨🇳

Beijing, China

Wangjing Hospital of China Academy of Chinese Medical Sciences

🇨🇳

Beijing, China

Xiyuan Hospital of China Academy of Chinese Medical Sciences

🇨🇳

Beijing, China

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