It is a double-blinded, randomized, placebo-controlled trial for advanced cancer patients with constipation. 60 patients will be randomly assigned to have individualized herbal intervention (treatment group) or placebo (control group) in 1:1 ratio. For the treatment group, MaZiRenWan 10g plus HuangQi 20g are chosen as the core prescription. Furthermore, six herbal granules can be added according to the syndrome differentiated for individual participant. Placebo is made from dextrin (76.03%), tea essence (23.61%), gardenin (0.02%), and caramel (0.34%) to achieve color, smell, taste, and texture comparable to the herbal granules. Patients are instructed to dissolve the granules in 150ml of hot water, twice daily for two weeks. The primary end point is the global symptom improvement. Secondary outcome measures include stool frequency, stool form, use of rescue herbal granules, constipation visual analogue scale (CVAS) (0=none to 7=most severe) and individual assessment of constipation related symptoms. For the safety profiles of herbal intervention, the important adverse events reported and clinical laboratory evaluations of liver and renal function are determined.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
Caritas Medical Centre
Hong Kong, Hong Kong
Hong Kong Buddhist Hospital
Hong Kong, Hong Kong
Our Lady of Maryknoll Hospital
Hong Kong, Hong Kong
Global symptom improvement (improved / same / worse)
Participants are asked to rate their impression of change in constipation symptoms in comparison with their baseline, with scores from 0 to 6 represents markedly worse or better at the respective extremes. The response categories are collapsed to simply "improved" for score 4-6, "same" for score 3, or "worse" for score 0-2.
Time frame: 2 weeks
Number of bowel movement (times/day)
Time frame: 2 weeks
Stool form
Stool form is assessed with 7-point Bristol Stool Scale (ranging from "separate hard lumps" to "watery")
Time frame: 2 weeks
Extra laxatives used (times/week)
Time frame: 2 week
Constipation visual analogue scale
The severity of constipation is evaluated by an eight point ordinal rating scale (0=none to 7=most severe)
Time frame: 2 weeks
Constipation related symptoms
Sensation of straining, incomplete evacuation, bloating, abdominal pain/cramping, nausea, and passing of gas are recorded using a 7-point ordinal scale (0=not at all and 6=very severe)
Time frame: 2 weeks
Adverse events
Time frame: 2 weeks
Blood creatinine level (umol/L)
Time frame: 2 weeks
Blood urea level (mmol/L)
Time frame: 2 weeks
Serum glutamic pyruvic transaminase(SGPT) Level (U/L)
Time frame: 2 weeks
Serum Glutamic Oxaloacetic Transaminase (SGOT) Level (U/L)
Time frame: 2 weeks
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