Cohort Study on Traditional Chinese Medicine Diagnosis and Treatment of Children With Henoch-Schonlein Purpura Nephritis

NCT02878018 | Unknown DMC

• 1 other identifier: ZJ16813
• Study Type: observational
• Target: 600
• Locations: 1 country
• Sites: 1

Brief Summary

Henoch-Schonlein purpura nephritis(HSPN) is one of the most common secondary glomerulonephritis in children. A large, prospective, multicenter cohort study is being conducted in three institutions. Eligible Henoch-Schönlein purpura nephritis children will be classified as the experimental group (n=300) and the control group (n=300) based on the interventions they receive. Patients taking Chinese herbal formula will be in the experimental group, and those taking Western medicine will be in the control group. The entire study will last 60 weeks, including a 12-week observation period and a followup at 12 months.

Conditions

Henoch-Schonlein Purpura Nephritis

Keywords

Cohort Study; Children; Henoch-Schonlein Purpura Nephritis; Traditional Chinese Medicine

Outcome Measures

Primary Outcomes (4)

• Urine protein

  1. Recovery:Urine protein(-). 2. Marked effect:Urine protein reduces by 2'+'. 3. Effective：Urine protein reduces by 1'+'. 4. Ineffective：Urine protein has no changes.

  2 weeks

• 24-hour urinary protein excretion

  1. Recovery:24-hour urinary protein excretion is normal. 2. Marked effect:24-hour urinary protein excretion reduction is larger than 50%. 3. Effective：24-hour urinary protein excretion reduction is smaller than 50%. 4. Ineffective：24-hour urinary protein excretion has no changes.

  2 weeks

• Urine erythrocyte

  1. Recovery:Urine erythrocyte is normal. 2. Marked effect:Urine erythrocyte reduction is larger than 50%. 3. Effective:Urine erythrocyte reduction is smaller than 50%. 4. Ineffective；Urine erythrocyte has no changes.

  2 weeks

• Creatinine clearance rate and Serum creatinine

  Diagnostic criteria of chronic renal failure: 1. Creatinine clearance rate\<80ml/min; 2. Serum creatinine\>133μmol/L; 3. The patient who have a history of chronic kidney diseases or systemic diseases involving kidney.

  1 year

Secondary Outcomes (2)

• Number of patients with hormone therapy

  3 months

• Number of patients with immunosuppressant therapy

  3 months

Study Arms (2)

TCM intervention

Participants with HSPN of the Heat-Toxin type will take the Qi-Ji Shen-Kang formula. HSPN patients of the Wet-Heat type will take the Zhu-Bai formula. Those of Qi-Deficiency with Blood-Stasis type will take the Yu-Shen formula.

Drug: Qi-Ji Shen-Kang formula; Zhu-Bai formula; Yu-Shen formula

WM conventional intervention

The WM conventional intervention, recommended by the Chinese Medical Association's (CMA) Scientific Statement, includes angiotensin-converting enzyme (ACE) inhibitor, adrenergic receptor binder (ARB), adrenal cortical hormone, Tripterygium wilfordii polyglycosidium and an immunosuppressant.

Drug: angiotensin-converting enzyme (ACE) inhibitor; adrenergic receptor binder (ARB); adrenal cortical hormone; Tripterygium wilfordii polyglycosidium; immunosuppressant

Interventions

Qi-Ji Shen-Kang formula; Zhu-Bai formula; Yu-Shen formula DRUG

Qi-Ji Shen-Kang formula:15g of field thistle,10g of common edelweiss herb,10g of spreading hedyotis herb,10g ofYunnan manyleaf Paris rhizome,10g of hairyvein agrimonia herb,10g of the root bark of the tree peony,15g of root of red rooted salvia, and 15g ofmembranous mikvetch root.Zhu-Bai formula:10g of glabrous greenbrier rhizome,5g of Chinese atractylodes rhizome,10g of amur corktree bark,10g of common edelweiss her),10g of field thistle,10g of lalang grass rhizome,10g of garden burnet root,5g of longbract cattail pollen,5g of rehmanniae radix, and 5g of Chinese angelica root.Yu-Shen formula:15g of membranous mikvetch root,10g of heterophylla falsestarwort root,10g of field thistle,10g of cogongrass rhizome,10g of spreading hedyotis herb,10g of root of red rooted salvia,10g of fresh root of rehmannia,10g of Asian puccoon,10g of wormwoodlike motherwort herb,10g of common cockscomb inflorescence,10g of gordon euyale,10g of root bark of the tree peony, and 5g of licorice root.

TCM intervention

angiotensin-converting enzyme (ACE) inhibitor; adrenergic receptor binder (ARB); adrenal cortical hormone; Tripterygium wilfordii polyglycosidium; immunosuppressant DRUG

prednisone at a dose of 1-1.5 mg/(kg·d) and Tripterygium wilfordii polyglycosidium at a dose of 1 mg/(kg·d). For each patient, the specific Western medicines used and their doses may be adjusted at the discretion of his or her physician, but the classes cannot be changed.

WM conventional intervention

Eligibility Criteria

• Age: 5 Years - 18 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)
• Sampling Method: Probability Sample

Study Population

Children with purpura nephritis who are treated in Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shengjing Hospital of China Medical University and The First Hospital of China Medical University will be regarded as the objects of study.

You may qualify if:

• A diagnosis of HSPN as well as three major constitution types (Heat-Toxin, Wet-Heat, Qi-Deficiency with Blood-Stasis) according to WM and TCM.
• Age: 5 to 18 years old (including 5 and 18 year-olds).
• The clinical classification of HSPN includes isolated hematuria, insolated proteinuria, hematuria with proteinuria, and acute glomerulonephritis.
• The ability to provide detailed connection and complete a followup.
• The ability to understand and sign a written informed consent.

You may not qualify if:

• HSPN with renal insufficiency.
• A clinical classification of HSPN that includes nephritic syndrome, rapidly progressive glomerulonephritis and chronic glomerulonephritis.
• Suffering from serious complications, such as respiratory, digestive, hematological or liver diseases.
• Tumor, infectious diseases, or mental disorders.
• Allergic to TCM use.
• No prescribed medication, poor compliance, or incomplete data affecting the efficacy and safety of these judgments.
• A history of another clinical trial in the previous 2 weeks.
• No consent form signed.

Sponsors & Collaborators

• Liaoning University of Traditional Chinese Medicine: lead
• First Hospital of China Medical University: collaborator
• Shengjing Hospital: collaborator

Study Sites (1)

Zhang Jun

Shenyang, Liaoning, 110032, China

Location

Related Publications (1)

• Zhang J, Lv J, Pang S, Bai X, Yuan F, Wu Y, Jiang H, Yang G, Zhang S. Chinese herbal medicine for the treatment of Henoch-Schonlein purpura nephritis in children: A prospective cohort study protocol. Medicine (Baltimore). 2018 Jun;97(24):e11064. doi: 10.1097/MD.0000000000011064.

  PMID: 29901610 DERIVED

Biospecimen

Retention: SAMPLES WITH DNA

We will retain the blood of each patient to do some research of lncRNA with patients'permission.Try to find some relationship between lncRNA and HSPN disease.We also retain the urine and coated tongue to establish the biospecimen repository for our patients.When they grow up,these spicimens may help them to understand their bodies more correctly.

MeSH Terms

Interventions

Dipeptidyl-Peptidases and Tripeptidyl-Peptidases; Adrenal Cortex Hormones; Immunosuppressive Agents

Intervention Hierarchy (Ancestors)

Exopeptidases; Peptide Hydrolases; Hydrolases; Enzymes; Enzymes and Coenzymes; Hormones; Hormones, Hormone Substitutes, and Hormone Antagonists; Immunologic Factors; Physiological Effects of Drugs; Pharmacologic Actions; Chemical Actions and Uses

Study Officials

• jun zhang, master

  Affiliated Hospital of Liaoning University of Traditional Chinese Medicine

  STUDY CHAIR

• jing lv, master

  Affiliated Hospital of Liaoning University of Traditional Chinese Medicine

  STUDY DIRECTOR

• shaoqing zhang, doctor

  Affiliated Hospital of Liaoning University of Traditional Chinese Medicine

  PRINCIPAL INVESTIGATOR

• guanqi yang, doctor

  Affiliated Hospital of Liaoning University of Traditional Chinese Medicine

  PRINCIPAL INVESTIGATOR

• shuang pang, doctor

  Affiliated Hospital of Liaoning University of Traditional Chinese Medicine

  PRINCIPAL INVESTIGATOR

• binyu wu, master

  Shengjing Hospital

  PRINCIPAL INVESTIGATOR

• yaoguo zhang, master

  First Hospital of China Medical University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 12 Months
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: August 17, 2016
• First Posted: August 25, 2016
• Study Start: September 1, 2016
• Primary Completion: March 1, 2019
• Study Completion: May 1, 2020
• Last Updated: March 4, 2019

Record last verified: 2019-03

Data Sharing

• IPD Sharing: Will share

Locations

CN (1)