晚期胃癌、结直肠癌新加良附健脾益气合方维持治疗的临床与机制研究

注册号:

Registration number:

ITMCTR2025000853

最近更新日期:

Date of Last Refreshed on:

2025-04-27

注册时间:

Date of Registration:

2025-04-27

注册号状态:

Registration Status:

补注册

Retrospective registration

注册题目:

晚期胃癌、结直肠癌新加良附健脾益气合方维持治疗的临床与机制研究

Public title:

Clinical and mechanism study on maintenance treatment of advanced gastric cancer and colorectal cancer with Xinjialiang Fujianpi Yiqihe prescription

注册题目简写:

English Acronym:

研究课题的正式科学名称:

晚期胃癌、结直肠癌新加良附健脾益气合方维持治疗的临床与机制研究

Scientific title:

Clinical and mechanism study on maintenance treatment of advanced gastric cancer and colorectal cancer with Xinjialiang Fujianpi Yiqihe prescription

研究课题的正式科学名称简写:

Scientific title acronym:

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

韩欣璞

研究负责人:

侯丽

Applicant:

Xinpu Han

Study leader:

Li Hou

申请注册联系人电话:

Applicant telephone:

18329703725

研究负责人电话:

Study leader's telephone:

13488695608

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

A18329703725@163.com

研究负责人电子邮件:

Study leader's E-mail:

houli1203@126.com

申请单位网址(自愿提供):

Study leader's website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website
(voluntary supply):

申请注册联系人通讯地址:

北京市朝阳区北三环东路11号北京中医药大学

研究负责人通讯地址:

北京市东城区海运仓5号

Applicant address:

Beijing University of Chinese Medicine No.11 North Third Ring East Road Chaoyang District Beijing

Study leader's address:

No.5 Ocean Freight Warehouse Dongcheng District Beijing

申请注册联系人邮政编码:

Applicant postcode:

100029

研究负责人邮政编码:

Study leader's postcode:

100700

申请人所在单位:

北京中医药大学

Applicant's institution:

Beijing University of Chinese Medicine

是否获伦理委员会批准:

Approved by ethic committee:

伦理委员会批件文号:

Approved No. of ethic committee:

2024DZMEC-496-02

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件

批准本研究的伦理委员会名称:

北京中医药大学东直门医院伦理委员会

Name of the ethic committee:

Ethics Committee of Dongzhimen Hospital Beijing University of Chinese Medicine

伦理委员会批准日期:

Date of approved by ethic committee:

2024/11/10 0:00:00

伦理委员会联系人:

韩雪婷

Contact Name of the ethic committee:

Xueting Han

伦理委员会联系地址:

北京市东城区海运仓5号

Contact Address of the ethic committee:

No.5 Ocean Freight Warehouse Dongcheng District Beijing

伦理委员会联系人电话:

Contact phone of the ethic committee:

010-84012709

伦理委员会联系人邮箱:

Contact email of the ethic committee:

dzmyyec@126.com

研究实施负责(组长)单位:

北京中医药大学东直门医院

Primary sponsor:

Dongzhimen Hospital Beijing University of Chinese Medicine

研究实施负责(组长)单位地址:

北京市东城区海运仓5号

Primary sponsor's address:

No.5 Ocean Freight Warehouse Dongcheng District Beijing

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

北京

市(区县):

Country:

China

Province:

Beijing

City:

单位(医院):

北京中医药大学东直门医院

具体地址:

北京市东城区海运仓5号

Institution
hospital:

Dongzhimen Hospital Beijing University of Chinese Medicine

Address:

No.5 Ocean Freight Warehouse Dongcheng District Beijing

经费或物资来源:

北京市财政经费及东直门医院匹配经费

Source(s) of funding:

Beijing Municipal Financial Funds and Matching Funds for Dongzhimen Hospital

研究疾病:

胃癌、结直肠癌

研究疾病代码:

Target disease:

gastric cancer colorectal cancer

Target disease code:

研究类型:

Study type:

干预性研究

Interventional study

研究设计:

Study design:

非随机对照试验

Non randomized control

研究所处阶段:

Study phase:

探索性研究/预试验

Pilot clinical trial

研究目的:

2020 年结直肠癌和胃癌的发病率分别位居我国第 2 和第 3 位,死亡率位居第 3 和第 5 位。超过 50%的胃癌、结直肠癌确诊时已处于晚期,严重威胁人民健康。晚期恶性肿瘤标准化疗后维持治疗阶段对延长患者的无进展生存期和总生存期具有重要意义。应用低毒、有效的抗肿瘤药物对经标准治疗后疾病得以控制的晚期恶性肿瘤实施维持治疗可延长患者生存期。目前,现代医学在胃癌、结直肠癌维持治疗阶段是否用药以及如何用药尚无共识,具有抗肿瘤、提高免疫效应的中医药在恶性肿瘤维持治疗阶段展现出重要的应用前景。 团队前期研究证实新加良附方、健脾益气方具有明确的抗肿瘤、提高免疫的效应。因此,本研究结合晚期胃癌、结直肠癌临床特点,拟应用新加良附健脾益气合方进一步聚焦晚期胃癌、结直肠癌维持治疗阶段,在中医药“异病同治”思想的辨证论治体系指导下,针对晚期胃癌、结直肠癌维持阶段“脾胃虚寒、气滞血瘀证”患者,开展多中心、非随机、同期对照临床研究,明确中医药维持治疗晚期胃癌、结直肠癌的有效性和安全性,并从炎症、免疫、代谢及转录层面探索潜在机制,解析中医药优势富集人群特征,为中医药维持治疗晚期胃癌、结直肠癌的临床价值和“异病同治”的辨证论治思想提供高级别证据,形成并优化中西医结合诊疗方案。

Objectives of Study:

In 2020 the incidence of colorectal cancer and stomach cancer ranked second and third in China respectively and the mortality rate ranked third and fifth. More than 50% of gastric cancer and colorectal cancer are diagnosed at an advanced stage posing a serious threat to people's health. Maintenance of treatment phase after standard chemotherapy is of great significance for prolonging progression-free survival and overall survival of patients with advanced malignant tumors. Maintenance therapy with low toxicity and effective antitumor drugs for advanced malignant tumors that can be controlled after standard treatment can prolong the survival of patients. At present there is no consensus on whether and how to use medicine in the maintenance treatment stage of gastric cancer and colorectal cancer in modern medicine. Traditional Chinese medicine which has anti-tumor and improved immune effect has shown important application prospects in the maintenance treatment stage of malignant tumors. The team's previous studies have confirmed that Xinjialiang Fu prescription and Jianpi Yiqi prescription have clear anti-tumor and immune-enhancing effects. Therefore combined with the clinical characteristics of advanced gastric cancer and colorectal cancer this study intends to apply Xinjialiang Fujianpiyiqi He formula to further focus on the maintenance treatment stage of advanced gastric cancer and colorectal cancer. Under the guidance of the syndrome differentiation and treatment system of TCM "treating different diseases with the same treatment" it aims to target patients with "spleen and stomach deficiency cold qi stagnation and blood stasis syndrome" at the maintenance stage of advanced gastric cancer and colorectal cancer. Conduct multi-center non-randomized concurrent controlled clinical studies to clarify the effectiveness and safety of TCM maintenance in the treatment of advanced gastric and colorectal cancer explore the potential mechanisms from the aspects of inflammation immunity metabolism and transcription and analyze the characteristics of the population enriched by TCM advantages. To provide high-level evidence of the clinical value of TCM in maintaining the treatment of advanced gastric cancer and colorectal cancer and the idea of syndrome differentiation and treatment of different diseases and to form and optimize the diagnosis and treatment plan of integrated Chinese and Western medicine.

药物成份或治疗方案详述:

Description for medicine or protocol of treatment in detail:

纳入标准:

试验组:①符合晚期胃癌、结直肠癌西医诊断标准;②符合中医“脾胃虚寒、气滞血瘀”辨证标准;③患者已完成诱导阶段治疗,疗效评价为完全缓解(Complete response,CR)、部分缓解(Partial response,PR)或疾病稳定(Stable disease,SD),即将进入维持治疗阶段,不耐受或不接受西药维持治疗,包含西药维持治疗 1 或 2 周期中断的患者;④年龄在 18 岁至 80 岁之间,男女均可;⑤预计生存期在 6 个月以上;⑥卡氏评分≥60 分;⑦未参加以临床疗效为观察目的的其他临床实践; ⑧受试者本人知情同意,并自愿签署知情同意书。 对照组:①符合晚期胃癌、结直肠癌西医诊断标准;②患者已完成诱导阶段治疗,疗效评价为 CR、PR 或 SD,即将进入维持治疗阶段,能耐受且接受卡培他滨或替吉奥维持治疗;③年龄在 18 岁至 80 岁之间,男女均可;④预计生存期在 6 个月以上;⑤卡氏评分≥60 分;⑥未参加以临床疗效为观察目的的其他临床实践;⑦受试者本人知情同意,并自愿签署知情同意书。注:对照组维持治疗 1 或 2 周期中断的患者可以转入试验组。 健康受试者:①既往无慢性疾病,血、尿、便常规、血生化、体格检查、心电图等检查无异常;②年龄在 18 岁至 80 岁之间,男女均可;③受试者本人知情同意,并自愿签署知情同意书。

Inclusion criteria

Experimental group: ① In line with the western diagnostic criteria for advanced gastric cancer and colorectal cancer; (2) In line with TCM "spleen and stomach deficiency cold qi stagnation and blood stasis" syndrome differentiation standard; (3) The patient has completed the induction phase of treatment and the efficacy is evaluated as Complete response (CR) Partial response (PR) or Stable disease (SD) and is about to enter the maintenance treatment stage and is intolerant or does not accept Western drug maintenance treatment. Include patients with 1 or 2 interrupted cycles of western drug maintenance therapy; Age between 18 and 80 years old male and female; (5) The expected survival time is more than 6 months; ⑥ Kastler score ≥60 points; (7) Did not participate in other clinical practices for the purpose of clinical efficacy observation; ⑧ The subject gives informed consent and signs the informed consent voluntarily. Control group: ① It met the western diagnostic criteria for advanced gastric cancer and colorectal cancer; ② The patient had completed the induction phase of therapy the efficacy was evaluated as CR PR or SD and was about to enter the maintenance phase of therapy and could tolerate and receive capecitabine or Tegorgone maintenance therapy; Age between 18 and 80 years old male and female; ④ The expected survival time is more than 6 months; ⑤ Kastler score ≥60 points; ⑥ did not participate in other clinical practices for the purpose of clinical efficacy observation; ⑦ The subject gives informed consent and signs the informed consent voluntarily. Note: Patients in the control group who maintained 1 or 2 cycles of treatment interruption could be transferred to the trial group. Healthy subjects: ① No chronic diseases in the past no abnormal blood urine stool routine blood biochemistry physical examination electrocardiogram and other examinations; ② Between the ages of 18 and 80 both male and female; ③ The subject gives informed consent and signs the informed consent voluntarily.

排除标准:

①同时合并有原发心、脑、肝、肾和造血系统疾病,或有严重的肿瘤并发症与合并症者;②正在参加以临床疗效为评价目的的其他临床实践;③妊娠、哺乳期妇女;④过敏体质或已知对处方中某些药物过敏者;⑤存在精神系统疾病或认知功能障碍;⑥不能按时用药或依从性差或不能坚持随访者;⑦合并其他原发恶性肿瘤。

Exclusion criteria:

① Patients with primary heart brain liver kidney and hematopoietic diseases or with serious tumor complications and complications; ② Participating in other clinical practices for the purpose of evaluating clinical efficacy; Pregnant and lactating women; (4) People who are allergic or known to be allergic to certain drugs prescribed; ⑤ There is a mental system disease or cognitive dysfunction; ⑥ Can not take medication on time or poor compliance or can not adhere to the interviewer; ⑦ Other primary malignant tumors.

研究实施时间:

Study execute time:

From 2024-07-01

To      2026-12-30

征募观察对象时间:

Recruiting time:

From 2024-11-15

To      2025-11-08

干预措施:

Interventions:

组别:

健康受试者组

样本量:

10

Group:

Healthy subject group

Sample size:

干预措施:

干预措施代码:

Intervention:

None

Intervention code:

组别:

试验组

样本量:

84

Group:

Experimental group

Sample size:

干预措施:

给予新加良附健脾益气合方颗粒剂

干预措施代码:

Intervention:

Give Xinjialiang Fujianpi Yiqihe prescription Granules

Intervention code:

组别:

对照组

样本量:

84

Group:

Control group

Sample size:

干预措施:

给予卡培他滨或替吉奥口服

干预措施代码:

Intervention:

Capecitabine or tigio are given orally

Intervention code:

样本总量 Total sample size : 178

研究实施地点:

Countries of recruitment
and research settings:

国家:

中国

省(直辖市):

福建省

市(区县):

厦门市

Country:

China

Province:

Fujian Province

City:

Xiamen City

单位(医院):

北京中医药大学东直门医院厦门医院

单位级别:

二级单位

Institution/hospital:

Xiamen Hospital Dongzhimen Hospital Beijing University of Chinese Medicine

Level of the institution:

Secondary units

国家:

中国

省(直辖市):

北京市

市(区县):

东城区

Country:

China

Province:

Beijing

City:

单位(医院):

北京中医药大学东直门医院

单位级别:

二级单位

Institution/hospital:

Dongzhimen Hospital, Beijing University of Chinese Medicine

Level of the institution:

Secondary units

国家:

中国

省(直辖市):

北京市

市(区县):

海淀区

Country:

China

Province:

Beijing

City:

Haidian District

单位(医院):

首都医科大学附属北京世纪坛医院

单位级别:

二级单位

Institution/hospital:

Beijing Shijitan Hospital affiliated to Capital Medical University

Level of the institution:

Secondary units

国家:

中国

省(直辖市):

北京市

市(区县):

西城区

Country:

China

Province:

Beijing

City:

Xicheng District

单位(医院):

首都医科大学附属北京友谊医院

单位级别:

二级单位

Institution/hospital:

Beijing Friendship HospitalCapital Medical University

Level of the institution:

Secondary units

测量指标:

Outcomes:

指标中文名:

症状评估量表

指标类型:

次要指标

Outcome:

Symptom assessment scale

Type:

Secondary indicator

测量时间点:

在入组时前 3 日内和入组后干预 2 个治疗周期(42 天)结束时前后 3 天内

测量方法:

通过MD 安德森症状量表进行打分

Measure time point of outcome:

Within the first 3 days at the time of enrollment and within 3 days before and after the end of 2 treatment cycles (42 days) of intervention after enrollment

Measure method:

Scored by the MD Anderson Symptom Scale

指标中文名:

简易疲乏量表

指标类型:

次要指标

Outcome:

Simple fatigue scale

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

疾病控制率

指标类型:

主要指标

Outcome:

Disease control rate

Type:

Primary indicator

测量时间点:

在入组时前 3 日内和入组后干预 2 个治疗周期(42 天)结束时前后 3 天内

测量方法:

根据病人情况计算

Measure time point of outcome:

Within the first 3 days at the time of enrollment and within 3 days before and after the end of 2 treatment cycles (42 days) of intervention after enrollment

Measure method:

Calculated according to the patient's condition

指标中文名:

细胞因子

指标类型:

次要指标

Outcome:

Cytokines

Type:

Secondary indicator

测量时间点:

在入组时前 3 日内和入组后干预 2 个治疗周期(42 天)结束时前后 3 天内

测量方法:

细胞因子测定

Measure time point of outcome:

Within the first 3 days at the time of enrollment and within 3 days before and after the end of 2 treatment cycles (42 days) of intervention after enrollment

Measure method:

Cytokine assays

指标中文名:

代谢组学变化

指标类型:

次要指标

Outcome:

Metabolomic changes

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

“脾胃虚寒、气滞血瘀证”症状与体征计分

指标类型:

次要指标

Outcome:

The symptoms and signs of "spleen and stomach deficiency and cold qi stagnation and blood stasis syndrome" are scored

Type:

Secondary indicator

测量时间点:

在入组时前 3 日内和入组后干预 2 个治疗周期(42 天)结束时前后 3 天内

测量方法:

通过量表进行打分

Measure time point of outcome:

Within the first 3 days at the time of enrollment and within 3 days before and after the end of 2 treatment cycles (42 days) of intervention after enrollment

Measure method:

Scoring is done by means of a scale

指标中文名:

转录组学变化

指标类型:

次要指标

Outcome:

Transcriptomic changes

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

生活质量问卷

指标类型:

次要指标

Outcome:

Quality of life questionnaire

Type:

Secondary indicator

测量时间点:

在入组时前 3 日内和入组后干预 2 个治疗周期(42 天)结束时前后 3 天内

测量方法:

通过胃癌、结直肠癌患者生活质量问卷进行打分

Measure time point of outcome:

Within the first 3 days at the time of enrollment and within 3 days before and after the end of 2 treatment cycles (42 days) of intervention after enrollment

Measure method:

Scoring was performed by the Quality of Life Questionnaire for Gastric Cancer and Colorectal cancer Patients

指标中文名:

无进展生存期

指标类型:

次要指标

Outcome:

Progression-free survival

Type:

Secondary indicator

测量时间点:

在入组时前 3 日内和入组后干预 2 个治疗周期(42 天)结束时前后 3 天内

测量方法:

根据病人情况计算PFS

Measure time point of outcome:

Within the first 3 days at the time of enrollment and within 3 days before and after the end of 2 treatment cycles (42 days) of intervention after enrollment

Measure method:

PFS is calculated according to the patient's condition

指标中文名:

淋巴细胞亚群计数

指标类型:

次要指标

Outcome:

Lymphocyte subset count

Type:

Secondary indicator

测量时间点:

在入组时前 3 日内和入组后干预 2 个治疗周期(42 天)结束时前后 3 天内

测量方法:

淋巴细胞亚群计数测定

Measure time point of outcome:

Within the first 3 days at the time of enrollment and within 3 days before and after the end of 2 treatment cycles (42 days) of intervention after enrollment

Measure method:

Lymphocyte subset count assay

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

blood

Tissue:

人体标本去向

使用后销毁

说明

Fate of sample 

Destruction after use

Note:

标本中文名:

大便

组织:

Sample Name:

defecate

Tissue:

人体标本去向

使用后销毁

说明

Fate of sample 

Destruction after use

Note:

标本中文名:

尿液

组织:

Sample Name:

Urine

Tissue:

人体标本去向

使用后销毁

说明

Fate of sample 

Destruction after use

Note:

征募研究对象情况:

正在进行

Recruiting

年龄范围:

最小 18
Min age years
最大 80
Max age years

Recruiting status:

Participant age:

性别:

Gender:

男女均可

Both

随机方法(请说明由何人用什么方法产生随机序列):

Randomization Procedure (please state who generates the random number sequence and by what method):

None

盲法:

Blinding:

是否共享原始数据:

IPD sharing:

No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

不共享

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

None

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

数据采集和管理使用为病例记录表(Case Record Form, CRF)

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Data collection and management are used for the Case Record Form (CRF).

数据管理委员会:

Data Managemen Committee:

Yes

研究计划书或研究结果报告发表信息
(杂志名称、期、卷、页,时间;或网址):

Publication information of the protocol/research results report
(name of the journal, volume, issue, pages, time; or website):

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