通心益脑方治疗老年冠心病轻度认知障碍的多中心、随机、 双盲、平行对照临床研究

注册号:

Registration number:

ITMCTR2024000125

最近更新日期:

Date of Last Refreshed on:

2024-07-16

注册时间:

Date of Registration:

2024-07-16

注册号状态:

Registration Status:

预注册

Prospective registration

注册题目:

通心益脑方治疗老年冠心病轻度认知障碍的多中心、随机、 双盲、平行对照临床研究

Public title:

Tongxin Yinao granules for mild cognitive impairment in elderly with coronary heart disease: study protocol for a multicenter, randomized, double-blind, placebo-controlled trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

通心益脑方治疗老年冠心病轻度认知障碍的多中心、随机、 双盲、平行对照临床研究

Scientific title:

Tongxin Yinao granules for mild cognitive impairment in elderly with coronary heart disease: study protocol for a multicenter, randomized, double-blind, placebo-controlled trial

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:

惠稼祺

研究负责人:

徐凤芹

Applicant:

Jiaqi Hui

Study leader:

Fengqin Xu

申请注册联系人电话:

Applicant telephone:

19800359897

研究负责人电话:

Study leader's telephone:

18800021979

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:

huijiaqi77@163.com

研究负责人电子邮件:

Study leader's E-mail:

doctorxu@aliyun.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:

北京市海淀区西苑操场1号

研究负责人通讯地址:

北京市海淀区西苑操场1号

Applicant address:

No. 1 Xiyuan Playground, Haidian District, Beijing

Study leader's address:

No. 1 Xiyuan Playground, Haidian District, Beijing

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

中国中医科学院西苑医院

Applicant's institution:

Xiyuan Hospital, China Academy of Chinese Medical Sciences

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:

2024XLA074-2

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:

中国中医科学院西苑医院医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee, Xiyuan Hospital, China Academy of Traditional Chinese Medicine, China

伦理委员会批准日期:

Date of approved by ethic committee:

2024/6/20 0:00:00

伦理委员会联系人:

贾敏

Contact Name of the ethic committee:

Min Jia

伦理委员会联系地址:

北京市海淀区西苑操场1号

Contact Address of the ethic committee:

No. 1 Xiyuan Playground, Haidian District, Beijing

伦理委员会联系人电话:

Contact phone of the ethic committee:

010-62835650

伦理委员会联系人邮箱:

Contact email of the ethic committee:

xyyirb@163.com

研究实施负责(组长)单位:

中国中医科学院西苑医院

Primary sponsor:

Xiyuan Hospital, China Academy of Chinese Medical Sciences

研究实施负责(组长)单位地址:

北京市海淀区西苑操场1号

Primary sponsor's address:

No. 1 Xiyuan Playground, Haidian 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

市(区县):

Country:

China

Province:

Beijing

City:

单位(医院):

中国中医科学院西苑医院

具体地址:

北京市海淀区西苑操场1号

Institution
hospital:

Xiyuan Hospital, China Academy of Chinese Medical Sciences

Address:

No. 1 Xiyuan Playground, Haidian District, Beijing

经费或物资来源:

中国中医科学院西苑医院中医药临床循证证据提升专项(揭榜挂帅项目XYZX0204-04)

Source(s) of funding:

Special Project on Enhancement of Clinical Evidence-Based Evidence in Traditional Chinese Medicine at Xiyuan Hospital, China Academy of Traditional Chinese Medicine (Project XYZX0204-04 of Unveiling the List of Commanding Officers)

研究疾病:

老年冠心病轻度认知障碍

研究疾病代码:

Target disease:

Mild cognitive impairment in elderly with coronary heart disease

Target disease code:

研究类型:

Study type:

干预性研究

Interventional study

研究设计:

Study design:

随机平行对照

randomized controlled trial(parallel group design)

研究所处阶段:

Study phase:

探索性研究/预试验

Pilot clinical trial

研究目的:

老年冠心病轻度认知功能障碍是老年共病中常见且重要的疾病群,轻度认知障碍一方面会逐步发展为痴呆,对老年人健康造成严重的影响,另一方面,合并轻度认知障碍的冠心病患者发生心血管事件风险也会增加。因此,积极探索老年冠心病合并轻度认知功能障碍患者的防治不仅能减缓共病中轻度认知障碍向痴呆的转化,同时能够降低老年冠心病患者的心血管事件发生率以及死亡率。然而,目前国内外缺乏老年冠心病合并轻度认知功能障碍的高质量循证研究,以及尚未提出有效的防治策略。基于“心脑同治”理论,以心血管衰老和脑血管衰老的防治为切入点,针对危害老年人群的心脑重大疑难共病,开展徐凤芹教授临证经验方的多中心随机平行对照试验,获得高质量临床循证证据,探索老年冠心病轻度认知功能障碍的防治策略及其科学内涵能够为我国老年人共病防治研究提供思路和方向。

Objectives of Study:

Mild cognitive impairment in elderly coronary heart disease (CHD) is a common and important disease group in the co-morbidities of the elderly. On the one hand, mild cognitive impairment will gradually develop into dementia, which will have a serious impact on the health of the elderly, and on the other hand, the risk of cardiovascular events will be increased in CHD patients with combined mild cognitive impairment. Therefore, actively exploring the prevention and treatment of elderly patients with coronary heart disease combined with mild cognitive dysfunction can not only slow down the transformation of mild cognitive impairment to dementia in co-morbidities, but also reduce the incidence of cardiovascular events as well as the mortality rate of elderly patients with coronary heart disease. However, there is a lack of high-quality evidence-based studies on mild cognitive impairment in elderly patients with CHD and effective prevention and treatment strategies have not yet been proposed. Based on the theory of "treating the heart and brain at the same time", taking the prevention and treatment of cardiovascular aging and cerebrovascular aging as the entry point, and targeting the major difficult cardiovascular and cerebrovascular co-morbidities endangering the elderly, we conducted a multi-center randomized, parallel-controlled trial of Prof. Xu Fengqin's empirical prescription to obtain high-quality clinical evidence and to explore the prevention and treatment strategy of mild cognitive dysfunction in elderly coronary heart disease. The study will explore the prevention and treatment strategy of mild cognitive dysfunction in elderly coronary heart disease and its scientific connotation, which can provide ideas and directions for the research on the prevention and treatment of co-morbidities in elderly people in China.

药物成份或治疗方案详述:

Description for medicine or protocol of treatment in detail:

纳入标准:

(1) 符合2023 AHA/ACC/ACCP/ASPC/NLA/PCNA慢性冠状动脉疾病患者管理指南:美国心脏协会/美国心脏病学会临床实践指南联合委员会的报告中冠心病的诊断标准[17];轻度认知功能障碍诊断标准:参考中国2018年《中国痴呆与认知障碍诊治指南》:轻度认知障碍的诊断与治疗[18]诊断标准:①Moca评分18~25分;②临床痴呆评定量表(CDR)得分为 0 或 0.5 分;参照《中药新药临床研究指导原则》[19]及肾虚血瘀证诊断标准[20],拟定老年冠心病MCI肾虚血瘀证中医证候诊断标准。 (2) 年龄≥65岁且≤80岁,性别不限; (3) 符合肾虚血瘀证辨证标准; (4) 视觉及听觉分辨力相对完好,能够配合完成相关测评; (5) 同意参加研究,患者本人签署知情同意书; (6) 未参加其他临床试验者。

Inclusion criteria

(1) Meet the diagnostic criteria for coronary artery disease in the 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guidelines for the Management of Patients with Chronic Coronary Artery Disease: a report of the Joint American Heart Association/American College of Cardiology Clinical Practice Guidelines Committee; (2) Meet the diagnostic criteria for mild cognitive impairment: refer to China's 2018 Chinese Guidelines for the Diagnosis and Treatment of Dementia and Cognitive Impairment: Diagnostic Criteria for the Diagnosis and Treatment of Mild Cognitive Impairment; (3) To formulate the diagnostic criteria for TCM symptoms of elderly coronary heart disease MCI with renal deficiency and blood stasis with reference to the "Guidelines for Clinical Research of New Chinese Medicines" and the diagnostic criteria for renal deficiency and blood stasis, and to meet the diagnostic criteria for renal deficiency and blood stasis; (2) Age ≥65 and ≤80 years old, gender is not limited; (3) Visual and auditory discrimination is relatively intact, and they are able to cooperate in completing the relevant assessments; (4) Agree to participate in the study and sign the informed consent form; (5) Not participating in other clinical trials.

排除标准:

(1) 诊断为 DSM-IV 痴呆诊断标准的各种原因痴呆,包括 AD、VaD,或其他类型痴呆,如帕金森病、亨廷顿病、正常压力脑积水 脑肿瘤、进行性核上性麻痹、癫痫、慢性硬膜下血肿及多发性硬化,有严重头外伤史伴持续神经功能缺损或已知的脑结构异常。 (2) 既往精神异常、先前 5 年内有药物或酒精滥用或依赖者。 (3) 试验前1个月内服用具有补肾益精作用的中药、抗胆碱药、抗惊厥药、抗帕金森药、兴奋性药、胆碱能药、抗精神病药,如服用多奈哌齐、卡巴拉汀、加兰他敏、石杉碱甲的患者。 (4) 严重肝肾功能不全者,如 ALT 或 AST 在正常值 1.5 倍以上,或血清 Cr 正常值上限以上,凝血功能障碍等预计不能完成试验患者。 (5) 曾对试验用药过敏者、服药不耐受者。

Exclusion criteria:

(1) Dementia of all causes with a diagnosis of DSM-IV diagnostic criteria for dementia, a history of severe head trauma with persistent neurologic deficits or known structural brain abnormalities; (2) A history of psychiatric abnormalities, drug or alcohol abuse or dependence within the prior 5 years; (3) Patients taking Chinese herbal medicines with tonic effects, anticholinergics, anticonvulsants, antiparkinsonian, excitatory, cholinergic, antipsychotics, such as donepezil, carboplatin, galantamine, and strychnine A, within 1 month prior to the trial; (4) Patients with severe hepatic or renal insufficiency, e.g., ALT or AST more than 1.5 times the normal value, or blood creatinine or urea nitrogen more than 1.2 times the normal value range, creatinine clearance CrCl <60 mL/min, coagulation dysfunction, etc. Patients who are expected to be unable to complete the test; (5) Patients who have been allergic to the test medication or intolerant to taking medication.

研究实施时间:

Study execute time:

From 2024-08-16

To      2025-10-01

征募观察对象时间:

Recruiting time:

From 2024-08-01

To      2024-08-15

干预措施:

Interventions:

组别:

试验组

样本量:

118

Group:

The treatment group

Sample size:

干预措施:

通心益脑颗粒+常规西医治疗

干预措施代码:

Intervention:

Tongxin Yinao granules+ conventional Western medicine treatment

Intervention code:

组别:

对照组

样本量:

118

Group:

The control group

Sample size:

干预措施:

通心益脑颗粒安慰剂+常规西医治疗

干预措施代码:

Intervention:

Tongxin Yinao granules placebo + conventional Western medicine treatment

Intervention code:

样本总量 Total sample size : 236

研究实施地点:

Countries of recruitment
and research settings:

国家:

中国

省(直辖市):

北京市

市(区县):

Country:

China

Province:

Beijing

City:

单位(医院):

中国中医科学院西苑医院

单位级别:

三甲医院

Institution/hospital:

Xiyuan Hospital, China Academy of Chinese Medical Sciences

Level of the institution:

Tertiary A hospital

国家:

中国

省(直辖市):

北京市

市(区县):

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:

三甲医院

Institution/hospital:

Dongzhimen Hospital of Beijing University of Chinese Medicine

Level of the institution:

Tertiary A hospital

国家:

中国

省(直辖市):

北京市

市(区县):

Country:

China

Province:

Beijing

City:

单位(医院):

首都医科大学附属北京中医医院

单位级别:

三甲医院

Institution/hospital:

Beijing Hospital of Traditional Chinese Medicine, Capital Medical University

Level of the institution:

Tertiary A hospital

测量指标:

Outcomes:

指标中文名:

中性粒细胞/淋巴细胞比值

指标类型:

次要指标

Outcome:

NLR

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

不良事件

指标类型:

副作用指标

Outcome:

Adverse events

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

颈动脉内-中膜厚度

指标类型:

次要指标

Outcome:

cIMT

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

成纤维细胞生长因子21

指标类型:

次要指标

Outcome:

FGF-21

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

西雅图心绞痛量表

指标类型:

主要指标

Outcome:

Seattle Angina Questionnaire

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

蒙特利尔认知评估量表(MoCA)评分

指标类型:

主要指标

Outcome:

Montreal Cognitive Assessment score

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

血清中腓骨蛋白-1

指标类型:

次要指标

Outcome:

Fibulin-1

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

中医证候积分

指标类型:

次要指标

Outcome:

TCM syndrome score

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

实验室检验指标

指标类型:

副作用指标

Outcome:

Laboratory test indicators

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

踝肱指数

指标类型:

次要指标

Outcome:

ABI

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

肱踝脉搏波传播速度

指标类型:

次要指标

Outcome:

baPWV

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

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:

征募研究对象情况:

尚未开始

Not yet recruiting

年龄范围:

最小 65
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):

由生物统计学家,在微机上采用SAS9.3统计软件,试验组与对照组按1:1的比例用随机化方法产生随机编码,所选择的区组(block)长度和随机初值种子参数等作为保密数据一起密封在盲底中。根据此随机数由与本试验无关的人员对药品进行编码,各临床研究中心按分配的药物编号、按病例入选次序依次使用。

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

By a biostatistician, using SAS 9.3 statistical software on a microcomputer, the test and control groups were randomized in a 1:1 ratio using a randomization method to generate a random code, and the selected block lengths (blocks) and random initial seed parameters were sealed together in a blind bottom as confidential data. Based on this random number the drugs were coded by a person not associated with this trial, and each clinical research center used the drugs according to the assigned drug number and in the order of case enrollment.

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):

2027年12月30日中国中医药心血管病真实世界数据库https://xz.cscps.com.cn/wms/#/user/login

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

Real World Database on Cardiovascular Disease in Chinese Medicine, December 30, 2027 https://xz.cscps.com.cn/wms/#/user/login

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:

数据采集和管理由两部分组成,病例记录表(Case Record Form, CRF)和电子采集和管理系统(Electronic Data Capture, EDC)

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

Data capture and management consists of two components, the Case Record Form (CRF) and the Electronic Data Capture (EDC) system.

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):

国际传统医学临床试验注册平台 京ICP备07032215号-5 提示:推荐使用IE8.0以上版本 宽屏显示分辨率下使用系统