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Trials

, 14:61

First Online: 28 February 2013Received: 21 August 2012Accepted: 08 February 2013DOI: 10.1186-1745-6215-14-61

Cite this article as: Yan, S., Zhang, R., Zhou, X. et al. Trials 2013 14: 61. doi:10.1186-1745-6215-14-61

Abstract

BackgroundChinese herbal medicine is one of the most popular Chinese medicine CM therapies for primary insomnia. One of the important characteristics of CM is that different Chinese clinicians give different prescriptions even for the same patient. However, there must be some fixed drug patterns in every clinician’s prescriptions. This study aims to screen the effective core drug patterns in primary insomnia treatment of three prestigious Chinese clinicians.

Methods-designA triple-blind, randomized, placebo-controlled, parallel-group clinical trial will be performed. Three clinicians will diagnose and treat every eligible patient individually and independently, producing three prescriptions from three clinicians for every patient. Patients will equally be randomized to one of four groups – medical group A, medical group B, medical group C, or placebo group – and observed for efficacy of treatment. The sample will include primary insomnia patients meeting DSM IV-TR criteria, Spiegel scale score >18, and age 18 to 65 years. A sequential design is employed. Interim analysis will be conducted when between 80 and 160 patients complete the study. The interim study could be stopped and treated as final if a statistically significant difference between treatment and placebo groups can be obtained and core effective drug patterns can be determined. Otherwise, the study continues until the maximum sample size reaches 300. Treatment of the CM group is one of three Chinese clinicians’ prescriptions, who provide independently prescriptions based on their own CM theory and the patient’s disease condition. Assessment will be by sleep diary and Pittsburgh sleep quality index, and CM symptoms and signs will be measured. Primary outcome is total sleep time. Assessment will be carried out at the washout period, weeks 1, 2, 3, and 4 and 4th week after the end of treatment. Effectiveness analysis will be per intent to treat. A multi-dimension association rule and scale-free networks method will be used to explore the effective core drug patterns.

DiscussionThe effective core drug patterns will be found through analyzing several prestigious CM clinicians’ treatment information. Screening the effective core drug patterns from prestigious clinicians can accelerate the development of new CM drugs.

Trial registrationNCT01613183

KeywordsPrimary insomnia Chinese medicine Randomized controlled trial Effective core drug pattern AbbreviationsCMChinese medicine

DSM-IV-TRDiagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision

SASSelf-rating Anxiety Scale

BDIBeck Depression Inventory

TSTtotal sleep time

PSQIPittsburgh Sleep Quality Index

AEAdverse Event

ITTIntent to Treat.

Electronic supplementary materialThe online version of this article doi:10.1186-1745-6215-14-61 contains supplementary material, which is available to authorized users.

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Author: Shiyan Yan - Runshun Zhang - Xuezhong Zhou - Peng Li - Liyun He - Baoyan Liu

Source: https://link.springer.com/







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