Professor Bian Zhaoxiang introduces the upcoming clinical study on irritable bowel syndrome at the media briefing


卞兆祥教授於新聞簡介會上,介紹即將開展的腸易激綜合症研究項目

Date: 06 Jun 2016 (Monday)

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HKBU School of Chinese Medicine recruits participants for clinical study on irritable bowel syndrome

浸大計劃招募合資格人士進行腸易激綜合症臨床研究 評估最新國際診斷標準下的中醫證型分佈及治療成效

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders in clinical practice, with about 10 to 20 percent of the world’s population suffering from the disease and in Hong Kong the comorbidity of IBS and other disorders is approximately 7%. IBS patients usually have symptoms of abdominal pain or discomfort associated with a change in stool consistency or frequency. Currently, there are no therapies or drugs with positive efficacy in treating IBS and conventional treatments target the symptoms.

The new ROME IV criteria, the most-up-to-date iteration of the most authoritative diagnostic criteria for functional gastrointestinal disorders, was officially released at Digestive Disease Week 2016 in America last month. With the content comprehensively updated, it is expected to deeply influence the diagnosis and treatment of functional gastrointestinal disorders. In this regard, the Hong Kong Chinese Medicine Clinical Study Centre (CMCS) under the School of Chinese Medicine (SCM) of Hong Kong Baptist University (HKBU) will conduct a clinical study on IBS, recruiting 400 suitable participants. On the basis of the participants’ different symptoms, the research team will classify them into patterns according to Chinese medicine theory and IBS subtypes in accordance with ROME IV criteria to study the distribution of IBS patterns and Chinese Medicine patterns, and compare the difference between ROME III and IV criteria. In addition, the serum, urine and stool samples of the participants will be collected to explore the host-gut microbiota metabolic interactions associated with IBS subtypes.

Professor Bian Zhaoxiang, Director of Clinical Division, SCM, and Director of CMCS, HKBU, said the objective of the research is to identify the core correlation between IBS subtypes, Chinese medicine patterns and host-gut microbiota based on the latest ROME IV criteria, with a view to laying the foundation for future clinical studies on IBS treatments that regulate intestinal microbiota with Chinese medicine.

According to Chinese medicine theory, IBS could be classified into six main patterns based on the foundation of different symptoms. They are spleen deficiency and dampness retention, liver depression and spleen deficiency, yang deficiency of spleen and kidney, dampness-heat of spleen and stomach, stagnation of liver qi, and dryness-heat of intestine. According to the latest ROME IV criteria, IBS could be classified based on predominant stool pattern: IBS with diarrhea, IBS with constipation, mixed IBS and unclassified IBS.

This research will be the largest systematic study on the distribution of IBS subtypes and IBS Chinese medicine patterns to date. It has been demonstrated that host-gut microbiota in IBS patients are significantly different from those found in healthy individuals, however, which types of microbiota are altered is still being hotly debated. Professor Bian hopes that this research could provide the answer.

The team is now recruiting 400 suitable individuals to participate in this study. Persons aged 18-65, and free of significant illnesses but suffered from persistent constipation and diarrhea in the past three months are welcome to join. Participants are required to fill in a few questionnaires and complete laboratory examinations to measure a number of parameters, including serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphate (ALP), 7α-hydroxy-4-cholesten-3-one (C4), fibroblast growth factor (FGF) 19, and bile acids (BAs). Moreover, fecal sampling will be collected to measure intestinal microbiota. No fees will be charged for the evaluation and testing. Participants will be given a brochure containing life cultivation and health preservation knowledge of IBS edited by licensed TCM practitioners and they will also be given priority to participate in the clinical study on IBS treatment with Chinese medicine after the completion of this study. For enquiries and enrollment, please contact Dr Zhong Lidan, Clinical Division of SCM at HKBU (Tel: 3411 2051; Fax: 3411 2929; Email: rct_fgd@hkbu.edu.hk; Website: http://scm.hkbu.edu.hk/ibssurvey).
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腸易激綜合症是臨床上最常見的一種胃腸功能紊亂性疾病,全球有一至兩成人士患有此病,2000年的一項研究指出香港的發病率約為7%。患者會出現腹痛、腹脹伴排便習慣改變(腹瀉或便秘)和糞便性狀異常(稀便、黏液便或便秘)等臨床表現,但此病至今尚未有一種具有肯定療效的治療方法或藥物,醫生多針對患者的症狀施治。

於上月舉行的權威性美國消化疾病周上,大會公佈了功能性胃腸病最新的診斷標準——羅馬Ⅳ標準,新標準將在未來十年深遠影響功能性胃腸病的診斷和治療。有見及此,香港浸會大學中醫藥學院轄下的香港中醫藥臨床研究中心將進行一項腸易激綜合症研究,計劃招募400名合資格人士參加。研究團隊會因應他們的臨床病徵,分別按中醫證型及最新羅馬Ⅳ標準的腸易激綜合症亞型分類,藉此研究腸易激綜合症亞型及中醫證型的分佈規律,同時比較羅馬Ⅳ標準相較羅馬Ⅲ標準的差異。研究人員亦會檢測參加者的血清、尿液和糞便樣本以探索與腸易激綜合症亞型相關的菌群代謝關係。

負責研究的浸大中醫藥學院臨床部主任暨香港中醫藥臨床研究中心主任卞兆祥教授表示,研究目的是為確定基於羅馬Ⅳ標準的腸易激綜合症亞型與中醫證型及腸道菌群三者之間的相關性,為下一步進行的中醫藥治療腸易激綜合症臨床研究奠下基礎,期望能通過中醫藥調節腸道菌群治療腸易激綜合症。

中醫的辨證論治一般會將患者大致分為六個證候,分別為脾虛濕阻、肝鬱脾虛、脾腎陽虛、脾胃濕熱、肝鬱氣滯和腸道燥熱。根據最新的羅馬Ⅳ標準,腸易激綜合症分為四種亞型:腹瀉型、便秘型、混合型和不定型。

今次將是有關腸易激綜合症亞型與中醫證型分佈規律研究中的最大型和最系統化的研究。雖然已有研究揭示了腸易激綜合症病人體內的腸道菌群與健康人士的存在顯著的差異,但究竟是哪一種腸道菌群存在差異,至今仍然眾說紛紜,卞教授期待這項研究能夠為疑團找出答案。

是次研究歡迎年齡介於18至65歲,沒有嚴重疾病,在過去三個月內持續便秘或腹瀉的人士參加,參加者須完成一系列問卷調查和進行多項的檢測,包括穀丙轉氨酶(ALT)、天冬氨酸轉氨酶(AST)、鹼性磷酸酶(ALP)、C4、纖維母細胞生長因數(FGF)、膽汁酸(BAs),以及留取大便樣本以檢測腸道菌群。所有評估及檢測均免費,參加者會獲得養生保健小冊子和註冊中醫師提供養生建議,並可優先參加稍後進行的中醫藥治療腸易激綜合症臨床研究。報名及查詢,請聯絡浸大中醫藥學院臨床部鍾麗丹醫師(電話:3411 2051;傳真:3411 2929;電郵:rct_fgd@hkbu.edu.hk;網頁:http://scm.hkbu.edu.hk/ibssurvey)。
   
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