Title

Herbal Preparation Used as Adjuvant Therapy on Diabetic Ulcers
An Evidence Base Study on the Clinical Effects of Integrated Western Medicine and Traditional Chinese Medicine for Diabetic Foot Ulcer Treatment
Chronic foot ulcers occurring among diabetic patients are difficult to heal. The frequent elderly age with co-morbidities, vascular insufficiencies, peripheral neuropathies and super imposed infections, all contribute towards the chronicity and failure of treatment. Preserving the ulcerated limb is the patients' wish. On the other hand, an infected ulcer that never heals just unnecessarily prolongs suffering. Nevertheless, patients earnestly like to try all methods of healing before accepting amputation.

Objective:To determine whether a course of herbal preparation used as an adjuvant therapy for diabetic patients suffering from chronic foot ulcers may promote healing so that major leg amputation can be avoided.
Study Started
Nov 30
2000
Primary Completion
Mar 31
2006
Study Completion
Mar 31
2006
Results Posted
Jul 01
2010
Estimate
Last Update
Jul 13
2010
Estimate

Drug TCM

The Decoction is taken orally, twice a day, treatment period is 24 weeks The herbal formulation or a placebo was given as an adjuvant therapy for the treatment of the unhealing ulcers in these diabetic patients. The formula consisted of 12 herbs, viz: Radix astragali, Rhizoma atractylodis marcocephalae, Radix stephaniae tetrandrae, Radix polygoni multiflori, Radix rehmanniae, Radix smilax china, Fructus corni, Rhizoma dioscoreae, Cortex moutan, Rhizoma alismatis, Rhizoma smilacis glabrae, and Fructus schisandrae

Drug Placebo

Placebo taking orally, twice a day, 24 week treatment period The herbal formulation or a placebo was given as an adjuvant therapy for the treatment of the unhealing ulcers in these diabetic patients. The placebo was made with starch and colouring materials.

Traditional Chinese Medicine Active Comparator

12 herbals formulation was given as an adjuvant therapy for the patients orally twice a day.

Placebo Placebo Comparator

Placebo was made with starch and colouring materials. Given to patient orally twice a day

Criteria

Inclusion Criteria:

Well Controlled diabetic state
Presence of gangrene or non-healing ulcer in diabetic patients over the foot or feet. Infection should be well controlled.
Good glycaemic control

Exclusion Criteria:

Pregnant women and women at risk of conception
Patients taking digitalis glycosides
Patients with abnormal liver function tests
Patients with plasma creatinine great then 150 umol/l or unstable renal function
Poorly controlled Diabetes Mellitus
Uncontrolled infection
History of adverse reaction to herbal medicine
Unstable medical conditions
Non-compliance with regime

Summary

Traditional Chinese Medicine

Placebo

All Events

Event Type Organ System Event Term

Number of Participants With Limb Salvage

The number of successful limb rescued (without amputation).

Traditional Chinese Medicine

37.0
Participants

Placebo

31.0
Participants

Tumour Necrosis Factor-alpha Levels in Serum

The state of inflammation at baseline and at 4 weeks after treatment. TNF-alpha are in value of serum level.

Traditional Chinese Medicine

Baseline

48.0
pg/mL (Mean)
Standard Deviation: 116

Week 4

28.0
pg/mL (Mean)
Standard Deviation: 62

Placebo

Baseline

44.0
pg/mL (Mean)
Standard Deviation: 83

Week 4

39.0
pg/mL (Mean)
Standard Deviation: 64

Time of Ulcer Healing

Time taken for maturation of granulation to enable skin grafting.

Traditional Chinese Medicine

5.9
Weeks (Mean)
Standard Deviation: 1.4

Placebo

9.2
Weeks (Mean)
Standard Deviation: 1.9

Total

80
Participants

Age Continuous

67.4
years (Mean)
Standard Deviation: 11.8

Region of Enrollment

Sex: Female, Male

Overall Study

Traditional Chinese Medicine

Placebo

Drop/Withdrawal Reasons

Traditional Chinese Medicine

Placebo