| Objective:Observation of spleen and kidney France efficacy of Chinese medicine combined with megestrol acetate treatment of malignant tumors, and discussion of Chinese medicine in improving the valuein patients with malignant nutritional status and quality of life.Methods:1. Clinical Part:Using a randomized controlled method,60cases exist nutritional disorders in malignant tumor patients were randomly divided into Chinese medicine Jianpi Bushen group plus megestrol acetate group, megestrol acetate group, best supportive care group,20cases in each group of patients. Before and after treatment were observed in the three groups of weight, mid arm circumference, Karnofsky scores, symptom score, adverse reactions and other clinical findings, serum albumin, prealbumin values value the results of laboratory examination.2. Experimental Research:Related indicators by the contrast between normal and tumor-bearing rats, and traditional Chinese medicine intervention in the treatment of tumor-bearing rats to observe the general situation, the tumor inhibition and survival of laboratory tests,and electron microscopy of skeletal muscle morphology, evaluation of traditional Chinese medicine treatment of malignant tumor efficacy, to explore traditional Chinese medicine treatment of cancer and improve the nutritional status of the mechanism of action.Results:1. Clinical Part:Collected60cases, the best support for the treatment group off lost to follow-one cases. Patients were enrolled into three groups no significant differences of gender, age, disease distribution, kps score. Three groups of patients after treatment, clinical and test results:①Three groups of patients with body weight:weight before and after treatment,medicine plus megestrol acetate group A to the progesterone group weight treatment than before treatment to increase, and the difference was significant (P<0.05);best support the treatment group patientsweight loss, and the difference was significant (P<().05);weight overall and pairwise differences between the three groups after treatment, no significant (P>0.05). Efficiency point of view, improving the weight situation, medicine plus megestrol acetate group of20cases of weight gain in total efficiency of95%of the megestrol acetate group, the total efficiency of90%, the best support the treatment group, the total efficiency of47.4%, three group efficacy exist significant differences (P<0.05).②Integrative Medicine group and megestrol acetate group therapy kps score significantly higher(P<0.05),no significant difference between the two groups(P>0.05), the best support group after treatment the kps was significantly decreased (P<0.05). Three treatment methods to improve the physical condition effects:the medicine plus megestrol acetate to improve the physical status of95%efficacy of megestrol acetate to improve the physical condition of the efficacy of95%and best supportive care group to improve the efficacy of physical condition,42.1%,showing that traditional Chinese medicine plus A to progesterone and a simple a to progesterone treatment efficacy was significantly higher than the best supportive care (P<0.05).③Circumference, upper arm in central:traditional Chinese medicine plus A to increase in the progesterone group after treatment than before treatment, but the difference was not significant(P>0.05), increased(P<0.05), A to the progesterone group after treatment than before treatment a significant increase in(P<0.05), the best support for patients treated with the treatment of weight loss, but the difference was significant(P>0.05).④Comparison of spleen deficiency symptoms:After treatment, medicine plus megestrol acetate group and spleen deficiency score the lowest, followed by megestrol acetate group, best support the highest score of the treatment group, and the difference was significant, traditional Chinese medicine and megestrol acetate group and A tospleen deficiency syndrome score in progesterone group after treatment compared to best support the treatment group (P<0.05). Improving spleen deficiency symptoms Efficiency of Integrative Medicine group was90%efficiency of90% of the megestrol acetate group, the best support the treatment group was26.4%, and the difference was significant (P<0.05).⑤Comparison of kidney deficiency symptoms:kidney from the before and after treatment score see Integrative Medicine group and A progesterone group treatment of kidney deficiency syndrome scores were significantly decreased (P<0.05), no significant difference in ratings between the two groups (P>0.05);best supportive care group before and after treatment the difference was not significant (P>0.05). Efficiency of improving the symptoms of kidney deficiency Integrative Medicine group, the total efficiency was95%, megestrol acetate group, the total efficiency of85%, the best supportive treatment group was36.8%, and significant difference(P<0.05).⑥Prealbumin(PA):After treatment, plus megestrol acetate group and megestrol acetate treatment, pre-albumin were significantly higher than the best supportive care group (P <0.05), no significant difference in ratings between the two groups (P>0.05). Before and after treatment, Chinese medicine and megestrol acetate group and the PA value of the megestrol acetate group compared with treatment slightly increased, but the difference was not significant (P>0.05);best supportive treatment, the PA compared with pre-treatment significantly reduced(P<0.05).⑦Albumin (ALB):After treatment, plus megestrol acetate group and the ALB of the megestrol acetate group compared with best supportive care group (P<0.05), no significant differences between the two groups (P>0.05). Megestrol acetate group, and megestrol acetate group ALB value compared with treatment before and after treatment medicine plus slightly increased, but the difference was not significant(P>0.05);best supportive treatment, ALB than before treatment reduced, but the difference There were no significant(P>0.05).⑧Among the three groups after treatment of the lactate dehydrogenase(LDH):LDH was no significant difference (P>0.05). Three groups before and after treatment, the Medicines LDH reduced after treatment, but the difference was not significant(P>0.05); A to pregnantketone group, best support the treatment group, LDH increased, the difference was not significant (P>0.05).⑨Erythrocyte sedimentation rate(ESR):The best support, the ESR values of the treatment group was significantly higher than the traditional Chinese medicine and megestrol acetate group, and megestrol acetate group(P<0.05), Chinese medicine and megestrol acetate group and the megestrol acetate group therapyreduced ESR, but no statistical significance (P>0.05);best support the treatment group, ESR was significantly increased(P<0.05).⑩C-reactive protein(CRP): C-reactive protein (CRP):CRP levels were elevated in the three groups after treatment, elevated CRP levels in traditional Chinese medicine plus megestrol acetate group and the best support the treatment group, P<0.05, the difference was statistically significant; Ato progesterone treatment, elevated CRP levels (P>0.05), no significant difference. After treatment, plus megestrol acetate group compared with best supportive care group (P<0.05) difference was statistically significant; traditional Chinese medicine and megestrol acetate group compared with megestrol acetate group, but P>0.05, no statistical difference significance;CRP of megestrol acetate group compared with best supportive care group low, but P>0.05, the difference is significant. Traditional Chinese medicine plus megestrol acetate group after treatment,15cases (75%) had no adverse reactions, four cases (20%) slightly adverse reactions, the unhandled may continue medication:one cases (5%) to more serious adverse reactions, be improved after symptomatic treatment. A to progesterone treatment in2cases (10%) adverse react ions;9cases (45%) a slight reaction, can continue to use not addressed;9cases (45%) of3adverse reactions were improved after treatment. The best support after treatment in2cases (10.5%) without adverse reaction;12cases(63.2%) a slight reaction, not addressed can continue to use;5cases (26.3%) grade3adverse events were improved after treatment. That spleen and kidney and combined megestrol acetate treatment of more single use of megestrol acetate treatment of cancer is more secure, spleen and kidney and in order to reduce the megestrol adverse reactions occur.2. Experimental Research:①Three groups of mice the gradual emergence of the mental state of deterioration, reduced activity, decreased appetite, weight loss, in line with the performance of the spleen and kidney deficiency syndrome, symptomatic medication to the case of kidney and spleen of proprietary Chinese medicines Shenqi solid.②The mouse mortality:Overall, Chinese medicine and megestrol acetate group of mice the lowest mortality (15%), megestrol acetate group, followed by(21.5%) and the blank group mortality (30%), three The overall mortality rate between the two groups showed no significant difference(P>0.05); mice death Late megestrol acetate group and blank group of mice death rate is rising, the growth rate of the blank group megestrol acetate group, mice in each group daily mortality was no significant difference (P>0.05).③Groups:tumor weight of the megestrol acetate group of tumor weight compared with traditional Chinese medicine plus A to progesterone group therapy group, the difference was statistically significant (P<0.05);Chinese medicine group than in the tumor weight of the blank group difference was not significant (P>0.05).④The inhibition rate:traditional Chinese medicine and megestrol acetate group0.27%,12.49%of the inhibition rate of the megestrol acetate group, blank group-12.74%⑤The traditional Chinese medicine and megestrol acetate groups and the megestrol acetate group to the tumor weight was significantly higher than blank group weight, the difference was significant difference(P<0.05);tumor weight between the treatment groups was no significant difference(P>0.05).⑥Serum albumin:megestrol acetate and control groups in serum ALB significantly compared with traditional Chinese medicine plus A to progesterone group (P<0.05);blank group ALB compared with megestrol acetate group is slightly higher, but the difference between the two groups There was no significant (P>0.05).⑦Liver function:three groups of tumor-bearing mice of AST, ALT, no significant differences in traditional Chinese medicine and megestrol acetate, megestrol acetate on liver function and the blank group was no significant difference between two groups of treatment programs for The liver function of tumor-bearing mice had no significant effect. No difference in liver function, Chinese medicine and megestrol group of mice with low protein, suggesting low reorganization of the mouse protein has nothing to do with liver function.⑧Three groups of serum lactate dehydrogenase:traditional Chinese medicine plus megestrol acetate group LDH minimum, megestrol acetate group, followed by a blank group, but the LDH significant difference among the three groups.Conclusion:1. Clinical Studies:Effect of Shenqi Guben decoction combined with megestrol acetate and megestrol acetate can increase the pure tumor patient weight, alleviate the clinical symptoms, improve the life quality of the patients, combining traditional Chinese and Western medicine treatment in improving the quality of life, reduce the spleen and kidney deficiency symptoms on curative effect of megestrol acetate. Tumor shows the nutritional status and related traditional Chinese medicine due to deficiency of spleen, strengthening the spleen and invigorating the kidney can increase the tumor nutrition curative effect, reduce ADRs, to further increase the tumor patients with antitumor therapy.2. Experimental Research:In tumor-bearing mice later appeared in spleen and kidney deficiency symptoms and signs of malnutrition, Jianpi Bushen herb can improve the tumor-bearing mice spleen and kidney deficiency, may reduce mortality in tumor bearing mice. Invigorating spleen and Tonifying Kidney plus megestrol acetate, megestrol acetate may stabilize the tumor body, improve the tumor-bearing mice body weight; traditional Chinese medicine of invigorating spleen and kidney combined with megestrol acetate can improve the tumor-bearing mice serum albumin, may improve megestrol improving on mice weight based on the increase in tumor-bearing mice to malignancy malnutrition tolerance.
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