| BackgroundCancer anorexia cachexia syndrome, which chiefly manifests anorexia andvery thin, often happen in advanced cancer patients, also with poor prognosis,many patients are dead because the body can not tolerate active therapy. Themechanism of cancer anorexia cachexia syndrome is very complicated, and hasnot been clarified up to now, both of chinese or western medicine are not veryeffective. Go deep into study the mechanism and way in chinese medicine, isan urgent problem that must be solved currently.ObjectivesThe trial was developed to contrast a Chinese herbal medicine powder whichcan nourish the essence of kidney, a progestational agent, or only withnutrition for the treatment of cancer anorexia cachexia syndrome, andultimately will prove the worth of nourishing the essence of kidney for thetreatment of cancer anorexia cachexia syndrome.Patients and MethodsAccording to the criteria established before trial, from Sep. 2006 toMar. 2007, 90 patients suffering from lung, large intestine,liver,gastricand pancreas cancer accompanied with anorexia cachexia syndrome, all came fromGuangdong Provincial TCM Hospital, were randomized to receive either a chineseherbal medicine powder(3g tid), megestrol acetate(160mg) orally every day,or only with nutrition support, and the three group all accept therapy ofdialectic Chinese Traditional Medicine. Patients were observed at a month intervals to evaluate the changes of weight,appetite,serum albumin,hemoglobin,Tcell level,grade of Kamofsky and quality of life,and drugtoxicity, Then analyze all the datas obtained from the research by spss13.0,and to see whether the way of nourishing essence of kidney is valuable or notin cancer anorexia cachexia syndrome therapy.ResultsSign of cachexia:(1)body weight: both rised in the cure group andcomparison group than before therapy(P＜0.01), but has no differences betweenthe two group(P=0.08), falled in the blank group(P＜0.01), and has notabledifferences compared with the two group before (P＜0.01). (2)hemoglobin: bothrised in cure group and comparison group than before therapy(P＜0.01, P=0.004),falled in the blank group(P=0.002), and it has notable differences among thethree groups(P＜0.01). (3)serum albumin: both rised in cure group andcomparison group than before therapy(P＜0.01, P=0.002), falled in the blankgroup(P=0.003), and has notable differences among three groups(P＜0.01).Immune ability: (1)CD3~+cell: both rised in cure group and comparison groupthan before therapy(P＜0.01, P=0.002), falled in the blank group(P＜0.01),and has notable differences among three groups(P＜0.01). (2)CD4~+cell: bothrised in cure group and comparison group than before therapy(P＜0.01, P=0.009),but has no differences between the two groups(P=0.825), and also has nodifferences in blank group than before therapy(P=0.0.282), but has notabledifferences comparedwith the two groups before.(3)CD8~+cell: both rised in curegroup and comparison group than before therapy(P＜0.01, P=0.008), falled inblank group(P=0.001), and has notable differences among three groups(P＜0.01).Quality of life: (1)appetite: obviously improved both in cure group andcomparison group, the effect cases in cure group is 21, which accounts for72.4％, 19 cases in comparison group, accounts for 65.5％, and 11 cases inblank group, accounts only for 40.7％, it has no differences between the cureand comparison group(P=0.079), but has notable differences in the two groupscompared with blank group. (2)Grades of Kamofsky: improved in cure group, which is 20 cases, account for 68.9％, 10 cases in comparison group, accountfor 34.4％, 9 cases in blank group, account for 33.3％, and has notabledifferences between cure group and comparison or blank group(P=0.019), butthere is no statistical differences between comparison group and blank group(P=0.738). (3) grades of quality of life: both rised in cure group and comparisongroup than before therapy(P=0.001, P=0.026), falled in blank group(P=0.002),and has notable differences among three groups(P＜0.01), and has no differencesbetween the two group(P=0.071), but there is statistical differences comparedwith blank group(P＜0.01).Conclusions(1) The way of nourishing essence of kidney, can improve appetite, increasebody weight,hemoglobin and albumin level, enhance immune ability, improvequality of lives for patients who suffer from cancer anorexia cachexiasyndrome, and is more curative than or at least equal to megestrol acetate,also has fewer side effects.(2) Only with nutrition support has few effects in cancer anorexia cachexiasyndrome therapy.This study ultimately shows that the prescription of traditional ChineseMedicine, formed according to nourishing essence of kidney, can improveappetite, increase body weight,hemoglobin and albumin level, enhance immuneability, improve quality of life in patients suffer from cancer anorexiacachexia syndrome, and is more curative or at least equal to megestrol acetate,also with fewer side effects. |
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