| Objective:To obersve the effect of appetizing and spleen-activating decoction on cancerous anorexia patients of advanced cancer with stomach-yin deficiency through comparing the appetite level,quality of life and TCM symptom score of the patients before and after treatment,and to explore whether serum OrexinA and Leptin levels are related to and cancerous anorexia and how they are related.Methods:60 cases of cancerous anorexia patients of advanced cancer with stomach-yin deficiency admitted to Suzhou Hospital of Traditional Chinese medicine in April 2019 to January 2020 were enrolled in this study,and they were divided into the treatment group and the control group,with 30 patients in each group.The patients in both groups received basic nutritional support treatment and the balance was considered.The treatment group took one dose of appetizing and spleen-activating decoction orally every day in two times,one after breakfast and one after dinner,and megestrol acetate dispersible tablets orally at the same time,160mg/d,for four continuous courses of treatment,with one week as one course.The control group only took megestrol acetate dispersible tablets orally,160mg/d,for four continuous courses of treatment,with one week as one course.The appetite NRS scores,KPS scores,TCM symptom scores,serum leptin and orexin-A levels,etc.of two groups before treatment(Day 1 in group)and after treatment(Day 29 in group)were recorded and the differences were compared.At last,the statistical analysis of the observation data of the two groups were conducted to draw a conclusion.Results:?Both the treatment group and the control group had reduced appetite NRS scores.The overall response rates of the treatment group and the control group were 73%and 50%,respectively.The differences in groups before and after treatment and between groups after treatment were all statistically significant(P<0.05);?The overall response rates of the treatment group and the control group in improving quality of life were 43%and 20%,respectively.The differences between groups after treatment were not statistically significant,but the treatment group(P<0.01)could improve the KPS core to a certain extent compared to the control group(P>0.05);?The overall response rate of the treatment group in relieving clinical symptoms(90%)was significantly higher than and that of the control group(57%).The differences of TCM symptom score in groups before and after treatment and between groups after treatment were all statistically significant(P<0.05);?The differences of serum Leptin and OrexinA levels in groups before and after treatment and between groups after treatment were all statistically significant(P<0.05);?In the aspect of safety,no significant changes of ECG,blood routine,blood coagulation,liver and kidney function indexes between the treatment group and the control group before and after treatment were observed(P>0.05),and the total rates of adverse reactions of the treatment group and the control group were 17%and 33%,respectively,indicating that appetizing and spleen-activating decoction could reduce the adverse reactions of megestrol acetate dispersible tablets.Conclusion:?The combination of appetizing and spleen-activating decoction and megestrol acetate dispersible tablets can effectively improve the appetite and quality of life of cancerous anorexia patients with stomach-yin deficiency,alleviate clinical symptoms and reduce adverse reactions,having high safety;?The combination of appetizing and spleen-activating decoction and megestrol acetate dispersible tablets can significantly increase the serum OrexinA level and reduce the Leptin level;?The serum OrexinA level is negatively correlated with the degree of cancerous anorexia,while the Leptin level is positively correlated with the degree of cancerous anorexia. |
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