Acupuncture Improves Clinical Study Of Cancerous Anorexia Cachexia Syndrome

Backgroud:With increasing incidence and mortality, cancer is the leading cause of death in China and is a major public health problem. Cancer anorexia cachexia syndrome (CACS) is the most concomitant disease related to cancer. There are lack of safe and effective management strategy for this conditon, acupuncture maybe the next alternative option.Objective:To investigate the safety and efficay of acupuncture in improving appetite,slowing weight loss, controlling the other symptoms with patients who suffered from lung or gastrointestinal tract cancers.Methods:Phase Ⅰ and phase Ⅱ clinical trails had been conducted for the objective that evaluating the safety and effectivity of acupuncture for CACS. 1.A small sample of 20 adivanced caner patients, one-group pre and postintervention feasibility study was designed and carried out in the phase Ⅰ clinical trail. The eligible patients were arrangeed 7 days acupuncture, and the saftey and feasibility of acupuncture for CACS assessed at baseline and endpoint.2. The phase Ⅱ clinical trail had been conducted with a multi-center single-blinded, double-dummy randomized controlled trail style. In this trial 129 eligible subjects were arrangeed randomly in 3 groulps accoding to the ratio 1:1:1. Acupuncture groulp(AG) received acupuncture and placebo, the Megestrol acetate groulp(MAG) got the Megestrol acetate pills and sham acupuncture, and Placebo groulp (PG) adopted sham acupuncture and palcebo.Acupuncture and sham acupuncture once daily for 7 sections.160mg palecbo or Megestrol acetate orally twice a day for a week. Data were collected using the visual analog scale (VAS) for appetite and Satisfaction with medication, Simplified Nutritional Appetite Questionnaire (SNAQ), body weight, Chinese Version of the Brief Fatigue Inventory (BFI-C), Edmonton Symptom Assessment Scale (ESAS), Fnctional Assessment of Anorexia/Cachexia Therapy(FFACT), Questionnaire of Acupuncture-related Events (QAE) at the baselin and the endpoint.Results:1.Theresults frome phase I clinical trail as followed:(1)There were 140 sections acupuncture planed to carried out,16 sections missed during the phase I trial, so the compliance rate was 94.3%. (2) The VAS scores of appetite and fatigue inproved statistically difference(P<0.05), so did the wellbeing. The body weight changed not significantly (P>0.05).(3)The pain, blood, ecchymosis, palmus and bending of needle were the common side effect related acupuncture, and there were no serious adverse events had been detected.2. (1)There were 107 subjects completed the interventions in Phase II trial. The general condition, demographic characteristic, expectancy value and effect criteria baseline in 3 groups were comparable (P>0.05).(2)The study indicates that the VAS for appetite scores of the 3 groups was statistically difference(P<0.05)at the 4th day point, while there were no significant difference at the endpoint (P>0.05). There was no statistic significance between AG and MAG comparison of the VAS for appetite scores improvement (P>0.05), while there were significant difference between AG and PG, MAG and PG(P<0.05).(3)There was no statistic significance among the 3 groups comparison of the body weight, FFACT, SNAQ and BFI scores improvement (P>0.05). From the pre and post-intervent evaluations, in the groulp self-comparisons of FFACT, SNAQ and BFI, the scores improvement of AG were statistically significant (P (0.05), while the scores of MAG and PG were not (P> 0.05).(4)The pain, blood, ecchymosis, palmus and fatigue related acupuncture were slight, and serious side effect did not occur, and the rate of compliance was 81.1%. (5)There was statistic significance among the 3 groups comparison of the VAS for Satisfaction with medication scores(P<0.05), and here were significant difference between AG and PG, MAG and PG(P<0.05).Conclution:(1) Acupuncture and Megestrol acetate have the equal power on improving the CACS patiens appetite significantly, and the effect of acupuncture much quicker than Megestrol acetate.(2) Acupuncture can not slowing weight loss and controlling the fatigue, insomnia, anxiety, depression, cough and pain, but the patient’s subjective sense of wellbeing, constipation and nausea can benefit from acupuncture.(3) The CACS patients tolerated acupuncture treatments well and indicates tha acupuncture is a safe intervent for this condtion, and satisfaction with acupuncture was good.