| Research objective:To observe the impact of Sijunzi Tang Jiawei in treating stage Ⅲ and Ⅳ cancer anorexia patients of spleen and stomach deficiency type on appetite, food intake, body weight, Karnofsky score, TCM syndrome score and T lymphocyte subsets in peripheral blood,in order to provide clinical reference for future clinical application of the treatment of cancer anorexia and clinical basis for advanced cancer patients in traditional Chinese medicine prescription to improve the appetite, the immunity and quality of life of patients etc.Research methods:According to random grouping principle,60 patients of stage Ⅲ and Ⅳ cancer anorexia patients of spleen and stomach deficiency type were divided into treatment group and control group,30 cases in the treatment group(Sijunzi Tang Jiawei group),30 cases in control group(megestrol group). 4 weeks of continuous observation from the date of inclusion. Compared the changes with the two groups before and after treatment on appetite, food intake, body weight, quality of life, T cell subsets in peripheral blood(CD4, CD8, CD4/CD8),TCM symptoms and adverse reactions ect. The United States SPSS 17 statistical software package was used for statistical analysis of data results.Results:(1) In terms of food intake and appetite, modified decoction of Sijunzi and megestrol capsule could effectively improve patient appetite, increased food intake, and the curative effect of two groups was almost the same, the differences were not statistically significant(P > 0.05);(2)In terms of weight change, the weight of the treatment group and the control group were increased, the difference of after and before treatment was statistically significant(P<0.01), but in comparison of weight improvement of the two groups before and after treatment, the difference of two groups was not statistically significant(P>0.05);(3)In terms of KPS score improvement, modified Sijunzi Decoction and megestrol acetate both can increase KPS score, improve the quality of life of the patients, the difference before and after treatment in the two groups had statistical significance(P < 0.05), But the improvement of KPS score in the treatment group was better than that in the control group(P<0.05);(4) In terms of TCM syndrome integral change, the two groups after treatment of TCM syndrome scores were both lower than before treatment, the difference was highly statistically significant(P<0.01), The total effective rate was 90% in the treatment group and 70% in the control group, after treatment, the difference between the two groups was statistically significant(P<0.01), so the curative effect of Sijunzi Tang Jiawei on patients’ TCM symptoms improvement was better than megestrol capsules’;(5) In terms of immune function, decoction of Sijunzi Tang Jiawei can significantly increase the value of CD4, CD4/CD8 in the peripheral blood of patients, reduce the value of CD8, effectively improve the immune function of the patients(P<0.01), While megestrol has no obvious effect on the immune function of patients(P>0.05), Compared with curative effect of the two drugs, Sijunzi Tang Jiawei was better than megestrol;(6) In terms of safety indicators and adverse reaction monitoring, In the control group, there were 1 people with mild pitting edema, after diuresis detumescence and other symptomatic treatments the edema was cured, no other adverse reactions were occurred except that, in the treatment group, adverse reactions were not observed, there was no obvious abnormality in the two groups in terms of safety index.Conclusion:Decoction of Sijunzi Tang Jiawei can effectively improve the appetite of cancer anorexia patients of middle and late stage of malignant tumor of spleen and stomach deficiency type, increase their food intake, meanwhile improve the KPS score of patients, increase their body weight. Among the changes in appetite, food intake and body weight, the curative effects of decoction of Sijunzi Tang Jiawei and megestrol capsule were almost the same, but in the KPS score improvement, Sijunzi Tang Jiawei was better than that of megestrol capsules. Decoction of Sijunzi Tang Jiawei can effectively improve the patients’ immune function, reduce the integral of TCM symptoms, improve their clinical symptoms, its’ curative effect is obviously better than megestrol acetate capsules, and no obvious side effects and adverse reactions were observed, with its unique advantages compared with western medicine megestrol,it is worth of clinical application. |
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