目的系统评价扶正化瘀散结法联合西药治疗厌食-恶病质综合征的有效性。方法系统检索维普(VIP)、中国知网(CNKI)、万方数据知识服务平台(Wan Fang)、中国生物医学文献数据库(CBM)、PubMed、Web of Science、Embase数据库、Cochrane Libr...目的系统评价扶正化瘀散结法联合西药治疗厌食-恶病质综合征的有效性。方法系统检索维普(VIP)、中国知网(CNKI)、万方数据知识服务平台(Wan Fang)、中国生物医学文献数据库(CBM)、PubMed、Web of Science、Embase数据库、Cochrane Library数据库,利用Jadad、Cochrane协作网RCT质量评价标准对纳入文献的研究质量进行评价,Meta分析提取数据。结果1)共纳入17个随机对照研究(RCT),患者1423例,纳入研究质量一般;2)Meta分析合并RR值包括体重变化[RR=1.36,95%CI(1.08,1.71),P=0.009]、KPS评分变化[RR=1.44,95%CI(1.29,1.60),P<0.00001]、进食量变化[RR=1.33,95%CI(1.15,1.55),P=0.0002]、白蛋白变化[MD=3.01,95%CI(2.10,3.93),P<0.00001]以及血红蛋白变化[MD=10.74,95%CI(1.91,19.58),P=0.02]。结论本研究证实扶正化瘀散结法在厌食-恶病质综合征应用的有效性优于单纯西药治疗或结合营养支持治疗。展开更多
目的系统评价醋酸甲地孕酮对晚期肿瘤患者生活质量的改善效果及安全性。方法采用计算机检索PubMed,The Cochrane Library,ClinicalTrials.gov,Web of Science,Embase及中国知网(CNKI)、中国生物医学文献系统(CBM)、万方(WanFang)数据库...目的系统评价醋酸甲地孕酮对晚期肿瘤患者生活质量的改善效果及安全性。方法采用计算机检索PubMed,The Cochrane Library,ClinicalTrials.gov,Web of Science,Embase及中国知网(CNKI)、中国生物医学文献系统(CBM)、万方(WanFang)数据库中2012年至2022年有关醋酸甲地孕酮治疗晚期肿瘤和厌食症-恶病质综合征的研究,根据纳入和排除标准筛选文献,分别采用Cochrane系统评价工具和非随机对照研究报告规范(TREND)评价随机对照试验(RCT)和类实验研究(QES)的质量和偏倚风险,采用RevMan 5.3软件进行Meta分析。结果共纳入24项研究,涉及1815例患者,包括5项RCT和19项QES。Meta分析结果显示,与仅接受常规治疗组比较,接受常规治疗+醋酸甲地孕酮组患者的体质量显著增加[OR=7.04,95%CI(5.31,9.33),P<0.00001],食欲显著改善[OR=10.85,95%CI(8.09,14.56),P<0.00001],卡氏功能状态(KPS)评分显著升高[OR=6.36,95%CI(4.74,8.54),P<0.00001]。醋酸甲地孕酮治疗晚期肿瘤487例患者共发生54例次(11.09%)不良反应,最常见的为四肢末端可凹性水肿(3.90%)。结论醋酸甲地孕酮可增加晚期肿瘤患者的体质量,改善其食欲,提高生活质量,且安全性较好。展开更多
The cancer-associated anorexia-cachexia syndrome is observed in 80% of patients with advanced-stage cancer, and is one of the major obstacles in chemo- therapy. Ghrelin is a orexigenic hormone that has been proposed t...The cancer-associated anorexia-cachexia syndrome is observed in 80% of patients with advanced-stage cancer, and is one of the major obstacles in chemo- therapy. Ghrelin is a orexigenic hormone that has been proposed to prevent anorexia. Aim of the study was to determine whether the addition of the ghrelin agonist growth hormone releasing peptide 2 (GHRP-2) to cytotoxic therapy with 5-fluoruracil (5-FU) prevents the anorexia associated with chemotherapy in cancer cachectic mice. Thirty-three BALB/c female tumourbearing mice were randomized to receive a solution containing: (a) placebo; (b) GHRP-2; (c) 5-FU; or (d) 5-FU + GHRP-2. Ten BALB/c no tumour-bearing mice received placebo solution. Food intake and survival were checked. Six hours after the drug injection the cumulative food intake was signifi cantly increased in mice treated with the combination of 5-FU + GHRP-2 versus the 5-FU alone (P = 0.0096). On day 3, the cumulative food intake of mice treated with GHRP-2,5-FU and 5-FU + GHRP-2 signifi cantly increased com- pared with naive and vehicle groups (P = 0.0007, P = 0.0038 and P = 0.0166, respectively). The median survival time was longer in 5-FU + GHRP-2 treated mice than in those with 5-FU, although it was not signifi cant (18 d versus 15.5 d, P = 0.7). For the fi rst time, we demonstrated that the addition of GHRP-2 to cytotoxic therapy with 5-FU improved appetite in tumour-bearing mice with anorexia/cachexia syndrome in early stage. These data suggest that GHRP-2 may improve the effi cacy of therapy and the quality of life of cancer patients thank to the amelioration of their nutritional state.展开更多
Background:None of the published studies involving cancer cachexia experimental models have included a measure of the severity of the syndrome like the scoring system previously developed for human subjects.The aim of...Background:None of the published studies involving cancer cachexia experimental models have included a measure of the severity of the syndrome like the scoring system previously developed for human subjects.The aim of the present investigation was to define and validate a cachexia score usable in both rat and mouse tumor models.Methods:In order to achieve this goal,we included in the study one rat model(Yoshida AH‐130ascites hepatoma)and two mouse models(Lewis lung carcinoma and Colon26 carcinoma).The Animal cachexia score(ACASCO)includes five components:(a)body and muscle weight loss,(b)inflammation and metabolic disturbances,(c)physical performance,(d)anorexia,and(e)quality of life measured using discomfort symptoms and behavioral tests.Results:Using the ACASCO values,three cut‐off values were estimated by applying hierarchical cluster analysis.Four groups were originally described,one exactly below the observed mean,a second exactly over the mean,and two other groups adjusted to every cue(inferior and superior).The three cut‐off values were estimated through maximization of the classification function.This was accomplished by using a similarity matrix based on the metric properties of the variables and assuming multinormal distribution.The results show that the four groups were:no cachexia,mild cachexia,moderate cachexia and advanced cachexia.Conclusions:The results obtained allow us to conclude that the score could be very useful as an endpoint in pre‐clinical studies involving therapeutic strategies for cancer cachexia.The potential usefulness of ACASCO relates to the primary endpoint in pre‐clinical cancer cachexia drug evaluations.展开更多
文摘目的系统评价扶正化瘀散结法联合西药治疗厌食-恶病质综合征的有效性。方法系统检索维普(VIP)、中国知网(CNKI)、万方数据知识服务平台(Wan Fang)、中国生物医学文献数据库(CBM)、PubMed、Web of Science、Embase数据库、Cochrane Library数据库,利用Jadad、Cochrane协作网RCT质量评价标准对纳入文献的研究质量进行评价,Meta分析提取数据。结果1)共纳入17个随机对照研究(RCT),患者1423例,纳入研究质量一般;2)Meta分析合并RR值包括体重变化[RR=1.36,95%CI(1.08,1.71),P=0.009]、KPS评分变化[RR=1.44,95%CI(1.29,1.60),P<0.00001]、进食量变化[RR=1.33,95%CI(1.15,1.55),P=0.0002]、白蛋白变化[MD=3.01,95%CI(2.10,3.93),P<0.00001]以及血红蛋白变化[MD=10.74,95%CI(1.91,19.58),P=0.02]。结论本研究证实扶正化瘀散结法在厌食-恶病质综合征应用的有效性优于单纯西药治疗或结合营养支持治疗。
基金Supported by (in part) A Grant-in-Aid for Scientic Research (B:16390208) from the Ministry of Education, Culture, Sports, Science and Technology of Japan (to A.I.)
文摘The cancer-associated anorexia-cachexia syndrome is observed in 80% of patients with advanced-stage cancer, and is one of the major obstacles in chemo- therapy. Ghrelin is a orexigenic hormone that has been proposed to prevent anorexia. Aim of the study was to determine whether the addition of the ghrelin agonist growth hormone releasing peptide 2 (GHRP-2) to cytotoxic therapy with 5-fluoruracil (5-FU) prevents the anorexia associated with chemotherapy in cancer cachectic mice. Thirty-three BALB/c female tumourbearing mice were randomized to receive a solution containing: (a) placebo; (b) GHRP-2; (c) 5-FU; or (d) 5-FU + GHRP-2. Ten BALB/c no tumour-bearing mice received placebo solution. Food intake and survival were checked. Six hours after the drug injection the cumulative food intake was signifi cantly increased in mice treated with the combination of 5-FU + GHRP-2 versus the 5-FU alone (P = 0.0096). On day 3, the cumulative food intake of mice treated with GHRP-2,5-FU and 5-FU + GHRP-2 signifi cantly increased com- pared with naive and vehicle groups (P = 0.0007, P = 0.0038 and P = 0.0166, respectively). The median survival time was longer in 5-FU + GHRP-2 treated mice than in those with 5-FU, although it was not signifi cant (18 d versus 15.5 d, P = 0.7). For the fi rst time, we demonstrated that the addition of GHRP-2 to cytotoxic therapy with 5-FU improved appetite in tumour-bearing mice with anorexia/cachexia syndrome in early stage. These data suggest that GHRP-2 may improve the effi cacy of therapy and the quality of life of cancer patients thank to the amelioration of their nutritional state.
基金Ministerio de Ciencia y Tecnología , Spain, Grant/Award Number: SAF-26091-2011
文摘Background:None of the published studies involving cancer cachexia experimental models have included a measure of the severity of the syndrome like the scoring system previously developed for human subjects.The aim of the present investigation was to define and validate a cachexia score usable in both rat and mouse tumor models.Methods:In order to achieve this goal,we included in the study one rat model(Yoshida AH‐130ascites hepatoma)and two mouse models(Lewis lung carcinoma and Colon26 carcinoma).The Animal cachexia score(ACASCO)includes five components:(a)body and muscle weight loss,(b)inflammation and metabolic disturbances,(c)physical performance,(d)anorexia,and(e)quality of life measured using discomfort symptoms and behavioral tests.Results:Using the ACASCO values,three cut‐off values were estimated by applying hierarchical cluster analysis.Four groups were originally described,one exactly below the observed mean,a second exactly over the mean,and two other groups adjusted to every cue(inferior and superior).The three cut‐off values were estimated through maximization of the classification function.This was accomplished by using a similarity matrix based on the metric properties of the variables and assuming multinormal distribution.The results show that the four groups were:no cachexia,mild cachexia,moderate cachexia and advanced cachexia.Conclusions:The results obtained allow us to conclude that the score could be very useful as an endpoint in pre‐clinical studies involving therapeutic strategies for cancer cachexia.The potential usefulness of ACASCO relates to the primary endpoint in pre‐clinical cancer cachexia drug evaluations.
