中草藥方劑對癌症惡病質之影響

The effect of Chinese herbal medicines on cancer cachexia

楊婷婷

癌症 ； 惡病質 ； 四君子湯 ； Lewis lung cancer cell ； Cancer ； cachexia ； Chinese herbal medicine ； Sijunzi Tang

中山醫學大學醫學研究所學位論文

2017年

碩士

徐士蘭;吳俊錡

繁體中文

根據調查高達八成的癌症病人會出現癌症惡病質症狀，其中四成的病患死於癌症惡病質而非腫瘤本身。癌症惡病質是一種綜合性的代謝症候，患者體內的代謝發生異常造成能量耗損增加。臨床常見的症狀包括食慾不振、大幅度的體重減輕和虛弱。癌症惡病質增加醫療支出與社會的負擔，降低病患與家屬的生活品質，並使病患死亡率提高。但臨床治療方面，目前尚無安全有效的藥物逆轉癌症惡病質症狀。因此，開發治療癌症惡病質的藥物是刻不容緩的議題。中草藥已有幾千年臨床使用的經驗傳承，許多文獻報導中草藥副作用少，且可增強免疫力，抑制蛋白質不當代謝，增進食慾及體重。因此，中草藥可能是治療癌因性惡病質的一個有效方案。四君子湯是一個補氣的藥方，具有健脾補胃的功效，但其是否可用於治療癌因性惡病質，尚無明確的研究實證。本實驗利用皮下注射的方式，施打小鼠肺癌細胞Lewis lung cancer cell於C57BL/6小鼠側腹誘發小鼠的癌因性惡病質的發生。以每週五天的頻率餵食罹癌小鼠四君子湯、清暑益氣湯或真菌液連續四週。結果發現，相較於腫瘤組小鼠，餵食複方漢藥能顯著減緩罹癌小鼠骨骼肌及心肌的流失，改善食慾不振的情形，並能抑制癌症惡病質造成的脾臟腫大，提高罹癌小鼠的存活率。由本實驗結果可得知兩測試方劑均有治療癌因性惡病質之效果，但複方漢藥治療效果較四君子湯更佳。顯示四君子湯及複方漢藥具有開發為治療癌因性惡病質藥物的潛力。

Cancer cachexia occurs in up to 80% of patients with advanced cancers and accounts for nearly 40% of cancer-related death. Typical symptoms of cancer cachexia are massive loss of body weight, anorexia, inflammation and pronounced muscle-wasting resulting in a drastic decrease of quality of life. It is also associated with poor responses to chemotherapy and survival. However, few therapeutic options are currently available for cancer cachexia. The management of cachexia remains a big challenge now. Chinese herbal medicine have been used to prevent or cure diseases for thousands of years. More and more research show that Chinese herbal medicine with less side effects, enhancing immune system, inhibiting protein catabolism, boosting the appetite and body weight, which maybe a promising treatment strategy and development tendency for cancer cachexia syndrome. Sijunzi Tang is an assembled formula for qi vacuity. It is a multiple component herbal extract. Sijunzi Tang has function not only in strengthening the spleen and replenishing qi but also in treating various kinds of symptoms from the qi vacuity. However, the effect of Sijunzi Tang on cancer cachexia is limitedly explored. In this study, Lewis lung carcinoma (LLC) tumor cells were subcutaneously inoculated into the flank region of 8-week-old female C57BL/6 mice to establish a mouse cancer cachexia model. LLC tumor cell implanted mice were oral fed with Sijunzi Tang and another Chinese herbal medicine five days a week for 4 weeks. Our results showed that supplementation of Chinese herbal medicine resulted in a significant improvement of food intake, myofiber cross-sectional area and physical performance in cancer cachexia mice. Moreover, these two Chinese herbal medicine not only prevented muscle wasting but also completely reversed prior loss of skeletal muscle and cardiac atrophy induced by LLC. Furthermore, feeding with Chinese herbal medicine could prolong the survival of cancer cachexic mice, but not inhibit the tumor growth. Overall, our studies demonstrated that the tested two Chinese herbal formula could ameliorate the LLC-induced cancer cachexia. Besides, the therapeutic effect of Chinese herbal medicine was more effective than Sijunzi Tang. These findings indicate that Chinese herbal medicine might be a promising drug to treat cancer cachexic patients.

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