研究疾病:
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癌性恶病质
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研究疾病代码:
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Target disease:
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Cancer Cachexia
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Target disease code:
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研究类型:
Study type:
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干预性研究
Interventional study
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研究设计:
Study design:
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随机平行对照
randomized controlled trial(parallel group design)
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研究所处阶段:
Study phase:
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探索性研究/预试验
Pilot clinical trial
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研究目的:
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1.观察中医针刺改善晚期肺癌癌性恶病质骨骼肌消耗疗效。
2.初步分析针刺改善癌性恶病质骨骼肌消耗的临床机制。
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Objectives of Study:
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1. Observe the effect of TCM acupuncture on skeletal muscle consumption in advanced lung cancer cachexia.
2. Preliminary analysis of the clinical mechanism of acupuncture to improve the consumption of skeletal muscle in cancerous cachexia.
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药物成份或治疗方案详述:
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所有受试对象及家属行癌性恶病质相关宣教,按照营养支持治疗的五阶梯原则进行营养支持治疗,其余对症支持治疗(如抗感染等)。
营养不良的五阶梯治疗
第一阶梯:饮食+营养教育
第二阶梯:饮食+口服营养补充
第三阶梯:全肠内营养支持
第四阶梯:部分肠内营养+部分肠外营养
第五阶梯:全肠外营养支持
上述五阶梯治疗原则及方法调整遵循2015年中国抗癌协会肿瘤营养与支持治疗专业委员会专家共识。
对照组:饮食宣教+营养支持代谢治疗,4周为1个疗程。
试验组:在对照组干预方案上给与针刺上脘、中脘、下脘、天枢、大横、气海、关元、足三里,每周5此,4周为1疗程。
定期随访,随访期间停用全身性抗癌疗法,停用一切中药及中成药,不影响抗癌治疗的其余药物可合理使用,记录治疗情况及治疗过程中出现的不良反应,详细记录合并用药的名称、时间、剂量。
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Description for medicine or protocol of treatment in detail:
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All subjects and their families received education related to cancer cachexia, nutritional support treatment according to the five-step principle of nutritional support treatment, and symptomatic support treatment (such as anti-infection, etc.).
Five - step treatment for malnutrition
Step 1: diet + nutrition education;
Step 2: diet + oral nutrition supplement;
Step 3: total enteral nutritional support;
Step 4: partial enteral nutrition + partial parenteral nutrition;
Step 5: total parenteral nutrition support.
The above five-step treatment principles and methods were adjusted in accordance with the consensus reached by the expert committee of cancer nutrition and supportive therapy of China anti-cancer association in 2015.
Control group: diet education + nutrition support metabolism treatment, 4 weeks for a course of treatment.
Experimental group: in the control group, acupuncture was administered in the intervention plan of upper wan, middle wan, lower wan, tianshu, daheng, qihai, guan yuan and zusanli, 5 times per week, 4 weeks for one course of treatment.
Regular follow-up, during the follow-up period, stop systemic anticancer therapy, stop all traditional Chinese medicine and Chinese patent medicine, do not affect the rational use of anti-cancer treatment of other drugs, record the treatment situation and adverse reactions occurred in the treatment process, and record the name, time and dosage of the combined drug in detail.
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纳入标准:
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1 受试者能够理解和遵守试验方案中所列的参数,并能在开始任何筛选或研究特定的程序前必须签署独立伦理委员会(IEC)/机构核查委员会(IRB)批准的知情同意 ;
2 受试者必须是年龄≥ 18岁的成人 ;
3 经影像及病理组织学和(或)细胞学检查确诊为非小细胞肺癌患者;
4 >1个三甲医院诊断为IIIB-IV期非小细胞肺癌;
5 符合2011年Lancet Oncology癌性恶病质诊断和分期共识:6个月内体重下降>5%或BMI<20kg/m2者出现体重下降>2%,或四肢肌肉指数与少肌症相符(男性<7.26kg/m2,女性<5.45kg/m2)者出现体重下降>2%,为开始进入恶病质期;
6 根据RECIST 1.1版肿瘤疗效评价标准,受试者至少于1家医院的CT扫描提示1个可测量病变。
7 育龄期女性和男性必须同意在入选研究前、研究期间和完成研究后的随访期内使用适当的避孕措施。育龄期女性在研究开始前7天内的尿妊娠试验必须为阴性和/或绝经后女性必须停经至少12个月,才可被视为无生育能力。
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Inclusion criteria
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1 subjects are able to understand and comply with the parameters listed in the protocol and must sign informed consent approved by the independent ethics committee (IEC)/institutional verification committee (IRB) before initiating any screening or study specific procedures;
2 subjects must be adults aged ≥ 18 years;
3 patients diagnosed with non-small cell lung cancer by imaging and histopathology and/or cytology;
4 > 1 grade a hospitals were diagnosed as stage iiiib -IV non-small cell lung cancer;
5 according to the 2011 Lancet Oncology consensus on the diagnosis and staging of cancer cachcachia, patients with body weight loss of >5% or BMI < 20kg/m2 experienced a body weight loss of > 2% within 6 months, or those with limb muscle index consistent with oligomyopathy (male < 7.26kg/m2 and female < 5.45kg/m2) experienced a body weight loss of > 2%, which was considered as the onset of cachcachia.
6 according to RECIST version 1.1 tumor efficacy evaluation criteria, the subject's CT scan at least one measurable lesion was suggested in one hospital.
7 women and men of reproductive age must agree to use appropriate contraceptives before they are enrolled in the study, during the study and during follow-up after completion of the study.Women of reproductive age must have a negative urine pregnancy test within 7 days prior to the start of the study and/or postmenopausal women must be in menopause for at least 12 months before they can be considered infertile.
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排除标准:
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1 受试者存在恶性肠梗阻继发恶病质;
2 根据美国国家癌症研究所常见不良事件评价标准(NCI CTCAE)的定义,受试者存在2级以上的脑病;
3 受试者的左心室射血分数<50%;
4 在临床显著的不可控制影响患者生存的肿瘤以外的其它疾病;
5 严重心、肝、肾疾病、糖尿病、风湿性关节炎、慢性阻塞性肺疾病;
6 合并血液系统疾病;
7 处于妊娠期或哺乳期的女性受试者;
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Exclusion criteria:
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1 secondary cachexia of subjects with malignant intestinal obstruction;
2 according to the NCI common adverse event evaluation criteria (NCI CTCAE), the subjects had encephalopathy above grade 2;
3 subjects' left ventricular ejection fraction <50%;
4 diseases other than clinically significant uncontrolled tumors that affect patient survival;
5 severe heart, liver and kidney diseases, diabetes mellitus, rheumatoid arthritis, and chronic obstructive pulmonary disease;
6 complicated with diseases of the blood system;
7 female subjects during pregnancy or lactation.
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研究实施时间:
Study execute time:
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从From
2019-09-10
至To
2022-09-10
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征募观察对象时间:
Recruiting time:
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从From
2019-09-10
至To
2022-03-10
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