Background: In contrast with Western medicine currently offers no approved pharmacotherapy for the selection of cachexia, in Japanese multi-component extract medicinal plants used by the national health insurance coverage. called “Kampo” This drug is an example of the modern concept of therapeutic multi-component / multi-target.
During the three traditional preparation Hochuekkito (), Juzentaihoto (), and Rikkunshito (), a lot of clinical research data associated with cachexia have been published. This preparation is also referred to as “Hozai” (). A similar concept is found in herbal medicine Russia, where the term “adaptogen” was created for active pharmacological substances which enhance the adaptive stress break.
Methods: The literature-including the original Japanese Scientific-reviewed articles on the effects of medicinal plants in cachexia. Cachexia is a complex set of symptoms including muscle wasting with loss of weight, fatigue, and weakness.
Results: In a study in 1985 by Kuroda et al, Hochuekkito shown success in weight loss forced and fatigue in 63% of the 16 2 patients with. genitourinary cancer. For cancer-related fatigue, a significant increase was reported within 2 weeks by Jeong et al. in 2010. In patients with chronic fatigue syndrome, Hochuekkito showed an overall increase by 8-12 weeks of therapy in a study of 1997 by Kuratsune et al. In a randomized trial of placebo-2005 by Satoh et al. in 13 patients in the geriatric Q1 16 -week treatment protocol, Hochuekkito showed significant improvement of general health, physical functioning and Profile Mood States (POMS).
In 71 patients with COPD geriatrics in 2009 randomized placebo-controlled study, Tatsumi et al. found a significant increase weight and CRP, TNF-α, IL -6 decline of more than 6 months of therapy. To Juzentaihoto in 48 patients with hepatocellular carcinoma, Tsuchiya et al. 2008 documented a significantly longer relapse-free survival (49 vs 24 months) compared with the control group (p = 0.023). For simpler Rikkunshito recipe, a 2011 retrospective study by Fujitsuka et al. 39 Stage III / IV pancreatic cancer patients treated with Gemcitabine (n = 33) or Gemcitabine / Rikkunshito (n = 6) showed the average life was significantly prolonged with 224 vs. 378.5 days (p <0.05).
Phytotherapy for Cachexia: Where Do We Stand?
In a clinical study in 2011 open-label by Utumi et al. in geriatric cachexia in 6 patients with dementia, treatment with Rikkunshito for 4 weeks resulted in a significant increase in body weight. In all of the above, the standard dose of 3×2.5 g / d extract granules for insurance covered most of Kampo extract-Japanese health preparation is applied.
Conclusion: Because there are currently no acceptable choice of pharmacotherapy for cachexia is available in the West, East Asian recipes gold transfer this standard into the European market would be desirable. We are better able to demonstrate that mTOR, interleucin and melatonin pathway modified by herbal compounds and thereby counteract cachexia. Further research in this field is needed in order to provide new, effective treatment for patients with cachexia.
Keywords: Hozai; Kampo (traditional Japanese herbal medicine); adaptogen; cachexia; interleukin; Mechanistic targets of rapamycin; melatonin; Phytotherapy. The mean percentage of PS and BOP were statistically significantly reduced with both FMPD and PDT from baseline to 4 weeks (p <0.05). Although the average PD was significantly reduced in both groups at any point in time, there is a significantly higher reduction with PDT compared with FMPD at 2 weeks post-treatment (p <0.05). comparison between groups showed PDT showed significantly higher HI at 2 and 4 weeks after treatment (p <0.05).
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The mean log CFU / mL of P. gingivalis and T. forsythia showed statistically significantly higher reduction with PDT from FMPD (p <0.05) in both 2-and 4-week follow-up.
