ABSTRACT
Objective To observe the effect of nutritional status change on hemodialysis patients of chronic renal failure and deficiency of spleen and kidney treated bytraditional Chinese medicine(TCM) of warming kidney and invigorating spleen. Methods In our center, 146 patients who were diagnosed chronic renal failure belonging to deficiency of spleen and kidney in TCM were received hemodialysis between Jun2012 and May2013. All patients were randomly divided into a treatment group (n=72) and a control group (n=74). 74 patients in the control groupreceived conventional hemodialysis and medicine treatment, and 72 patients in treatment group received conventional hemodialysis、medicine treatment and TCM treatment of warming kidney and invigorating spleen. The comprehensive nutritional assessment of all patients were treated by modified SGAN method (MQSGAN), anthropometric, biochemical and laboratory examination before and 6 monthsafter the treatment. Results The treatment group patients of modified SGAN(9.58±3.15), BMI (body mass index 19.34±0.52) Kg/m2, MAC(upper arm circumference 27.51±1.95)cm, TSF(tricepsskinfold thickness 12.92± 2.42) mm and MAMC(upper arm muscle circumference 23.64±1.96)cm were significantly improved compared with the control g roup(respectively data 13.23±3.14, 17.29±0.76) Kg/m2, (24.01±2.55, 10.58±2.71) mm, (20.71±2.04)cm, P<0.05,and treatment group patients with ALB(serum albumin 38.19±1.95)g/L, PA(prealbumin 2.23±0.16)g/L, TF(transferrin 0.21±0.04)g/L, CH(cholesterol 4.02±0.26)mmol/L, BUN(blood urea nitrogen 19.58±2.17)mmol/L and SCr (creatinine 869.54±79.15)mmol/L were significant improved also compared with the control group(respectively data 33.73±1.31)g/L, (1.67±0.25)g/L, (0.17±0.02)g/L, (3.22± 0.46)mmol/L, (16.27±1.12)mmol/L, (792.73±71.65)mmol/L, P<0.05. Conclusion Traditional Chinese medicine of warming kidney and invigorating spleen can improve the nutritional status and quality of life on patients with chronic renal failure belonging to deficiency of spleen and kidney type during hemodialysis.
ABSTRACT
A platinum-based doublet with a third-generation agent represents the standard first-line treatment for advanced non-small cell lung cancer patients with good performance status (PS). Traditional chemotherapy provides response rates of 20 %-40 % and a median survival of 8-10 months. In an attempt to improve its outcome, alternative schedules have been proposed, namely sequential, alternating, and maintenance therapy. Sequential chemotherapy with a platinum-based doublet followed by a single agent is feasible in patients with good PS; The use of sequential single agents is an option for elderly and frail patients unsuitable for a platinum-based combination. Based on trials published so far, it is unlikely that an alternating chemotherapy strategy will be proved superior to standard chemotherapy in patients with good PS.Consolidation chemotherapy may provide additional benefit for patients achieving disease control after standard first-line chemotherapy.