臨牀消化器内科 Vol.31 No.9(4-2)


特集名 臨床に必要な消化管による食欲調節の知識
題名 食欲異常と消化管 (2) 消化器がんと食欲
発刊年月 2016年 08月
著者 上園 保仁 国立がん研究センター研究所がん患者病態生理研究分野
【 要旨 】 消化器がんの生存率は臓器によってかなりの違いがあるが,生存率の延びているがんも多く,長期に抗がん剤治療を受ける患者の副作用対策は急務である.
消化器がんでとくに多いのが「がん悪液質」である.がん悪液質の症状改善は患者QOLの向上に必須であり,食思を改善し筋肉量の減少を防ぐことが重要である.食思改善にグレリンシグナルを促進する薬物の開発が進んでいるが,漢方薬六君子湯にグレリンシグナル増強効果が証明され,その応用が期待されている.また半夏瀉心湯には抗がん剤による口内炎を早期に治癒させる効果があることがわかってきた.消化器がんによる食欲低下に対する漢方薬の応用は重要な一手であると考える.
Theme The Gastrointestinal Tract and Appetite Control : Essential Clinical Knowledge
Title Gastrointestinal Cancer and Appetite : Possible Improvement Therapy by Japanese KAMPO Medicine
Author Yasuhito Uezono Division of Cancer Pathophysiology, National Cancer Center Research Institute
[ Summary ] Although there are differences among survival rates of patients suffering from several types of gastrointestinal cancers, some of these rates have been expanding and, consequently, the incidence of side effects in patients with cancer receiving chemotherapy has increased. Owing to this circumstance, it is important to act and take extra care of patients with cancer. Most of the patients with gastrointestinal cancer suffer from cancer cachexia, and therefore, the relief of the suffering caused by the symptoms related to cancer cachexia is indispensable to improve their quality of life (QOL). Among these typical symptoms, the improvement of appetite and the prevention of skeletal weight loss are particularly important. Many approaches are being taken to achieve the improvement of the QOL of patients suffering from cancer cachexia. One of these approaches involves the development of drugs that potentiate ghrelin signaling, a peptide that promotes appetite. Rikkunshito, a Japanese Kampo medicine, is a candidate to promote ghrelin signaling and improves appetite in patients with gastrointestinal cancer. Furthermore, the benefits of another Japanese KAMPO medicine, hangeshashito, have been recognized for the treatment of oral stomatitis in patients with cancer. Several other Japanese KAMPO medicines are also attractive candidates for treatments aiming at improving appetite and QOL in patients with gastrointestinal cancer.
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