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[Observation on therapeutic effect of megestrol acetate on patients with chronic obstructive pulmonary disease at remission stage]

Author(s): Qin X, Cai Y, Xu Q

Affiliation(s): Department of Medicine, Second Textile Hospital, Shanghai.

Publication date & source: 1996-07, Zhonghua Nei Ke Za Zhi., 35(7):466-70.

Publication type: Clinical Trial; English Abstract; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

It has been reported that malnutrition is common in stable chronic obstructive pulmonary disease (COPD) patients. In order to observe the effects of Megestrol Acetate (MA) on nutritional status, respiratory muscle strength and immunological parameters in stable COPD patients, 31 stable COPD patients were divided into two groups at random--a treatment group of 16 cases and a control group of 15 cases. Before and after treatment all parameters were recorded, including food and energy intake, body weight, triceps skinfolds (TSF), pre-albumin, transferrin, albumin. Lung function, respiratory muscle and handgrip strength were examined and immunological parameters also determined. After taking MA 160 mg/day orally for two weeks, the treatment group got benefits as follows: heat energy and protein intake increased fro 6977.9 +/- 1136 kJ/d and 44.65 +/- 13.75 g/d to 9854.0 +/- 2355.3 kJ/d and 84.80 +/- 20.23 g/d respectively. With the increase of daily energy and protein intake, body weight increased from 48.27 +/- 8.61kg to 50.34 +/- 8.76 kg, TSF from 11.75 +/- 4.50 mm to 15.06 +/- 4.73 mm, serum pre-albumin from 306.6 +/- 33.7 mg/L to 332.6 +/- 1 mg/L, transferrin from 3.09 +/- 0.21 g/L to 3.46 +/- 0.32 g/L, albumin from 38.00 +/- 1.73 g/L to 42.64 +/- 3.36 g/L, MIP from 4.77 +/- 2.14 kPa (1 kPa = 7.5 mmHg) to 6.31 +/- 2.87 kPa, MEP from 6.21 +/- 2.90 kPa to 7.20 +/- 3.67 kPa and 6 minutes walking distance from 280.2 +/- 76.4 m to 370.6 +/- 81.5 m. Handgrip strength also improved. Blood lymphocyte transformation rate elevated too. (The changes of all these parameters indicated above were statistically significant, P < 0.01). However, parameters of lung function, blood gas analysis, serum immunoglobulin and complement 3 did not change significantly. In 15 control patients all the parameters did not change significantly. There were few side effects; only one case complained of nausea and vomiting. It was shown that MA can stimulate appetite and increase dietintake, improve nutritional status, elevate respiratory muscle strength, and enhance immunity. MA is a safe and effective drug which exerts a beneficial influence on stable COPD.

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