A Case Study on the Use of Megestrol Acetate and Korean Medical Treatment for the Loss of Appetite and Weight Loss in Patients with Amyotrophic Lateral Sclerosis(ALS)

Article information

J Korean Acupunct Moxib Soc. 2013;30(5):185-192
Publication date (electronic) : 2013 December 20
doi : https://doi.org/10.13045/acupunct.2013057
1Department of Acupuncture & Moxibustion Medicine, Gwang-Ju Oriental Medical Hospital, Wonkwang University
2Department of Internal Medicine, Gwang-Ju Oriental Medical Hospital, Wonkwang University

This study was supported by a grant of the Korean Health Technology R & D Project(B110076), Ministry of Health & Welfare, Republic of Korea

*Corresponding author : Department of Acupuncture & Moxibustion Medicine, Gwang-Ju Oriental Medical Hospital, Wonkwang University, 1140-23, Hoejae-ro, Nam-gu, Gwangju, 503-832, Republic of Korea, Tel : +82-62-670-6441 E-mail : kkscndl@hanmail.net
Received 2013 August 12; Revised 2013 November 21; Accepted 2013 November 21.

Abstract

Objectives:

Weight loss and loss of appetite in amyotrophic lateral sclerosis patients are common symptoms, these are associated with survival as well as nutritional condition. The changes in weight and appetite were reported after treatment using Megestrol acetate and Korean medical treatments.

Methods:

Amyotrophic lateral sclerosis patient with weight loss and loss of appetite were treated by administering megestrol acetate a known anti-malignant tumor agent and Korean medical treatments such as acupuncture, pharmacopuncture and herbal medicine. The changes in weight and appetite were checked using body mass index(BMI) and simplified nutritional appetite questionnaire(SNAQ).

Results:

There was a more than 17 kg increase in weight. BMI increased from 15.94 kg/m2 to 21.97 kg/m2 and SNAQ score increased from 7 to 16. Owing to several side effects, Megestrol acetate was stopped after which only Korean medical treatments were provided. After which the lasting effects in BMI and appetite could be seen.

Conclusion:

There are few studies on weight loss and loss of appetite in ALS patients. Using only megestrol acetate can cause several considerable side effects. Which respect to this, the findings in this study could open up new clinical guideline possibilities.

Fig. 1.

Change of weight and BMI

Fig. 2.

Change of SNAQ score

Herbal Medicine Treatment

Weight and BMI Change

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Article information Continued

Fig. 1.

Change of weight and BMI

Fig. 2.

Change of SNAQ score

Table 1.

Herbal Medicine Treatment

Date Herbal medicine
2011. 9. 23∼10.3 Jihwangumja Decoction(based on Donguibogam)
2011.12. 14∼22 Scolopendra 8 g, Radix ginseng 4 g, Fructus schisandrae 6 g, Chaenomeles sinensis Koebhne 8 g, Fructus crataegi 4 g, Fructus amomi rotundus 4 g, Fructus amomi xanthioidis 4 g, Radix platycodi 8 g, Radix glycyrrhizae 8 g, Broiled Radix aconiti lateralis preparata 2 g(3 times/d)
2011. 12. 23∼2012. 1. 24 Scolopendra 10 g, Radix ginseng 4 g, Fructus crataegi 4 g, Fructus amomi rotundus 4 g, Fructus amomi xanthioidis 4 g, Radix platycodi 6 g, Radix glycyrrhizae 10 g, Broiled Radix aconiti lateralis preparata 6 g, Cortex magnoliae officinalis 4 g, Radix puerariae 10 g, Semen glycine 10 g, Fructus schisandrae 6 g(3 times/d)
2012. 1. 25∼6. 10 Scolopendra 8 g, Radix ginseng 4 g, Fructus crataegi 4 g, Fructus amomi rotundus 4 g, Fructus amomi xanthioidis 4 g, Radix platycodi 6 g, Radix glycyrrhizae 8 g, Broiled Radix aconiti lateralis preparata 2 g, Cortex magnoliae officinalis 4 g, Radix puerariae 10 g, Semen glycine 10 g, Fructus schisandrae 6 g, Batryticatus bombycis 2 g, Holotrichia 2 g, Herba cirsii 4 g, Arillus longan 4 g, Semen raphani 4 g(3 times/d)
2012. 6. 11∼22 Cortex acanthopanacis 12 g, Semen raphani 8 g, Herba cirsii 10 g, Cortex cinnamomi 6 g, Fructus hordei germinatus 6 g, Fructus amomi rotundus 10 g, Semen benincasae 6 g, Radix ginseng 4 g, Fructus chaenomelis 10 g, Thallus laminariae 4 g, Fructus ziziphi jujubae 4 g, Rhizoma zingiberis recens 4 g(3 times/d)
Whenever patient complains of costipation Mazain Powder, Lubirax(Plantago ovata 2,168 mg, Senna alexandrina 496 mg)(2 times/d)

Table 2.

Weight and BMI Change

Date Weight(kg) BMI(kg/m2)
2011. 5 45 15.94
2011. 6 45 15.94
2011. 7 44 15.59
2011. 8 45 15.94
2011. 9 45 15.94
2011. 10 48.5 17.18
2011. 11 53.1 18.81
2011. 12 53.5 18.96
2012. 1 56.1 19.88
2012. 2 56.4 19.88
2012. 3 56.8 20.12
2012. 4 56.6 20.05
2012. 5 57.5 20.37
2012. 6 60.0 21.26
2012. 7 60.0 21.26
2012. 8 62.0 21.97