Enteral Nutritional Therapy with Herbal Medicine for Elderly Critically Ill Patients: Basic Research for Skeletal Muscle Maintenance

2022 Fiscal Year Final Research Report

• Project/Area Number: 20K17912
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55060:Emergency medicine-related
• Research Institution: Osaka Medical and Pharmaceutical University
• Principal Investigator: Huzii Kensuke 大阪医科薬科大学, 医学部, 非常勤医師 (50846904)
• Project Period (FY): 2020-04-01 – 2023-03-31
• Keywords: 人参養栄湯 / サルコペニア / 筋萎縮 / 腹膜炎 / 熱傷

Outline of Final Research Achievements

To examine the effect of Ninjin'yoeito on the severe invasion model mouse, we performed volumetric measurements of skeletal muscles of the lower limbs using the Lathela LCT-200 and muscle strength measurements using the grip test. In a peritonitis model mouse with cecal ligation and puncture (treatment group: 18 vs. control group: 18) and a severe burn model mouse with a third-degree burn on 30% of the body surface area (treatment group: 6 vs. control group: 6), no differences were observed in body weight, lower limb skeletal muscle volume and weight, or survival rate between the two groups. Muscle tissue analysis in the peritonitis model showed no significant differences in 4E-BP1 and Atrogin-1, which are associated with protein synthesis and degradation. In a peritonitis model mouse, upper limb grip strength was improved in the Ninjin'yoeito treatment group on day 28 (P value: 0.03).

Free Research Field

一般消化器外科、救急診療科

Academic Significance and Societal Importance of the Research Achievements

「筋肉量の低下に筋力または身体機能の低下を伴う状態」と定義されるサルコペニアは、救急治療の領域でもその重要性が明らかになっており、重症患者の骨格筋量が高いほど長期予後が改善する可能性があるが、薬剤による栄養療法の介入を行った効果を検証した研究は殆どなく、本研究ではこれまで慢性疾患や担癌患者に対して、骨格筋萎縮の予防に使用されている人参栄養湯を、特に集中治療後の身体機能障害に長期間悩まされる重症高齢患者に対して応用できるかを検討した。本研究の結果では骨格筋量の改善は認めなかったが、短期間で上肢握力の改善を認めており、骨格筋の質に関してさらなる研究が必要である。