冬凌草液联合丝裂霉素膀胱内灌注预防浅表性膀胱癌术后复发的疗效

Rabdosia rubescens combined with mitomycin urinary bladder irrigation in the treatment of post operative bladder cancer

目的：比较中药冬凌草液热疗和多次丝裂霉素膀胱内灌注预防浅表性膀胱移行细胞癌术后复发的疗效。方法选择2009年10月至2012年1月泸州医学院附属中医医院收治的81例浅表性膀胱移行细胞癌患者，将其随机分为对照组40例和观察组41例。对照组给予多次丝裂霉素膀胱内灌注治疗；观察组同时给予中药冬凌草液热疗。比较两组患者术后复发率、治疗前后血清血管内皮生长因子（VEGF）水平及治疗前后免疫功能相关指标水平。结果对照组患者术后复发率为25.00%，显著高于观察组的9.76%（P〈0.05）；两组治疗后血清中VEGF水平均显著低于治疗前（P〈0.05），且观察组治疗后血清VEGF水平也均显著低于对照组治疗后（P〈0.05）；两组治疗后CD3＋、CD4＋、CD4＋/CD8＋水平均显著高于治疗前（P〈0.05），CD8＋水平显著低于治疗前（P〈0.05）；两组治疗后血清IgA、IgG及IgM水平均显著低于治疗前（P〈0.05）；两组治疗后免疫功能指标水平差异均具有统计学意义（均P〈0.05）。结论与多次丝裂霉素膀胱内灌注治疗方案相比，中药冬凌草液热联合丝裂霉素化疗方案可有效预防浅表性膀胱移行细胞癌术后复发及提高患者免疫功能，应在临床上进行推广。

Objective The aim of this study was to evaluate the clinical efficacy of rabdosia rubescens combined with mitomycin urinary bladder irrigation in the treatment of post operative bladder cancer.Methods From October 2009 to January 2012,80 post operative bladder cancer were randomly divided into control group（n=40） and experiment group（n=41） in the Traditional Chinese Medicine Hospital Affiliated to Luzhou Medical College.Patients in the control group were given mitomycin urinary bladder irrigation and patients in the observation group were also given abdosia rubescens urinary bladder irrigation. After treatment,the recurrence rate,pos treatment serum VEGF level and immune function were compared between the two groups.Results The recurrence were 25.00% and 9.76% in the control and observation group respectively with statistical difference（P〈0.05）;The serum level of VEGF were significant decreased after treatment for the two group（P〈0.05）.And the observation group were much lower than the control group（P〈0.05）;The CD3＋,CD4＋,CD4＋/CD8＋ level were significant increased after treatment for the two groups（P〈0.05）,the CD8＋was significant decreased（P〈0.05）;The serum level of IgA,IgG and IgM were significant decreased after treatment for the two groups（P〈0.05）;The immune function were significant improved after treatment（P〈0.05）.Conclusion Rabdosia rubescens combined with mitomycin urinary bladder irrigation can decrease the recurrence risk and improve the immune system.