华蟾素治疗膀胱癌血尿的回顾性临床观察

Effects of bladder intravesical instillation of cinobufagin injection on hematuria patients with bladder cancer: a retrospective clinical research

目的探讨华蟾素注射液膀胱灌注治疗膀胱癌血尿的疗效及安全性。方法对16例(对照组)接受基础治疗(注射用白眉蛇毒血凝酶,2U,静滴,每日3次+补充造血原料)和12例(治疗组)接受华蟾素注射液膀胱灌注联合基础治疗的膀胱癌血尿患者进行回顾性临床分析,对患者用药后的止血效果、改善贫血效果、中医局部证候、尿道疼痛症状、生活质量评分(KPS)、不良反应进行比较。结果治疗后,治疗组尿中RBC水平下降≥50%的占66.67%,而对照组为31.25%;治疗组全血HGB水平增加≥20 g/L的占58.33%,而对照组为25.00%;治疗组止痛药物减量≥50%的占62.50%,而对照组为10.00%;治疗组KPS高于对照组,差异有统计学意义(P<0.05);部分患者在治疗期间出现轻度消化道反应、疼痛、发热等,经对症处理可缓解。结论华蟾素膀胱灌注联合白眉蛇毒凝血酶治疗可有效控制膀胱癌血尿,减少膀胱出血,减轻尿道疼痛,改善患者生活质量,可作为膀胱癌血尿的有效治疗方法之一。

Objective To investigate the efficacy and safety of cinobufagin injection on hematuria patients due to bladder cancer.Methods 28 cases were divided into treatment group （n =12）and control group （n =16）.The patients in control group were treated with regular medicine of hemocoagulase （2 Unit, intravenous drip,three times a day）and hematopoietic materials such as Vitamin 12,folic acid,and chalybeate.In addition to the therapy for the control group,the patients in the treatment group were bladder intravesically instillated with cinobufagin injection.Then a retrospective study was carried out by comparing the effects of hemostasis,alleviating anemia,TCM patterns,urethral pain,Karnofsky Perform-ance Status （KPS）,and adverse effect between the two groups.Results After treatment,66.60 % of patients in the treatment group showed urinary red blood cells counts decreasing more than 50%,while only 31.25 % patients in the control group did;58.33 % of patients in treatment group showed blood HGB level increasing more than 20 g/L,while 25.00 % patients in the control group;the doses of analgesic drug decreased by more than 50% were 62.50% in the treatment group,higher than 10.00 %in the control group;KPS in the treatment group was significantly higher than that in the control group（P〈0.05）.After symptomatic supportive treatment,the adverse effects including mild gastrointestinal reac-tion,pain,and fever could be relieved.Conclusion The treatment of combined bladder intravesical in-stillation of cinobufagin injection with intravenous drip of hemocoagulase would alleviate hematuria due to bladder cancer,attenuate urethral pain and improve the patients＆#39;life quality.It can be one of options for treatment for hematuria patients with bladder cancer.