中药消癥汤联合羟基喜树碱膀胱灌注预防膀胱癌术后复发的效果及对患者血清VEGF的影响

Effect of Xiaozheng decoction combined with hydroxycamptothecin bladder instillation on postoperative recurrence of bladder tumor and serum VEGF

目的探讨中药消癥汤联合羟基喜树碱膀胱灌注预防膀胱癌术后复发的效果及对患者血清血管内皮生长因子(VEGF)的影响。方法选取160例非肌层浸润性膀胱癌患者,依据随机数字表法将患者分为对照组和观察组,每组80例。对照组患者接受羟基喜树碱膀胱灌注治疗,观察组患者接受中药消癥汤联合羟基喜树碱膀胱灌注治疗。比较两组患者的术后复发率、不良反应发生情况及灌注前后的血清VEGF水平。结果灌注前和灌注后3个月,两组患者的血清VEGF水平比较,差异均无统计学意义(P﹥0.05);灌注后6个月和灌注后12个月,观察组患者的血清VEGF水平均低于对照组,差异均有统计学意义(P﹤0.05)。治疗后观察组患者食欲不振、恶心呕吐、尿频尿急、尿常规异常的发生率均低于对照组(P﹤0.05);两组患者血常规异常、血尿、发热、肝功能异常和膀胱刺激症状的发生率比较,差异均无统计学意义(P﹥0.05)。观察组患者术后1.5年和术后2年的复发率分别为6.25%和3.75%,分别低于对照组的16.25%和12.50%,差异均有统计学意义(P﹤0.05)。结论中药消癥汤联合羟基喜树碱膀胱灌注治疗膀胱癌能够有效减少不良反应的发生率,预防膀胱癌术后复发,作用机制可能与VEGF有关。

Objective To investigate the effect of Xiaozheng decoction combined with hydroxycamptothecin bladder instillation on postoperative recurrence of bladder tumor and serum VEGF level. Method Total of 160 patients with non- muscle invasive bladder cancer were randomly divided into control group and observation group, 80 cases in each group. Patients in control group underwent hydroxycamptothecin bladder instillation and patients in observation group underwent Xiaozheng decoction combined with hydroxycamptothecin bladder instillation. The postoperative recurrence rates, adverse reactions and serum VEGF levels before and after instillation in two groups were compared. Result Before instillation and after 3 months of instillation, there was no significant difference in serum VEGF between the two groups （P〉0.05）. After 6 and 12 months of instillation, the levels of serum VEGF in the observation group were significantly lower than those in the control group （P〈0.05）. In the observation group, the incidence of loss of appetite, nausea and vomit- ing, urinary frequency and urinary urgency, and urinary abnormalities were significantly lower than those in the control group （P〈0.05）; but no significant difference was found between two groups on incidence rates of abnormal blood rou- tine, hematuria, fever, liver dysfunction and bladder irritation （P〉0.05）. The recurrence rates of patients in the observation group at 1.5 years and 2 years after surgery were 6.25% and 3.75%, respectively, which were significantly lower than those in the control group （16.25% and 12.50%, P〈0.05）. Conclusion The Xiaozheng decoction combined with hydroxycamptothecin could effectively reduce the adverse reactions and prevent recurrence of bladder cancer after operation, whose mechanism probably related to VEGF.