非肌层浸润性膀胱癌经尿道膀胱肿瘤切除术后应用中药序贯疗法的效果观察

Study on the efficacy of sequential Chinese medicine therapy in patients with non-muscle-invasive bladder cancer

目的回顾性分析非肌层浸润性膀胱癌(NMIBC)经尿道膀胱肿瘤切除术(TURBt)后中药序贯疗法的临床效果。方法收集2016年1月—2021年1月北京中医药大学东方医院诊治的55例NMIBC患者资料,根据灌注期间是否服用中药分为对照组31例、中药组24例。TURBt后,对照组规律行膀胱灌注治疗,中药组给予膀胱灌注加口服中药治疗。对比2组不良反应、复发情况。结果对照组不良反应1级12例、≥2级8例,发生率为64.5%(20/31);中药组不良反应1级5例、≥2级2例,发生率为29.2%(7/24)。2组不良反应发生率比较,差异有统计学意义(χ^(2)=6.79,P=0.03)。2组均无肝肾功能异常及胃肠道反应。对照组复发11例,复发率为35.5%;中药组复发2例,复发率为8.3%。2组复发率比较,差异有统计学意义(χ^(2)=5.53,P=0.03)。中药组低危、中危、高危复发率均低于对照组(P<0.05)。对照组无复发生存时间为11.5(3~24)个月,中药组无复发生存时间为24(3~24)个月,2组间差异有统计学意义(P<0.05)。2组无复发生存率比较,差异有统计学意义(P=0.048)。结论中药序贯治疗联合表柔比星膀胱灌注,可降低灌注的不良反应及术后复发率,延长患者的无复发生存时间。

Objective To analyze the clinical effect of TCM sequential therapy in the treatment of non-muscle-invasive bladder cancer(NMIBC)by retrospective analysis.Methods The general data of NMIBC patients diagnosed and treated in our department from January 2016 to January 2021 were retrospectively analyzed.They were divided into control group(31 cases)and traditional Chinese medicine group(24 cases)according to whether they took traditional Chinese medicine during perfusion.After TURBt,the control group was treated with bladder perfusion regularly,while the Chinese medicine group was treated with bladder perfusion and oral Chinese medicine.The adverse reactions and recurrence of the two groups were compared.Results In the control group,there were 12 cases with Grade 1 adverse reactions and 8 cases with Grade≥2 adverse reactions,the incidence rate was 64.5%(20/31).In the traditional Chinese medicine group,there were 5 cases with Grade 1 adverse reaction and 2 cases with Grade≥2 adverse reaction,the incidence rate was 29.2%(7/24).The incidence of adverse reactions between the two groups was statistically significant(χ^(2)=6.79,P=0.03).There was no abnormal liver and kidney function and gastrointestinal reaction in both groups.11 cases recurred in the perfusion group,the recurrence rate was 35.5%,and 2 cases in Chinese Medicine group,the recurrence rate was 8.3%,the difference between the two groups was statistically significant(χ^(2)=5.53,P=0.03).The recurrence rates of low-risk,medium-risk and high-risk in TCM group were lower than those in control group(P<0.05).The relapse-free survival time of the two groups was 11.5(3-24)months in the perfusion group and 24(3-24)months in the perfusion+Chinese medicine group.The difference in the relapse-free survival rate between the two groups was statistically significant(P=0.048).Conclusions The sequential treatment of TCM combined with epirubicin bladder infusion can reduce the postoperative recurrence rate of NMIBC patients,reduce the adverse reactions of epirubicin infusion,and extend the recurrence free survival time of patients,with good compliance.