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1.上海中医药大学附属曙光医院泌尿外科(上海 200120)
2.上海中医药大学附属曙光医院中西医结合外科研究室(上海 200120)
3.上海中医药大学附属曙光医院西医外科研究室(上海 200120)
袁继翔,男,博士研究生,主要从事中西医结合治疗泌尿外科疾病的临床及基础研究工作。
徐东亮,主任医师,教授,博士研究生导师; E-mail:dr_xudongliang@shutcm.edu.cn
收稿日期:2024-05-21,
纸质出版日期:2025-02-10
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袁继翔,臧鑫玥,谈鸣岳,等.麝香保心丸口服联合化学疗法对非肌层浸润性膀胱癌术后复发的影响[J].上海中医药杂志,2025,59(2):14-18.
YUAN Jixiang,ZANG Xinyue,TAN Mingyue,et al.Effects of Shexiang Baoxin Pill oral intake combined with chemotherapy on postoperative recurrence of non‑muscle invasive bladder cancer[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(2):14-18.
袁继翔,臧鑫玥,谈鸣岳,等.麝香保心丸口服联合化学疗法对非肌层浸润性膀胱癌术后复发的影响[J].上海中医药杂志,2025,59(2):14-18. DOI: 10.16305/j.1007-1334.2025.z20240521004.
YUAN Jixiang,ZANG Xinyue,TAN Mingyue,et al.Effects of Shexiang Baoxin Pill oral intake combined with chemotherapy on postoperative recurrence of non‑muscle invasive bladder cancer[J].Shanghai Journal of Traditional Chinese Medicine,2025,59(2):14-18. DOI: 10.16305/j.1007-1334.2025.z20240521004.
目的
2
观察麝香保心丸口服联合吉西他滨膀胱灌注对非肌层浸润性膀胱癌术后复发及生存质量的影响。
方法
2
将123例瘀毒蕴结型非肌层浸润性膀胱癌术后患者随机分为治疗组(61例)、对照组(62例),对照组予吉西他滨膀胱灌注治疗,治疗组在此基础上加用麝香保心丸口服,两组均持续治疗1年。观察两组肿瘤复发情况、不良反应发生情况及中医证候疗效,比较癌症患者生存质量核心量表及浅表性膀胱癌患者特异性症状量表评分的变化情况。
结果
2
①最终纳入统计者108例,其中治疗组53例、对照组55例。②治疗组和对照组术后1年总复发率分别为15.1%、32.7%,治疗组低于对照组(
P
<
0.05)。③治疗前后组内比较,治疗组疲倦、疼痛、失眠等症状评分降低(
P
<
0.05),经济困难及治疗相关问题评分升高(
P
<
0.05);对照组疲倦、食欲丧失、躯体功能等评分降低(
P
<
0.05),经济困难、排尿症状及治疗相关问题评分升高(
P
<
0.05)。组间治疗后比较,疼痛、情绪功能、总体健康状况、排尿症状及治疗相关问题评分差异有统计学意义(
P
<
0.05)。④治疗组中医证候疗效优于对照组(
P
<
0.05)。⑤治疗组膀胱刺激征发生率、不良反应发生率低于对照组(
P
<
0.05)。
结论
2
与单纯采用吉西他滨膀胱灌注治疗相比,加用麝香保心丸口服有利于降低瘀毒蕴结型非肌层浸润性膀胱癌术后患者的复发率,改善患者的生存质量及中医证候,减轻化学疗法药物灌注的不良反应。
Objective
2
To observe the effects of Shexiang Baoxin Pill oral intake combined with gemcitabine intravesical instillation on postoperative recurrence and quality of life of non-muscle invasive bladder cancer (NMIBC).
Methods
2
A total of 123 postoperative patients with NMIBC of accumulated stasis and toxin syndrome were randomly divided into treatment group (
n
=61) and control group (
n
=62). Both groups were treated with gemcitabine intravesical instillation, and the treatment group was additionally treated with Shexiang Baoxin Pill orally. The treatment lasted for one year in both groups. The tumor recurrence rate, adverse events, and the traditional Chinese medicine (TCM) symptom efficacy were observed. The changes in cancer patients' scores of quality of life questionnaire-core 30 and superficial bladder cancer specific symptom questionnaire were compared.
Results
2
① A total of 108 patients were included in the final analysis, with 53 patients in the treatment group and 55 in the control group. ②The one-year recurrence rates were 15.1% in the treatment group and 32.7% in the control
group, with the treatment group showing a significantly lower recurrence rate than the control group (
P
<
0.05). ③Intra-group comparisons before and after treatment showed that in the treatment group, the symptom scores of fatigue, pain and insomnia etc. decreased (
P
<
0.05), while scores for financial difficulties and treatment-related problems increased (
P
<
0.05). In the control group, the symptom scores of fatigue, appetite loss and physical function etc. decreased (
P
<
0.05), while scores for financial difficulties, urination symptoms, and treatment-related problems increased (
P
<
0.05). Inter-group comparisons after treatment revealed significant differences in pain, emotional function, general health status, urination symptoms, and treatment-related problems (
P
<
0.05). ④The treatment group showed a significantly better TCM symptom efficacy (
P
<
0.05). ⑤The incidences of bladder irritation and adverse events were significantly lower in the treatment group than in the control group (
P
<
0.05).
Conclusion
2
The combined use of Shexiang Baoxin Pill oral intake and gemcitabine intravesical instillation is more effective than gemcitabine alone in reducing the tumor recurrence rate, improving patients' quality of life and TCM symptoms, and alleviating the adverse reactions associated with chemotherapy intravesical instillation in patients with non-muscle invasive bladder cancer of accumulated stasis and toxin syndrome.
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