抵当汤联合吉西他滨治疗非肌层浸润性膀胱癌术后患者的疗效评价

目的:观察抵当汤联合吉西他滨膀胱灌注化疗治疗非肌层浸润性膀胱癌术后患者的临床疗效。方法:选择2015年1月至2019年9月期间于江苏省第二中医院、江苏省中医院就诊的非肌层浸润性膀胱癌患者100例随机分为观察组和对照组,其中观察组50例给予抵当汤联合吉西他滨膀胱灌注治疗,对照组50例给予安慰剂联合吉西他滨膀胱灌注治疗。在治疗周期前后,检测两组患者的血生化、免疫T细胞亚群(CD3⁺,CD4⁺,CD8⁺及CD4⁺/CD8⁺)评估治疗组安全性及免疫功能变化;采用膀胱癌患者生命质量核心量表(EORTC QLQ-C30)与浅表性膀胱癌患者特异性量表(EORTC QLQ-BLS24)量化反映治疗前后患者的躯体、角色、情绪与社会等功能情况,疲劳、疼痛、恶心呕吐、气促、失眠、食欲减弱、腹泻和便秘等症状情况及治疗产生问题、未来担心、肠道症状及尿路症状等膀胱癌特异症状。结果:两组患者年龄、性别、病程和肿瘤分期等均无差异。在治疗周期内,两组均无复发病例及不良反应事件,且观察组中医疗效较对照组明显升高(χ²=7.23,P=0.02)。相较对照组治疗后,观察组中的CD3⁺,CD4⁺细胞数量以及CD4⁺/CD8⁺都有明显升高(P<0.05)。与治疗前相比,两组在角色功能、社会功能和总体健康领域均较治疗前明显升高(P<0.05)。此外,观察组的治疗后疲劳、腹泻、便秘、肠道症状以及尿路症状较对照组明显降低(P<0.05)。结论:抵当汤可减轻非肌层浸润性膀胱癌患者术后吉西他滨灌注化疗期间的不良临床症状,改善尿道、肠道不适反应,改善免疫功能,提高患者的生活质量。

Clinical Efficacy of Didangtang Combined with Gemcitabine in Postoperative Patients with Non-muscle-invasive Bladder Cancer

Objective:To observe the clinical efficacy of Didangtang combined with gemcitabine chemotherapy in postoperative patients with non-muscle invasive bladder ctraditional chinese medicineancer(NMIBC).Method:A total of 100 patients with NMIBC in Jiangsu Provincial Second Chinese Medicine Hospital and Jiangsu Province Hospital of Chinese Medicine from January 2015 to September 2020 were randomly divided into control group and treatment group.50 cases in the treatment group received Didangtang combined with intravesical infusion of gemcitabine,and 50 cases in the control group received placebo combined with intravesical infusion of gemcitabine.Before and after the treatment cycle,the blood biochemistry,immune cell subsets(CD3⁺,CD4⁺and CD4⁺/CD8⁺)were detected to assess the safety and immune function changes in treatment group.Quality of life scale for patients with bladder cancer prepared by European Organization for the Research and Treatment of Cancer(EORTC QLQ-C30)and Specificity scale for patients with superficial bladder cancer(EORTC QLQ-BLS24)were scored to assess the changes in physical,role,emotional and social functioning of the patients,symptomatic conditions such as fatigue,pain,nausea and vomiting,shortness of breath,insomnia,loss of appetite,diarrhea and constipation,as well as bladder cancerspecific symptoms such as treatment-generated problems,future concerns,bowel symptoms and urinary tract symptoms.Result:There were no differences in terms of age,sex,disease duration and tumor states.During the treatment period,both groups had no recurrence or adverse events.The traditional Chinese medicine(TCM)efficacy in the treatment group was significantly better than that in the control group(χ²=7.23,P=0.02).After treatment,the number of CD3⁺,CD4⁺,CD8⁺cells and the CD4⁺/CD8⁺ratio in the treatment group were significantly higher than those in control group(P<0.05).Both groups showed significant improvements in the domains of role functioning,social functioning,and general health after treatment(P<0.05).In addition,fatigue,diarrhea,constipation,intestinal symptoms,and urinary tract symptoms in the treatment group were significantly better than those in the control group after treatment(P<0.05).Conclusion:Didangtang can reduce adverse clinical symptoms during postoperative gemcitabine infusion chemotherapy in patients with NMIBC,reduce urethral and intestinal discomfort reactions,improve immune function and enhance quality of life for patients.