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蔡蔚,贺潇,蒋伟平,刘起立,狄奇,蒋斌,黄丽玲,毛璟弢.马归液联合吉西他滨膀胱灌注治疗膀胱癌的疗效观察[J].湖南中医药大学学报英文版,2023,43(2):289-293.[Click to copy
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| 马归液联合吉西他滨膀胱灌注治疗膀胱癌的疗效观察 |
| 蔡蔚,贺潇,蒋伟平,刘起立,狄奇,蒋斌,黄丽玲,毛璟弢 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 目的 观察马归液联合吉西他滨（gemcitabine, GEM）膀胱灌注治疗膀胱癌的疗效。方法 将2016年1月至2017年12月在湖南中医药大学第一附属医院泌尿外科行经尿道膀胱肿瘤电切除术（transurethral resection of bladder tumors, TURBT）的90例非肌层浸润性膀胱癌（non-muscular-invasive bladder cancer, NMIBC）患者随机分为治疗1组、治疗2组和对照组，每组30例。对照组采用GEM膀胱灌注治疗；治疗1组以GEM联合马归液膀胱灌注治疗；治疗2组在治疗1组基础上加入马归液口服。检测治疗前后各组患者的CD3+、CD4+、CD8+、CD4+/CD8+、血管内皮生长因子（vascular endothelial growth factor, VEGF）水平；随访各组患者术后1年、2年、3年的复发例数；记录各组患者恶心呕吐、血尿、膀胱刺激征、尿常规异常、发热的不良反应发生例数。结果 治疗后，治疗1组、治疗2组CD3+、CD4+、CD8+、CD4+/CD8+较治疗前均升高，血清VEGF水平均降低（P<0.05）；与对照组相比，治疗1组、治疗2组CD3+、CD4+、CD4+/CD8+均升高，血清VEGF水平均降低（P<0.05）；两组治疗组的上述指标比较，差异无统计学意义（P>0.05）。术后2年、3年，治疗1组、治疗2组的复发率均低于对照组（P<0.05），治疗2组复发率低于治疗1组（P<0.05）。治疗1组、治疗2组的不良反应发生率均低于对照组（P<0.05），治疗2组的不良反应发生率低于治疗1组（P<0.05）。结论 马归液口服加膀胱灌注的“内服外治”法联合GEM膀胱灌注治疗NMIBC，能有效提高CD3+、CD4+、CD4+/CD8+水平，降低血清VEGF水平，改善免疫系统，减少复发风险和不良反应，临床应用安全有效。 |
| 关键词: 马归液 内服外治法 吉西他滨 膀胱灌注 非肌层浸润性膀胱癌 经尿道膀胱肿瘤电切除术 复发率 |
| DOI：10.3969/j.issn.1674-070X.2023.02.018 |
| Received:April 07, 2021 |
| 基金项目:湖南省自然科学基金面上项目（2022JJ30452）；长沙市自然科学基金重点项目（kq2202448）；湖南省卫生健康委员会一般指导课题（202204054156）；湖南省普通高校教学改革研究课题重点项目（HNJG-2022-0135）。 |
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| Observation on the efficacy of intravesical instillation with Magui Liquid combined with gemcitabine on bladder cancer |
| CAI Wei,HE Xiao,JIANG Weiping,LIU Qili,DI Qi,JIANG Bin,HUANG Liling,MAO Jingtao |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Objective To observe the efficacy of intravesical instillation with Magui Liquid combined with gemcitabine (GEM) on bladder cancer. Methods A total of 90 patients with non-muscular invasive bladder cancer (NMIBC) who underwent transurethral resection of bladder tumors (TURBT) in the Department of Urology, the First Hospital of Hunan University of Chinese Medicine from January 2016 to December 2017 were randomly divided into Treatment Group 1 (n=30), Treatment Group 2 (n=30) and control group (n=30). The control group was treated with GEM intravesical instillation. Treatment Group 1 was treated with GEM combined with Magui Liquid for intravesical instillation. Treatment Group 2 was orally supplemented with Magui liquid on the basis of Treatment Group 1. The levels of CD3+, CD4+, CD8+, CD4+/CD8+ and vascular endothelial growth factor (VEGF) were detected before and after treatment. The recurrent cases in each group was followed up in the first, second and third years after surgery respectively. The cases of adverse reactions in each group, such as nausea and vomiting, hematuria, bladder irritation, abnormal results of urinalysis and fever were recorded. Results After treatment, the levels of CD3+, CD4+, CD8+, CD4+/CD8+ in Treatment Group 1 and 2 were higher than those before treatment, and the levels of serum VEGF were lower (P<0.05); compared with the control group, the levels of CD3+, CD4+, CD4+/CD8+ in Treatment Group 1 and 2 increased, and the level of serum VEGF decreased (P<0.05); there was no significant difference between the two treatment groups in the above indexes (P>0.05). In the second and third years after operation, the recurrence rate of Treatment Group 1 and 2 was lower than that of the control group (P<0.05), and the recurrence rate of Treatment Group 2 was lower than that of Treatment Group 1 (P<0.05). The incidence of adverse reactions in Treatment Group 1 and 2 was lower than that in the control group (P<0.05), and the incidence of adverse reactions in Treatment Group 2 was lower than that in Treatment Group 1 (P<0.05). Conclusion Oral administration of Magui Liquid plus intravesical instillation and GEM, which is known as a method of "combining oral administration and external treatment", in the treatment of NMIBC can significantly increase the levels of CD3+, CD4+ and CD4+/CD8+, lower the serum VEGF level, improve the function of the immune system, and decrease the risk of recurrence and adverse reactions, so it is safe and effective in clinical application. |
| Key words: Magui Liquid the method of "combining oral administration and external treatment" gemcitabine bladder perfusion non-muscular infiltrating bladder cancer transurethral resection of bladder tumors recurrence rate |
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