根治性经尿道膀胱肿瘤电切术联合化疗及益气活血通络法治疗肌层浸润性膀胱癌疗效观察

摘要

目的 观察根治性经尿道膀胱肿瘤电切术(TURBt)联合化疗及益气活血通络法治疗肌层浸润性膀胱癌的疗效.方法 将70例肌层浸润性膀胱癌患者随机分为观察组35例和对照组35例,对照组患者给予TURBt联合羟基喜树碱膀胱灌注化疗治疗,观察组在此基础上于手术后1周开始给予益气活血通络法即抗癌1号方治疗,2组均治疗1年.比较2组患者的无瘤生存率及总生存率,观察2组治疗前后生活质量评分及血清VEGF和CD4 +、CD8 +T细胞亚群及IgG、IgA、IgM 水平.结果 观察组患者的无瘤生存期显著长于对照组(P<0.05).观察组患者的1,3,5年的无瘤生存率均显著高于对照组(P均<0.05),但2组1,3,5年的总生存率比较差异无统计学意义(P>0.05).治疗后1年, 2组患者各项生活质量评分均显著高于治疗前(P<0.05),血清VEGF水平和CD8+水平均显著低于治疗前(P均<0.05),CD4 +、CD4 +/CD8 +及IgA、IgM、IgG水平均显著高于治疗前(P均<0.05),且观察组各指标改善情况均明显优于对照组(P均<0.05).结论 TURBt联合化疗及抗癌1号方治疗肌层浸润性膀胱癌可有效预防膀胱癌术后复发,增强患者免疫功能,值得在临床借鉴应用.%Objective It is to observe the curative effect of radical transurethral resection of bladder tumor (TURBt) combined with chemotherapy and supplementing Qi and activating blood and dredging collaterals method in the treatment of myometrial invasive bladder cancer. Methods 70 patients with myometrial invasive bladder cancer were randomly divided into the observation group (35 cases) and the control group (35 cases). The patients were treated with TURBt combined with hydroxycamptothecin for intravesical instillation chemotherapy in the control group, and with anti-cancer recipe 1 for supplementing Qi and activating blood and dredging collaterals on the basis of the control group in the observation group af-ter 1 weeks of operation. The 2 groups were treated for 1 years. The tumor free survival rate and the overall survival rate were compared between the two groups,and the quality of life score,the levels of serum VEGF,CD4 +,CD8 +T cell sub-sets and IgG,IgA,IgM were observed before and after treatment in the 2 groups. Results The tumor free survival time in the observation group was significantly longer than that in the control group(P<0.05). The 1-,3-and 5-year survival rate in the observation group was significantly higher than that in the control group (P<0.05), but there was no significant difference in the overall survival rate in 1,3 and 5 years between the 2 groups(all P>0.05). After 1 years of treatment, the scores of quality of life in the 2 groups were significantly higher than those before treatment(all P<0.05),the levels of serum VEGF and CD8 +were significantly lower than those before treatment (all P <0.05), the levels of CD4 +, CD4 +/CD8 +and IgA,IgM,IgG were significantly increased than those before treatment(all P<0.05),and the improve-ment of the above indicators in the observation group after treatment was significantly better than that in the control group (all P<0.05). Conclusion TURBt combined with chemotherapy and anti-cancer recipe 1 is effective in preventing postop-erative recurrence of bladder cancer,and improve the immune function,it should be used for reference in clinical practice.