摘要
目的观察知柏地黄汤加减对注射用盐酸吡柔比星膀胱灌注膀胱癌患者血清丙二醛(MDA)、超氧化物歧化酶(SOD)、总抗氧化活性(AOA)水平的影响。方法将92例膀胱癌患者按照随机数字表法分为2组,2组均采用经尿道膀胱肿瘤切除术(TUR-BT)治疗,对照组46例术后行注射用盐酸吡柔比星膀胱灌注,治疗组46例在对照组治疗基础上于术后3周服用知柏地黄汤加减治疗。2组均治疗8周。比较2组术后3、6、9周中医证候评分、卡氏功能状态量表(KPS)评分、细胞黏附因子44(CD44)、细胞角蛋白20(CK20)、膀胱肿瘤抗原(BTA)、CD3^(+)、CD4^(+)、自然杀伤(NK)细胞水平、CD4^(+)/CD8^(+)值、MDA、SOD、AOA水平,以及毒副反应发生情况。结果2组术后6、9周KPS评分均较本组术后3周升高(P<0.05),2组术后9周均较本组术后6周升高(P<0.05),且治疗组术后6、9周均高于对照组同期(P<0.05)。2组术后6、9周尿液CD44、CK20、BTA水平均较本组术后3周降低(P<0.05),2组术后9周均较本组术后6周降低(P<0.05),且治疗组术后6、9周均低于对照组同期(P<0.05)。治疗组术后6、9周CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、NK细胞水平均较本组术后3周升高(P<0.05),治疗组术后9周均较本组术后6周升高(P<0.05),且治疗组术后6、9周均高于对照组同期(P<0.05)。治疗组术后6、9周血清MDA水平均较本组术后3周降低(P<0.05),SOD、AOA水平均升高(P<0.05),治疗组术后9周均较本组术后6周改善(P<0.05),且治疗组术后6、9周血清MDA水平低于对照组同期(P<0.05),SOD、AOA水平均高于对照组同期(P<0.05)。2组骨髓抑制、胃肠道反应发生率比较差异无统计学意义(P>0.05),治疗组尿路感染、膀胱刺激征发生率低于对照组(P<0.05)。结论知柏地黄汤加减应用于注射用盐酸吡柔比星膀胱灌注患者,可有效抑制肿瘤标志物表达,缓解症状,减少毒副反应,提高患者生活质量,其作用机制可能与调节免疫功能及氧化-抗氧化平衡有关。
Objective To observe the regulatory effects of the modified Zhibai Dihuang Decoction on serum malondialdehyde(MDA),superoxide dismutase(SOD)and total antioxidant activity(AOA)in bladder cancer(BC)patients treated with intravesical infusion of pirarubicin hydrochloride for injection.Methods A total of 92 BC patients treated with transurethral resection of bladder tumor(TUR-BT)were randomly assigned into the treatment group(n=46)and the control group(n=46).All patients were managed by postoperative intravesical infusion of pirarubicin hydrochloride for injection,and those in the treatment group were additionally given to the modified Zhibai Dihuang Decoction at 3 weeks postoperatively.After 8 weeks of treatment,traditional Chinese medicine(TCM)syndrome scores,Karnofsky performance status(KPS)scores,relative levels of cell adhesion molecule cluster of differentiation(CD)44(CD44),cytokeratin 20(CK20),bladder tumor antigen(BTA),CD3^(+),CD4^(+),CD8^(+),natural killer(NK)cells,CD4^(+)/CD8^(+),MDA,SOD,and AOA,and the incidence of adverse events were compared between groups.Results The KPS scores in both groups at 6 and 9 weeks postoperatively were significantly higher than those at 3 weeks postoperatively(P<0.05),which,at 9 weeks postoperatively were significantly higher than those at 6 weeks postoperatively(P<0.05).The KPS scores in the treatment group at 6 and 9 weeks postoperatively were significantly higher than those in the control group(P<0.05).Relative levels of CD44,CK20,and BTA in both groups at 6 and 9 weeks postoperatively were significantly lower than those at 3 weeks postoperatively(P<0.05),which,at 9 weeks postoperatively were significantly lower than those at 6 weeks postoperatively(P<0.05).Relative levels of CD44,CK20,and BTA in the treatment group at 6 and 9 weeks postoperatively were significantly lower than those in the concurrent control group(P<0.05).Relative levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and NK cells in the treatment group at 6 and 9 weeks postoperatively were significantly higher than those at 3 weeks postoperatively(P<0.05),which were significantly higher than those in the control group at 6 and 9 weeks postoperatively(P<0.05).Relative levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),and NK cells in the treatment group at 9 weeks postoperatively were significantly higher than those at 6 weeks postoperatively(P<0.05).MDA in the treatment group at 6 and 9 weeks postoperatively was significantly lower than that at 3 weeks postoperatively(P<0.05),while SOD and AOA levels were significantly higher(P<0.05),improvement of which in the treatment group were significantly pronounced compared with those in the control group(P<0.05).The improvement of MDA,SOD and AOA levels at 9 weeks postoperatively in the treatment group was significantly pronounced than that at 6 weeks postoperatively(P<0.05).There were no significant differences in the incidences of myelosuppression and gastrointestinal reactions between groups(P>0.05).The incidences of urinary tract infection and irritation symptoms of bladder were significantly lower in the treatment group than those in the control group(P<0.05).Conclusion The modified Zhibai Dihuang Decoction can effectively inhibit the expressions of tumor markers,relieve symptoms,reduce toxicity,and improve the quality of life by regulating immune function and oxidation-antioxidant balance in BC patients treated with intravesical infusion of pirarubicin hydrochloride for injection.
作者
赵彬
索栋梁
胡杰
吴永吉
ZHAO Bin;SUO Dongliang;HU Jie;WU Yongji(Department of Urology,the People's Hospital of Langfang City,Langfang,Hebei 065000;Department of Urology,the Second Hospital of Handan,Handan,Hebei 056000)
出处
《河北中医》
2023年第5期727-732,共6页
Hebei Journal of Traditional Chinese Medicine
基金
邯郸市科学技术研究与发展计划(编号:21422083039)。
关键词
知柏地黄汤
膀胱肿瘤
术后
化疗
中西医结合疗法
Zhibai Dihuang Decoction
Bladder cancer
Postoperative
Chemotherapy
Integrated traditional Chinese and Western medicine therapy
