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张恺,鄢祺,阮善明.中药联合膀胱灌注治疗非肌层浸润性膀胱癌根治术后的Meta分析[J].浙江中西医结合杂志,2020,30(7):
中药联合膀胱灌注治疗非肌层浸润性膀胱癌根治术后的Meta分析
Meta-Analysis of TCM Combined with Intravesical Chemotherapy in Treatment for Postoperative Non-Muscle-Invasive Bladder Cancer
投稿时间:2020-02-19  修订日期:2020-06-07
DOI:
中文关键词:  中西医结合  膀胱恶性肿瘤  膀胱灌注  系统评价
英文关键词:Integrated Traditional Chinese and Western Medicine  Bladder Carcinoma  Intravesical Chemotherapy  System Review
基金项目:浙江省高等学校“院士结对培养青年英才计划”项目,中华中医药学会2017-2019年度青年人才托举工程项目,浙江省教育厅“十三五”高等学校学科专业带头人培养计划
作者单位E-mail
张恺 浙江中医药大学附属第一医院 zhangkaitcm@163.com 
鄢祺 浙江中医药大学第一临床医学院  
阮善明 浙江中医药大学附属第一医院 shanmingruan@zcmu.edu.cn 
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中文摘要:
      摘 要 目的 评价中药联合膀胱灌注在非肌层浸润性膀胱癌(Non-Muscle-Invasive Bladder Cancer,NMIBC)根治术后治疗中的疗效,为制定治疗方案提供高质量的循证医学证据。方法 检索关于中药联合膀胱灌注治疗NMIBC根治术后的临床研究、时间范围在2000年1月至2020年1月之间的研究,将单纯膀胱灌注治疗纳入西医组,将中药联合膀胱灌注治疗纳入中医组,全面检索符合要求的随机对照临床试验,同时进行系统评价。结果 纳入13项研究,共有1077例NMIBC根治术后患者,西医组和中医组分别为521例与556例。Meta分析结果显示:中医组显著降低1年和2年复发率,但在降低0.5年复发率方面疗效不明显,同时能够改善膀胱灌注化疗引起的不良反应,如减弱膀胱刺激征,降低血尿发生率,减轻发热等症状,缓解胃肠道反应,减少尿常规异常的发生。结论 中药联合膀胱灌注的中医组对治疗NMIBC根治术后的疗效优于膀胱灌注的西医组,但是由于纳入研究的临床试验质量不高,需要高质量、多中心、大样本的随机对照临床试验进行验证。
英文摘要:
      ABSTRACT Objective To evaluate the effectiveness of TCM combined with intravesical chemotherapy in treatment for postoperative non-muscle-invasive bladder cancer. Methods Generally retrieved clinical literatures of TCM combined with intravesical chemotherapy in treatment for postoperative non-muscle-invasive bladder cancer from January 2000 to January 2020, conducted intravesical chemotherapy alone as control group and TCM combined with intravesical chemotherapy as treatment group, and had a comparison by Meta-analysis. Results Thirteen clinical trials with 1077 postoperative non-muscle-invasive bladder cancer were included. 521 patients were in the control group, and 556 patients were in the treatment group. Meta-analysis indicated that treatment group were superior to control group in decreasing one year recurrence rate and two year recurrence rate, while the difference of half a year recurrence rate was not statistically significant between the two groups. In terms of adverse reactions generated by intravesical chemotherapy, TCM could alleviate irritation symptoms of bladder, hematuria, fever, gastrointestinal reaction and abnormal urine routine with statistically significantly differences. Conclusion The curative effect of treatment group is superior to the control group. However, due to the low methodological quality of the literature, it still needs a large sample, multi-center, high-quality clinical research trials continue to validate.
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