李洁 周文垚 谭枚秀

[摘要] 放射性膀胱炎是由于盆腔恶性肿瘤放射性治疗后的常见并发症，主要在宫颈癌术后放疗患者中最容易出现，常导致尿频、尿急、尿痛、小便困难、血尿等，严重者甚至伴随尿失禁等症状的一种疾病。中医将其归属于淋症范畴。本文主要论述自拟益肾泄浊方加味（主要以小蓟饮子加上补肾化浊之品化裁而成）治疗宫颈癌术后放疗后导致的放射性膀胱炎的临床应用，阐述放射性膀胱炎的西医发生机制，介绍放射性膀胱炎中医发病的病因病机、治疗方法，并举病案佐证。

[关键词] 宫颈癌术后放射性膀胱炎;自拟益肾泄浊方;湿热蕴结下焦;肾虚为本

[中图分类号] R730.55          [文献标识码] B          [文章编号] 1673-9701（2021）35-0146-04

Clinical experience of self-prepared Yishen Xiezhuo Decoction in the treatment of postoperative radiation cystitis for cervical cancer

LI Jie1   ZHOU Wenyao1   TAN Meixiu2

1.Graduate School， Hunan University of Chinese Medicine， Changsha   410208， China; 2.Department of Gynecology， The Second Affiliated Hospital of Hunan University of Chinese Medicine， Changsha   410011， China

[Abstract] Radiation cystitis is a common complication after radiotherapy for pelvic malignancies， mainly in patients with postoperative radiotherapy for cervical cancer. It often leads to symptoms such as urine frequency， urine urgency， pain in urination， dysuria， hematuria， and even incontinence in severe cases. According to traditional Chinese medicine， it is classified as stranguria. This paper mainly discusses the clinical application of the self-prepared Yishen Xiezhuo decoction （mainly made by small thistle decoction and kidney-tonifying and turbidity-dissolving herbs） in the treatment of radiation cystitis caused by postoperative radiotherapy for cervical cancer， and clarifies the mechanism of radiation cystitis in western medicine. Besides， this paper introduces the pathogenesis and treatment of radiation cystitis in traditional Chinese medicine， and cites cases to support the evidences.

[Key words] Postoperative radiation cystitis for cervical cancer; Self-prepared Yishen Xiezhuo Decoction; Dampness-heat in the lower energizer; Kidney deficiency.

放射性膀胱炎主要在患者早期進行盆腔恶性肿瘤放射性手术治疗后的一种常见临床并发症，主要在宫颈癌术后放疗患者中最容易出现。此类疾病在是否发生以及病情严重程度与使用放射线使用剂量、放射线的持续时间等因素直接有关，如膀胱接受40～50 Gy剂量照射时对放射性膀胱炎较为敏感[1]。本研究主要针对宫颈癌放化疗术后之放射性膀胱炎进行阐述，临床常见尿频、尿急、尿痛、小便困难、血尿等，严重者甚至尿失禁。中医目前尚无指出关于放射性膀胱炎的具体病名，根据其具体的的临床表现症状和疾病表达，应该归属于中医淋证的疾病范畴。淋证的基本病机主要为体内湿热蕴结于下焦，肾与膀胱的气化功能相对不利，从而出现相应的临床症状，其主要病变位点位于膀胱和肾。……