评价膀胱灌注透明质酸钠联合膀胱区极超短波照射在治疗非细菌性膀胱炎中的疗效。

选取兖矿集团总医院2013年3月至2016年6月诊断为非细菌性膀胱炎患者46例，按照治疗方式分为三组，对照组18例，采用膀胱灌注自配混合液（地塞米松+糜蛋白酶+利多卡因+无菌注射用水）；实验一组13例，采用膀胱灌注透明质酸钠液联合膀胱区极超短波照射；实验二组15例，采用单纯膀胱灌注透明质酸钠液。灌注疗程均为每周一次共12次，其后每2周1次，共6次。治疗前、治疗3个月、治疗结束后复查膀胱镜，在病变区行大体观拍照并取活检行HE染色，在治疗前、治疗3个月及疗程结束后分别进行问卷调查记录盆腔疼痛+尿频/尿急症状评分（PUF评分）、膀胱镜及HE染色淋巴细胞计算膀胱炎组织学评分、排尿日记计算日排尿次数及最大膀胱容量，记录治疗期间的不良反应，观察并分析三组患者的数据变化。

45例随访至6个月，实验二组1例因连续2次灌注后出现皮肤瘙痒而中断治疗。疗程结束后，实验一组和实验二组的PUF评分、膀胱炎组织学评分、日排尿次数及最大膀胱容积等指标与治疗前相比，差异有统计学意义（P<0.05），与同期对照组相比差异亦有统计学意义（P<0.05）。疗程结束后，实验一组与实验二组的上述评价指标的差异没有统计学意义，但在治疗中期，实验一组的上述指标要好于实验二组，差异有统计学意义（P<0.05）。治疗期间无严重不良反应。

膀胱灌注透明质酸钠联合膀胱区极超短波照射治疗非细菌性膀胱炎疗效明确，无严重并发症。相比单纯灌注透明质酸钠，透明质酸钠联合极超短波治疗能更快的改善症状和炎症程度，为非细菌性膀胱炎的综合治疗提供了新的思路，开拓了新的空间。

To evaluate the efficacy of bladder perfusion with sodium hyaluronate combined with ultrashort wave irradiation in bladder region in treatment of non-bacterial cystitis.

Altogether 46 patients who were diagnosed as non-bacterial cystitis in our hospital from March 2013 to June 2016 were divided into three groups according to different treatment methods: 18 patients who accepted bladder perfusion with mixed liquid [dexamethasone + chymotrypsin + lidocaine + SWFI (Sterile Water for Injection)] were classified as Control Group; 13 patients who accepted bladder perfusion with sodium hyaluronate solution and ultra-shortwave radiation in the bladder area were classified as Experiment A Group; 15 patients who simply accepted intravesical instillation of sodium hyaluronate were classified as Experiment B Group. All the patients underwent the same course of instillation treatment (once a week for 12 times and then once every two weeks for 6 times) and accepted cystoscopy re-examinations before treatment, during 3-month treatment and after treatment. In the lesion area, the general view was adopted to take photos and the biopsy was performed for HE staining. Questionnaires were made before treatment, during 3-month treatment and after treatment respectively, to record pelvic pain+urgency / frequency symptom score (PUF score), cystoscopy, HE-stained lymphocytes for calculation of the histological score of cystitis, micturition diary for calculation of the frequency of daily micturition and maximum bladder capacity, as well as intra-treatment adverse reactions. Data changes of three groups were also observed and analyzed.

Among all the cases, 45 cases were followed up for 6 months, while, the treatment for 1 patient in Experiment B Group was discontinued due to itchy skin after two continuous perfusions. The post-treatment indexes of Experiment A Group and Experiment B Group such as the PUF score, the histological score of cystitis, the frequency of daily micturition and maximum bladder capacity had statistically significant difference in contrast with pre-treatment ones (P<0.05) and those of Control Group at the same period (P<0.05). No statistically significant difference was seen in the post-treatment indexes listed hereinabove of neither Experiment Group, but Experiment A Group was better than Experiment B Group in intra-treatment indexes, with statistically significant difference (P<0.05). No serious adverse reactions were found during the treatment.

Combination of application of bladder perfusion with sodium hyaluronate and ultrashort wave irradiation has clear effect in the treatment of non-bacterial cystitis without serious complications. In comparison with simple perfusion of sodium hyaluronate, combination therapy can improve the symptoms and inflammation in a faster manner, which provides a new train of thought and opens up a new space for comprehensive treatment of non-bacterial cystitis.