补肾通淋方治疗反复发作尿路感染临床研究
|
摘要
目的:探讨补肾通淋方治疗反复发作尿路感染(recurrent urinary tract infections,RUTI)的临床疗效。方法:选取2016年1月至2018年9月本院收治的中老年RUTI患者40例为研究对象,随机分为观察组和对照组各20例。对照组在一般治疗基础上给予常规抗感染药物治疗,后根据药敏及临床疗效选择敏感抗生素,急性抗感染治疗有效后给予长时程低剂量抑菌疗法,观察组在对照组治疗的基础上联合补肾通淋方治疗。观察并记录两组患者临床症状(小便频数,排尿灼热感,小便涩痛,尿急,乏力,腰酸痛,口苦心烦,小腹坠胀)轻重程度及患者6个月内反复发作情况。结果:观察组有效率75%,对照组有效率40%,观察组优于对照组,但两组间有效率比较,无统计学差异(P=0. 054> 0. 05);治疗后,两组患者中医证候积分均较治疗前明显改善(P <0. 05),且观察组优于对照组,差异有统计学意义(P <0. 05);与治疗前比较,两组患者治疗后临床症状(小便频数,排尿灼热感,小便涩痛,尿急,乏力,腰酸痛,口苦心烦,小腹坠胀)评分均较前明显改善(P <0. 05),且观察组优于对照组,差异有统计学意义(P <0. 05);随访6个月,对照组复发率(45%)高于观察组(25%),但两组间比较无统计学差异(P> 0. 05)。结论:补肾通淋方治疗中老年反复发作尿路感染,能显著改善患者临床症状,提高治疗效果,降低尿路感染复发率。
Objective: To explore the clinical curative effect of Kidney-Nourishing and Strangulia-Relieving Formula on recurrent urinary tract infections(RUTI). Methods: Forty middle-aged and elderly patients with RUTI admitted to our hospital from January 2016 to September 2018 were randomly divided into the observation group and the control group,with 20 cases in each group.The control group was given routine anti-infective drugs on the basis of general treatment,then sensitive antibiotics were selected according to drug sensitivity and clinical efficacy,and long-term low-dose bacteriostatic therapy was given after acute anti-infective treatment had been effective. The observation group was additionally treated with Kidney-Nourishing and Strangulia-Relieving Formula on the basis of the control group. The clinical symptoms(including frequency of urination,burning sensation of urination,astringent pain of urination,urgency of urination,fatigue,low back pain,distress of mouth,abdominal distension) and recurrence within 6 months were observed and recorded. Results: The effective rate was 75% in the observation group and 40% in the control group. The effective rate in the observation group was better than the control group,but there was no statistical difference between the two groups(P = 0. 054 > 0. 05). After the treatment,the scores of TCM syndromes in the two groups were significantly improved compared with those before the treatment(P < 0. 05),and the observation group was better than the control group,the difference was statistically significant(P < 0. 05). Compared with before the treatment,the scores of clinical symptoms(frequency of urination,burning sensation of urination,astringent pain of urine,urgency of urine,fatigue,lumbar pain,distress of mouth,abdominal distension) in the two groups were significantly improved after the treatment(P < 0. 05),and the observation group was better than the control group,the difference was statistically significant(P < 0. 05). After 6 months of follow-up,the recurrence rate of the control group(45%) was higher than that of the observation group(25%),but there was no significant difference between the two groups(P > 0. 05). Conclusion: Kidney-Nourishing and Strangulia-Relieving Formula has a remarkable efficacy on recurrent urinary tract infections in middle-aged and old people,can significantly improve the clinical symptoms,improve the treatment effect and reduce the recurrence rate of urinary tract infection.
Objective: To explore the clinical curative effect of Kidney-Nourishing and Strangulia-Relieving Formula on recurrent urinary tract infections(RUTI). Methods: Forty middle-aged and elderly patients with RUTI admitted to our hospital from January 2016 to September 2018 were randomly divided into the observation group and the control group,with 20 cases in each group.The control group was given routine anti-infective drugs on the basis of general treatment,then sensitive antibiotics were selected according to drug sensitivity and clinical efficacy,and long-term low-dose bacteriostatic therapy was given after acute anti-infective treatment had been effective. The observation group was additionally treated with Kidney-Nourishing and Strangulia-Relieving Formula on the basis of the control group. The clinical symptoms(including frequency of urination,burning sensation of urination,astringent pain of urination,urgency of urination,fatigue,low back pain,distress of mouth,abdominal distension) and recurrence within 6 months were observed and recorded. Results: The effective rate was 75% in the observation group and 40% in the control group. The effective rate in the observation group was better than the control group,but there was no statistical difference between the two groups(P = 0. 054 > 0. 05). After the treatment,the scores of TCM syndromes in the two groups were significantly improved compared with those before the treatment(P < 0. 05),and the observation group was better than the control group,the difference was statistically significant(P < 0. 05). Compared with before the treatment,the scores of clinical symptoms(frequency of urination,burning sensation of urination,astringent pain of urine,urgency of urine,fatigue,lumbar pain,distress of mouth,abdominal distension) in the two groups were significantly improved after the treatment(P < 0. 05),and the observation group was better than the control group,the difference was statistically significant(P < 0. 05). After 6 months of follow-up,the recurrence rate of the control group(45%) was higher than that of the observation group(25%),but there was no significant difference between the two groups(P > 0. 05). Conclusion: Kidney-Nourishing and Strangulia-Relieving Formula has a remarkable efficacy on recurrent urinary tract infections in middle-aged and old people,can significantly improve the clinical symptoms,improve the treatment effect and reduce the recurrence rate of urinary tract infection.
引文
[1]李雪玲,钟逸斐.慢性尿路感染的中医药治疗进展[J].中医临床研究,2016,8(33):101-104.
[2]王海燕.肾脏病学[M].3版.北京:人民卫生出版社,2009:1246.
[3]尿路感染诊断与治疗中国专家共识编写组.尿路感染诊断与治疗中国专家共识(2015版):尿路感染抗菌药物选择策略及特殊类型尿路感染的治疗建议[J].中华泌尿外科杂志,2015,36(4):245.
[4]BEX A,LJUNGBERG B,POPPEL H V,et al.The Role of Cytoreductive Nephrectomy:European Association of Urology Recommendations in 2016[J].European Urology,2016,70(6):901-905.
[5]尿路感染诊断与治疗中国专家共识编写组.尿路感染诊断与治疗中国专家共识(2015版)-复杂性尿路感染[J].中华泌尿外科杂志,2015,36(4):241-244.
[6]陆再英,钟南山.内科学[M].7版.北京:人民卫生出版社,2008:674-675.
[7]周仲瑛.中医内科学[M].2版.北京:中国中医药出版社,2007:345.
[8]郑路,秦贵军,刘娇,等.2型糖尿病伴发复发性尿路感染一例并文献复习[J].郑州大学学报(医学版),2018,53(6):827-829.
[9]中华人民共和国卫生部.中药新药临床研究指导原则[S].北京:中国医药科技出版社,1993:145-146.
[10]王燕芬,赵玉芬.泌尿系感染抗菌治疗的药学监护[J].安徽医学,2012,33(12):1609-1611.
[11]安海燕,王暴魁.反复尿路感染的中西医结合治疗[J].中国临床医生,2013,41(4):9-10.
[12]李晓静,汪悦,吴勇俊,等.中医药治疗复杂性尿路感染研究进展[J].世界最新医学信息文摘,2018,43(18):105-106.
[13]段苇,黄秀贞,董彬.猪苓汤加减治疗女性反复尿路感染疗效观察[J].云南中医学院学报,2017,40(2):58-60.
[14]曹宠华.知柏地黄丸为主治疗老年女性复发性尿路感染68例[J].浙江中医杂志,2013,48(11):815.
[15]孙成力,高建东,陶慧琳,等.栝楼瞿麦丸加味治疗慢性尿路感染的临床观察[J].中国中西医结合肾病杂志,2017,18(6):538-539.
[16]王荣宝,杨翠萍.八正散、无比山药丸佐治糖尿病并复杂性尿路感染30例[J].国医论坛,2017,32(2):52-53.
[17]刘俊鹤,李洁,杨洪涛.杨洪涛教授辨证论治老年复杂尿路感染经验[J].中国中西医结合肾病杂志,2016,17(10):850-851.
[18]阙中桂,叶应阳.陈根成教授基于命门学说论治老年慢性尿路感染的临床思路[J].四川中医,2017,35(6):22-23.
[19]李强,邓丽娥,何世东,等.何世东教授中西医结合治疗慢性尿路感染的临床经验[J].中国中西医结合肾病杂志,2015,16(8):668-669.
[20]于卓,张佩青.张佩青教授辨证论治复杂性尿路感染经验[J].中国中西医结合肾病杂志,2017,18(11):943-944.
[2]王海燕.肾脏病学[M].3版.北京:人民卫生出版社,2009:1246.
[3]尿路感染诊断与治疗中国专家共识编写组.尿路感染诊断与治疗中国专家共识(2015版):尿路感染抗菌药物选择策略及特殊类型尿路感染的治疗建议[J].中华泌尿外科杂志,2015,36(4):245.
[4]BEX A,LJUNGBERG B,POPPEL H V,et al.The Role of Cytoreductive Nephrectomy:European Association of Urology Recommendations in 2016[J].European Urology,2016,70(6):901-905.
[5]尿路感染诊断与治疗中国专家共识编写组.尿路感染诊断与治疗中国专家共识(2015版)-复杂性尿路感染[J].中华泌尿外科杂志,2015,36(4):241-244.
[6]陆再英,钟南山.内科学[M].7版.北京:人民卫生出版社,2008:674-675.
[7]周仲瑛.中医内科学[M].2版.北京:中国中医药出版社,2007:345.
[8]郑路,秦贵军,刘娇,等.2型糖尿病伴发复发性尿路感染一例并文献复习[J].郑州大学学报(医学版),2018,53(6):827-829.
[9]中华人民共和国卫生部.中药新药临床研究指导原则[S].北京:中国医药科技出版社,1993:145-146.
[10]王燕芬,赵玉芬.泌尿系感染抗菌治疗的药学监护[J].安徽医学,2012,33(12):1609-1611.
[11]安海燕,王暴魁.反复尿路感染的中西医结合治疗[J].中国临床医生,2013,41(4):9-10.
[12]李晓静,汪悦,吴勇俊,等.中医药治疗复杂性尿路感染研究进展[J].世界最新医学信息文摘,2018,43(18):105-106.
[13]段苇,黄秀贞,董彬.猪苓汤加减治疗女性反复尿路感染疗效观察[J].云南中医学院学报,2017,40(2):58-60.
[14]曹宠华.知柏地黄丸为主治疗老年女性复发性尿路感染68例[J].浙江中医杂志,2013,48(11):815.
[15]孙成力,高建东,陶慧琳,等.栝楼瞿麦丸加味治疗慢性尿路感染的临床观察[J].中国中西医结合肾病杂志,2017,18(6):538-539.
[16]王荣宝,杨翠萍.八正散、无比山药丸佐治糖尿病并复杂性尿路感染30例[J].国医论坛,2017,32(2):52-53.
[17]刘俊鹤,李洁,杨洪涛.杨洪涛教授辨证论治老年复杂尿路感染经验[J].中国中西医结合肾病杂志,2016,17(10):850-851.
[18]阙中桂,叶应阳.陈根成教授基于命门学说论治老年慢性尿路感染的临床思路[J].四川中医,2017,35(6):22-23.
[19]李强,邓丽娥,何世东,等.何世东教授中西医结合治疗慢性尿路感染的临床经验[J].中国中西医结合肾病杂志,2015,16(8):668-669.
[20]于卓,张佩青.张佩青教授辨证论治复杂性尿路感染经验[J].中国中西医结合肾病杂志,2017,18(11):943-944.