二丁二仙汤及滋肾清利方中医辨证治疗慢性尿路感染的疗效评价

摘要

目的:评估中医辨证治疗慢性尿路感染(再发性泌尿道感染)的临床疗效和中医药改善慢性尿路感染患者生命质量的作用.方法:纳入成年女性再发性尿路感染患者,随机分为中药组和西药组,急性期予敏感抗生素治疗14 d,临床症状缓解后纳入临床试验,中药组予辨证后予中药二丁二仙方或滋肾清利方加减治疗,西药组予单剂量抗生素抑菌治疗联合中药安慰剂,治疗12周,并随访3个月.比较两组的复发情况,观察两组患者治疗前后中医临床证候积分、生命质量SF-36量表评分等变化.结果:治疗12周内复发率中药组与西药组差异无统计学意义.停药后随访3个月中药组复发率明显低于西药组;治疗12周后,中医证候疗效及中医证候总积分显著低于西药组;生命质量SF-36量表积分比较,中药组较西药组有明显改善.结论:慢性尿路感染在缓解期采用中医辨证治疗可以改善患者临床症状、身体状况、提高生命质量、降低远期复发率.%Objective:This study is aimed to assess the clinical effect of T.C.M.differentiation treatment on chronic UTI (recurrent UTI),and also the role of Chinese herb in improving the quality of life in chronic UTI patient.Methods:The adult female patients diagnosed as recurrent UTI were randomly divided into two groups:T.C.M.group & Western Medicine group.Initially,the patients in both groups were treated with sensitive antibiotics for 14 days during the acute phase.After the symptoms were relieved,they were enrolled into the clinical trial.The T.C.M.group were treated with either Er Ding Er Xian decoction or Zishen Qingli decoction after syndrome differentiation.While the Western medicine group were treated with one dose antibiotics for bacteria suppression,combined with T.C.M.-like placebo.The whole process of treatment lasted for three months,with three-month follow-up.The recurrence rate,the T.C.M.syndrome scores,and the quality of life using SF-36 form were evaluated in the two groups before and after treatment.Results:No difference was showed in the recurrence rate between the two groups after 12-week treatment.By contrast,after 3-month follow-up,the recurrence rate in the T.C.M.group was significantly lower than that in the Western Medicine group.Also,after 12-week treatment,the efficiency and scores of T.C.M.as well as the scores of SF36 in the T.C.M.group were significantly lower than that in the Western group.Conclusion:This study has indicated that T.C.M.differentiation treatment could be used in the chronic UTI patients during remission to improve the clinical symptoms,physical conditions and quality of life and to reduce the long-term recurrence rate.