益肾清利法治疗反复发作性尿路感染的临床疗效观察

发布时间：2018-02-04 14:29

本文关键词： 益肾清利法尿路感染反复发作临床研究　出处：《南京中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：通过观察治疗前后患者的主要症状及实验室指标的变化,观察益肾清利疗法对缓解反复发作性尿路感染症状、改善相关实验室指标及减少复发的影响,综合评价该疗法对反复发作性尿路感染(RUTI)的防治效果。方法：收入自2013年9月至2016年1月期间于江苏省中医院肾科、泌尿外科门诊及病房的RUTI共90个病例患者。根据中医辨证标准和RUTI诊断标准将患者分为气阴两虚和气阳两虚两类,每一类分为治疗组和对照组。气阴两虚类病例60例,其中1治疗组40例,对照组20例：气阳两虚类病例30例,其中治疗组、对照组分别20例、10例。对照组均根据药敏结果应用抗生素治疗,治疗组在它的基础上再用益肾清利方,其中,对气阴两虚证采取益气养阴,清利湿热法治疗,对气阳两虚证采取温补脾肾,清利湿热法治疗,疗程4周。共随访6个月以上。结果：1.对全部入组患者年龄分布情况统计,入组患者均为女性,多集中在45-75年龄段。2.在中医证候疗效方面比较,两类治疗组痊愈率、显效率均高于对照组,但总有效率两组相当,无统计差异。其中,气阴两虚证治疗组治疗后,尿频、尿急、尿痛或灼热感、小腹胀痛症状均有极显著改善(p0.01),对排尿不畅有显著改善(p0.05)。与对照组比较,治疗组在小便浑浊、口干咽干方面的改善优于对照组,其他症状无显著差异。气阳两虚证治疗组全部症状具有极显著改善(p0.01)；对照组中遇劳加剧、大便溏薄、乏力显著改善(p0.05),尿频数、排尿不畅极显著改善(p0.01)。两组疗后积分比较,治疗组遇劳加剧、畏寒怕冷症状积分显著低于对照组(p0.05)。这表明治疗组在改善尿频数、排尿不畅方面与对照组疗效相当,而腰部隐痛、大便溏薄、小腹坠胀、畏寒怕冷等气阳两虚症状的改善则显著优于对照组。3.治疗组和对照组的尿白细胞计数降低极显著(p0.01),治疗组优于对照组。4.随访6个月后,治疗组复发率均低于对照组,气阴两虚证具有极显著性差异(p0.01)。结论：益肾清利法治疗反复发作性尿路感染具有很好的临床疗效,能显著改善症状、降低实验室指标、减少复发。
[Abstract]:By observing the changes of main symptoms and laboratory indexes before and after treatment, we observed the effects of Yishen Qingli therapy on relieving the symptoms of recurrent urinary tract infection, improving related laboratory indexes and reducing recurrence. Methods: from September 2013 to January 2016, the patients were enrolled in the Department of Kidney, Jiangsu Provincial Hospital of traditional Chinese Medicine. There were 90 cases of RUTI in urology clinic and ward. According to the criteria of TCM syndrome differentiation and RUTI diagnosis, the patients were divided into two categories: Qi and Yin deficiency and Qi and Yang deficiency, each of which was divided into treatment group and control group. There were 60 cases of Qi and Yin deficiency. There were 40 cases in the treatment group and 20 cases in the control group: 30 cases of deficiency of Qi and yang, of which 20 cases were treated with antibiotics in the treatment group and 20 cases in the control group. Among them, Qi-Yin deficiency syndrome is treated with the method of supplementing qi and nourishing yin, clearing away the dampness and heat, and treating the deficiency of qi and yang with the method of warming up the spleen and kidney, and clearing away the dampness and heat. The course of treatment was 4 weeks and followed up for more than 6 months. Results: 1.The age distribution of all the patients in the group was female, mostly in 45-75 age group .2.Compared with the curative effect of TCM syndromes, the recovery rate of the two treatment groups was higher than that of the control group. The effective rate was higher than that of the control group, but the total effective rate was the same between the two groups, and there was no statistical difference. The symptoms of flatulence in the lower abdomen were significantly improved (P 0.01), and the dysuria was significantly improved (P 0.05). Compared with the control group, the improvement of urine turbidity and dry mouth pharynx in the treatment group was better than that in the control group. There was no significant difference in other symptoms. All symptoms of Qi-Yang deficiency syndrome treatment group were significantly improved (P 0.01); in the control group, fatigue was aggravated, stool was thin, fatigue was significantly improved (p 0.05), frequency of urine, dysuria was significantly improved. After treatment, the scores of the two groups were compared. The scores of cold and cold symptoms in the treatment group were significantly lower than those in the control group (P 0.05). This indicated that the treatment group had the same curative effect as the control group in improving the frequency of urination and dysuria, but the pain in the waist, thin stools and distension of the lower abdomen. The improvement of qi and yang deficiency symptoms such as chilling and chilling was significantly better than that of control group .3.The urine white blood cell count in treatment group and control group was significantly lower than that in control group, and that in treatment group was better than that in control group .4.After 6 months follow-up, the recurrence rate in treatment group was lower than that in control group. Conclusion: Yishen Qingli method has a good clinical effect in treating recurrent urinary tract infection, it can significantly improve symptoms, reduce laboratory indexes and reduce recurrence.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R277.5

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