八正散联合左氧氟沙星治疗女性下尿路感染患者临床疗效  

Clinical efficacy of Bazheng powder combined with levofloxacin in the treatment of female patients with lower urinary tract infection

作　　者：李昭融 吕莹 张妍琪 LI Zhaorong;LYU Ying;ZHANG Yanqi(The Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300150,China;Tianjin Beichen Shuangfu Outpatient Department,Tianjin 300150,China;Graduate School of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]天津中医药大学第二附属医院,天津300150 [2]天津北辰双福门诊部,天津300150 [3]重庆医科大学研究生院,重庆400016

出　　处：《西部医学》2024年第9期1365-1370,共6页Medical Journal of West China

基　　金：天津市中医药管理局·中医中西医结合科研课题(2021112)。

摘　　要：目的观察八正散联合左氧氟沙星治疗女性下尿路感染患者的临床疗效,并探究其作用机制。方法以天津中医药大学第二附属医院收治的141例女性下尿路感染患者作为研究对象,采用随机对照法分为八正散组、联合组和对照组,每组各47例。对照组给予左氧氟沙星治疗,八正散组予八正散治疗,联合组予八正散联合左氧氟沙星治疗,3组患者均治疗2周。观察比较患者治疗前后尿频、尿急、尿道灼热刺痛、尿黄赤症状的中医证候积分、尿白细胞计数、尿细菌培养、血清降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素6(IL-6)、肿瘤坏死因子-α(TNF-α)炎症因子水平及临床疗效和不良反应情况。结果八正散组和联合组患者治疗后中医证候积分、尿白细胞计数、尿培养转阴率、PCT、CRP、IL-6、TNF-α等炎症因子水平较治疗前均有明显改善(P<0.01);与对照组相比,八正散组、联合组患者尿频、尿急、尿道灼热刺痛、尿黄赤等症状改善效果更佳显著(P<0.05),尿白细胞计数显著减少,PCT、CRP、IL-6、TNF-α等炎症因子水平均明显下降,联合组患者尿培养转阴率升高(均P<0.05);与八正散组相比,联合组尿白细胞计数下降显著(P<0.05)。八正散组、联合组、对照组患者总有效率分别为85.11%、93.62%和76.60%,与对照组相比,联合组的有效率较高(P<0.05)。3组患者均出现1例不良反应。结论八正散联合左氧氟沙星治疗女性下尿路感染患者疗效显著,可有效改善患者尿频、尿急、尿道灼热刺痛、尿黄赤等临床症状,降低尿白细胞计数,提高尿培养转阴率,作用机制与减轻炎症反应密切相关,且联合使用优于单独使用。Objective To observe the clinical efficacy of Bazhengsan combined with levofloxacin in the treatment of female patients with lower urinary tract infection,and explore its mechanism in treating female with Dampness-heat Down-flowing.Methods A total of 141 female patients with lower urinary tract infection admitted to The Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were selected as the research objects.By randomized control method,they were divided into Bazhengsan group,combined group and control group,with 47 cases in each group,respectively.The control group was treated with levofloxacin,the Bazhengsan group was treated with Bazhengsan,and the combination group was treated with Bazhengsan combined with Levofloxacin.All patients in the three groups were treated for 2 weeks.Before and after treatment,the TCM syndrome scores,urinary white blood cell count,urinary bacterial culture,serum levels of procalcitonin(PCT),C-reactive protein(CRP),interleukin 6(IL-6),tumor necrosis factor-α(TNF-α)inflammatory factors,clinical efficacy and adverse reactions of patients were observed and compared.Results After treatment,TCM syndrome score,urinary white blood cell count,urine culture negative rate,PCT,CRP,IL-6,TNF-αand other inflammatory factors in Bazhengsan group and combination group were significantly improved compared with before treatment(P<0.01).Compared with the control group,the symptoms such as frequency of urination,urgency of urination,burning and stinging urethra,and yellow and yellow urine in the Bazhingsan group and combined group were significantly improved(P<0.05 or P<0.01),the urinary white blood cell count was significantly decreased(P<0.01),and the levels of inflammatory factors such as PCT,CRP,IL-6 and TNF-αwere significantly decreased(P<0.01).The rate of urine culture turning negative in combination group was increased(P<0.05).Compared with Bazhengsan group,the urine white blood cell count in combination group was significantly decreased(P<0.05).The total effective

关 键 词：八正散 左氧氟沙星 下尿路感染 湿热下注证 

分 类 号：R691.3[医药卫生—泌尿科学]