中西医结合治疗糖尿病患者泌尿系感染46例

Clinical Observation of 46 Diabetics with Urinary Tract Infection by Treatment of Combing Traditional Chinese and Western Medicine

目的:观察糖尿病患者泌尿系感染的细菌学特点、药敏情况、临床特点及中西医结合治疗糖尿病患者泌尿系感染的临床疗效。方法:88例糖尿病合并泌尿系感染的患者随机分为两组,均采用常规抗菌治疗,治疗组(46例)加服中药煎剂,观察糖尿病患者泌尿系感染的细菌学特点、药敏情况、临床特点及治疗前后临床症状和实验室检查指标的变化。结果:细菌培养结果显示近年引起感染的菌群仍以革兰氏阴性杆菌为主,但革兰氏阳性菌比例较以往报道有所升高;革兰氏阴性菌对亚胺培南、头孢哌酮+耐β内酰胺酶类抗生素敏感性高;革兰氏阳性菌对万古霉素、哌拉西林或阿莫西林+耐β内酰胺酶类抗生素敏感性高;而以往尿路感染常用的喹诺酮类抗生素耐药性相对偏高。感染者往往血糖高、尿糖高、年龄大。治疗组综合疗效总有效率为95.65%,对照组综合疗效总有效率为88.09%。组间比较差异有统计学意义(P<0.05)。结论:糖尿病患者泌尿系感染的细菌学特点以革兰氏阴性杆菌为主,但常用西药耐药性增加;中西医结合对糖尿病患者泌尿系感染具有良好防治作用。

Objective：To observe bacteriological characteristics,antimicrobial susceptibility,clinical characteristics of the diabetic’s urinary tract infection and clinical curative effect cured by the treatment of combining traditional Chinese and western medicine.Method：88 diabetics with urinary tract infection were randomly divided into two groups and conventional antibiotic therapy was used in both groups.The treatment group（46 cases） additionally used traditional decoction.Observing diabetic’s urinary tract infection bacteriological characteristics,antimicrobial susceptibility,clinical characteristics,clinical symptoms before and after treatment and the index changes detected by laboratory.Result： Bacterial culture results show that,in recent years,bacterial group causing infections caused by the bacterium is still gram-negative bacilli.However,the ratio of gram-positive bacteria is higher than reported before.Susceptibility： gram-negative bacterium have higher sensitivity to imipenem,cefoperazone combining resistant to β lactam antibiotics enzymes.Gram-positive bacterium have higher sensitivity to vancomycin,piperacillin or amoxicillin combining resistant to β lactam antibiotics enzymes.Whereas quinolone antibiotic usually used for urinary tract infection have higher resistance relatively.The main factors causing infection are high blood sugar,high urine sugar and older age.The total effective rate in treatment group is 95.65% and comparison group is 88.09%.Comparison difference between groups has statistically significance（P 0.05）.Conclusion： The treatment combining traditional Chinese and western medicine for diabetic patients with urinary tract infection has good effects of prevention and cure.