开郁补肾方治疗老年女性慢性尿路感染伴发抑郁倾向的临床研究

Clinical Study on Elderly Women with Chronic Urinary Tract Infection-related Depressive Tendency

目的:探讨开郁补肾方治疗老年女性慢性尿路感染伴发抑郁倾向患者的疗效及其作用机制。方法:采用随机对照法将符合纳入标准的60例患者分为治疗组30例和对照组30例,分别接受开郁补肾方和小剂量抗菌素(SMZCO、呋喃妥因、头孢克洛或敏感抗生素)序贯治疗,疗程12周,通过观察治疗前后两组ZUNG氏抑郁自评量表(SDS)、肝郁证候量表、淋证证候量表得分改善及6个月观察期内复发的情况,了解开郁补肾方治疗老年女性慢性尿感伴发抑郁倾向的疗效。结果:治疗前治疗组与对照组相比,SDS量表、肝郁证候量表、淋证证候量表得分无明显差异(P>0.05),治疗后两组相比三个量表得分都有明显差异,具统计学意义(P<0.01)。治疗组治疗前后相比,三个量表得分都有显著性差异(P<0.001),对照组治疗前后相比,ZUNG量表、肝郁证候量表得分无明显差异(P>0.05),淋证证候量表得分有显著性差异(P<0.001)。治疗后6个月内,治疗组的复发例数、复发频次分别为15人、22次,而对照组分别为23人、58次,两组复发率的差异有统计学意义(P<0.05)。结论:开郁补肾方能有效地改善此类患者的尿感及抑郁症状,并能有效控制尿感的复发,是治疗老年女性慢性尿感伴发抑郁倾向的有效组方。

Objective：Through clinical research,to investigate and evaluate the therapeutic efficacy,action and mechanism of liv- er -energy -dispersing and kidney -invigorating recipe. Methods ：60 cases of chronic UTI patients whose symptoms measure up to the diagnostic criterion of stagnation of liver - QI are randomly divided into two groups of treatment group （30） and control group （30）, received liver- energy- dispersing and kidney- invigorating recipe and sequential therapy of small dose antibiotics（ SMZ- TMP, Cistofuran, Cefaclor or other antibiotics）respectively for 12 weeks, tile changes in scores of SDS, stagnation of liver- QI symp- tomatic scale and stranguria symptomatic scale and recurrence rate were observed,the therapeutic effects and acting mechanism were evaluated. Results ：Were evaluated Before treatment,the scores of scales between treatment group and control group have no differ- ence （ P 〉 0.05 ）, but have obviously differences after treatment （ P 〈 0.01 ）. Control group＇ scores of SDS and stagnation of liver - QI symptomatic scale have no difference after treatment （ P 〉 0.05 ）, while treatment group does （P 〈 0.001 ）. Both control group and treatment group＇ scores of stranguria symptomatic scale have notable differences after treatment. During six months＇ observa- tion,the cases of relapse and the frequencies of relapse of treatment group are 15 and 22 respectively, while control group are 23 and 58, the differences between the two groups are significant （P 〈 0.05 ）. Conclusion：Liver- energy -dispersing and kidney -invigor- ating recipe can alleviate the depressive and urinary irritation symptoms, and reduce the relapse rate of chronic UTI effectively.