五味消毒饮联合抗生素治疗导管相关性尿路感染的临床观察

Clinical observation of Wuweixiaoduyin combined with antibiotics in treatment of catheter-associated urinary tract infection

目的:探讨五味消毒饮加减方联合抗生素治疗导管相关性尿路感染的临床疗效及安全性。方法:选取84例复发性下尿路感染患者,随机分为对照组和观察组,每组42例。对照组给予常规西医治疗,观察组在对照组基础上联五味消毒饮加减口服治疗。比较两组患者临床疗效、细菌学疗效、治疗后炎症水平及导管尖端细菌生物膜等情况。结果:观察组总有效率为90%,对照组总有效率为88%,两组总有效率差异无统计学意义(P>0.05)。而在症状改善方面观察组证候积分3.52±1.87,对照组证候积分4.60±1.53,两组证候积分差异有统计学意义(P<0.05)。在IL-6改善方面观察组74.55±20.90,对照组82.57±12.41,两组差异有统计学意义(P<0.05)。而在尿白细胞数、尿细菌计数及C-反应蛋白方面,两组差异无统计学意义。在治疗后两组细菌生物膜形成能力比较方面,两组差异有统计学意义,观察组优于对照组(P<0.05)。结论:五味消毒饮联合抗生素治疗CAUTI在缓解患者症状,抑制导尿管细菌生物膜形成能力方面优于单用抗生素治疗,具有一定应用价值。

Objective:To investigate the clinical efficacy and safety of Modification Prescription of Wuweixiaoduyin combined with antibiotics in the treatment of catheter-related urinary tract infection.Method:84 patients with recurrent lower urinary tract infection were randomly divided into control group and observation group,42 cases in each group.The control group was treated with conventional western medicine,and the observation group was given oral treatment with Modification Prescription of Wuweixiaoduyin on the basis of the control group.Clinical efficacy,bacteriological efficacy,inflammation level after treatment and bacterial biofilm at the catheter tip were compared between the two groups.Result:The total effective rate was 90%in the observation group and 88%in the control group,and there was no significant difference between the two groups(P>0.05).In terms of symptom improvement,the syndrome score of the observation group was 3.52±1.87,and that of the control group was 4.60±1.53.The difference of syndrome scores between the two groups was statistically significant(P<0.05).The improvement of IL-6 was 74.55±20.90 in the observation group and 82.57±12.41 in the control group,and the difference between the two groups was statistically significant(P<0.05).There was no significant difference between the two groups in the count of urinary white blood cells,urinary bacteria and C-reactive protein.In the comparison of bacterial biofilm formation ability between the two groups after treatment,there was statistically significant(P<0.05).Conclusion:Modification Prescription of Wuweixiaoduyin combined with antibiotics in the treatment of CAUTI has certain application value in alleviating the symptoms of patients and inhibiting the ability of bacterial biofilm formation in the catheter.