乳杆菌活菌联合常规方案治疗绝经后复发性尿路感染的疗效及安全性

Efficacy and safety of live lactobacillus combined with routine treatment in postmenopausal recurrent urinary tract infection

目的探讨乳杆菌活菌联合常规治疗绝经后复发性尿路感染(rUTI)的疗效及安全性。方法选取2019年1月1日至2021年4月30日期间在四川锦欣妇女儿童医院及成都市第三人民医院妇产科诊治的绝经后rUTI患者作为研究对象。按随机数字表法将其分为观察组和对照组,各115例。对照组患者口服左氧氟沙星片(每次0.5 g,每日1次)及普罗雌烯阴道胶囊(每次10 mg,每日1次)治疗,观察组在对照组治疗基础上联合阴道用乳杆菌活菌胶囊(每次0.25 g,每日1次)治疗,疗程2周。治疗结束后1周时对疗效进行判定,比较两组患者尿路刺激症状消失时间、血清学指标、阴道pH值、6个月及12个月内的复发率、平均复发时间及不良反应发生情况。结果治疗后,观察组治愈率及总有效率均显著高于对照组(71.30%比58.26%,92.17%比83.48%;均P<0.05);观察组尿路刺激症状消失时间显著短于对照组(P<0.05);两组患者治疗后的血清白细胞介素IL-6、IL-8、血清淀粉样蛋白A(SAA)、阴道pH值均显著低于治疗前(均P<0.05),治疗后观察组血清(IL)6、IL-8、SAA、阴道pH值均显著低于对照组(均P<0.05);观察组6个月及12个月内复发率均显著低于对照组(8.49%比19.79%,13.20%比27.08%;均P<0.05),平均复发时间显著长于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论阴道用乳杆菌活菌胶囊联合常规治疗绝经后rUTI,可提高治愈率及总有效率,促进临床症状缓解,减少复发率,安全性高。

Objective To investigate the efficacy and safety of live lactobacillus combined with routine treatment in post?menopausal recurrent urinary tract infection(rUTI).Methods Postmenopausal patients with rUTI from January 1,2019 to April 30,2021 were randomly divided into the observation group(n=115)and the control group(n=115).The patients in the control group were treated with levofloxacin tablets(0.5 g/time,once daily)and colpotrophine vaginal capsules(10 mg/time,once daily)for two weeks,while the patients in the observation group were treated with live lactobacillus vaginal capsules(0.25 g/time,once daily)on the basis of the control group for two weeks.The efficacy was determined one week after the end of treatment,and the disappearance time of urinary tract irritation symptoms,serological indexes and vaginal pH were com?pared.Also,the recurrence rate and average recurrence time within 6 months and 12 months,average time to recurrence and adverse reactions were counted.Results After treatment,the cure rate(71.30%vs 58.26%)and the total effective rate(92.17%vs 83.47%)in the observation group were higher than that of the control group(P<0.05).The disappearance time of urinary tract irritation symptoms in the observation group was shorter than that in the control group(P<0.05).The serum lev?els of interleukin(IL)6,IL-8,serum amyloid A(SAA)and pH in both groups were lower than those before treatment(P<0.05).After treatment,the serum IL-6,IL-8,SAA and pH in the observation group were lower than those in the control group(P<0.05).The recurrence rates in the observation group within 6 and 12 months were lower than those in the control group(8.49%vs 19.79%,13.20%vs 27.08%)(P<0.05).The average time to recurrence in the observation group was longer than that of the control group within 6 months and 12 months(P<0.05).There was no significant difference in the incidence of ad?verse reactions between the two groups(P>0.05).Conclusion Live lactobacillus combined with routine treatment can im?prove the cure rate and the total effective rate in the treatment of postmenopausal rUTl,promote the remission of clinical symp?toms,reduce the recurrence rate,and have acceptable safety.