大肠埃希氏菌生物膜形成与中医证候相关性研究

Correlation between Escherichia coli Biofilm Formation and TCM Syndromes

目的分析尿路致病性大肠杆菌生物膜形成与中医证候及复发的相关性。方法收集2020年7月—2020年12月在中国中医科学院望京医院住院部及门诊部就诊的初发、再发尿路感染患者各34例,对两组患者进行中医四诊信息的采集与证型判定,观察其尿液样本中生物膜形成情况,追访两组患者3个月复发情况,采用卡方检验、回归分析等方法分析尿路感染患者生物膜形成与中医证候特征及复发的相关性。结果(1)尿道灼热涩痛(P=0.002,OR=6.48)、溺后余沥(P=0.032,OR=6.063)与病原菌在膀胱尿路上皮定殖形成生物膜存在相关性。(2)溺后余沥(P=0.018,OR=6.721),口苦口黏(P=0.019,OR=5.692),遇劳则发、遇冷则发(P=0.021,OR=5.536)与复发存在相关性。(3)湿热证是病原菌定植形成生物膜(P=0.018,OR=4.048)以及感染复发(P=0.009,OR=4.067)的危险因素。结论湿热证是尿路感染缠绵反复的关键,阳气亏虚是反复发作的根本,提示治疗时应注重“清热利湿”与“温阳祛邪”。

Objective To analyze the correlation between uropathogenic Escherichia coli biofilm formation and TCM syndrome and recurrence.Methods From July 2020 to December 2020,34 patients with initial and recurrent urinary tract infection who were treated in the inpatient department and outpatient department of Wangjing Hospital of the Chinese Academy of Chinese Medical Sciences were collected.The information of the four diagnostic methods of traditional Chinese medicine in the two groups was collected and the syndrome type was determined.The formation of biofilm in their urine samples was observed,the recurrence of the two groups were followed up for three months,and the correlation between the formation of biofilm in patients with urinary tract infection and the TCM syndrome characteristics and recurrence were analyzed by Chi-squared test,regression analysis and other methods.Results①The urethral burning pain(P=0.002,OR=6.48)and the residual leeches after drowning(P=0.032,OR=6.063)were correlated with the formation of biofilms by pathogenic bacteria in the bladder urothelium.②After drowning(P=0.018,OR=6.721),the mouth was bitter and sticky(P=0.019,OR=5.692),and it was related to recurrence when it was tired and cold(P=0.021,OR=5.536).③Damp-heat syndrome was a risk factor for pathogen colonization to form biofilm(P=0.018,OR=4.048)and infection recurrence(P=0.009,OR=4.067).Conclusion Damp-heat syndrome is the key to recurrent urinary tract infections,and deficiency of Yangqi is the fundamental cause of recurrent episodes.It suggests that the attention should be paid to“clearing heat and promoting dampness”and“warming Yang to dispel pathogenic factors”in treatment.