消渴通淋汤治疗2型糖尿病合并尿路感染的临床疗效及对血清CRP、HMGB1、sTREM-1水平的影响

Clinical effect of Xiaoketonglin decoction on treatment of type 2 diabetes mellitus patients complicated with urinary tract infection and influence on serum CRP,HMGB1 and sTREM-1

目的分析消渴通淋汤治疗2型糖尿病(T2DM)合并尿路感染(UTI)的临床疗效及对血清C-反应蛋白(CRP)、高迁移率族蛋白B1(HMGB1)、可溶性髓系细胞触发受体-1(sTREM-1)水平的影响。方法选取2020年3月-2023年3月衡水市人民医院收治的T2DM合并UTI患者96例为研究对象,随机数字表法分为对照组与中医组,各48例。对照组给予哌拉西林钠舒巴坦钠治疗、中医组在此基础上应用消渴通淋汤,治疗2周,随访6个月。比较两组治疗2周后疗效,临床症状改善情况,治疗前、治疗2周后免疫功能、炎症因子,治疗期间不良反应及随访6个月复发情况。结果治疗2周后,中医组总有效率为95.83%(46/48),高于对照组的77.08%(38/48)(P<0.05)。中医组尿频、尿急、小便涩痛、血尿、下腹疼痛改善时间较对照组更短(P<0.05)。较治疗前,治疗2周后,两组全血CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平升高(P<0.05),中医组水平在两组中更高(P<0.05);两组全血CD_(8)^(+)水平,血清CRP、HMGB1、sTREM-1水平降低(P<0.05),且中医组在两组中更低(P<0.05)。治疗期间,两组血、大便常规、肝、肾功能检测未见异常。随访6个月,中医组复发率2.08%(1/48),低于对照组的16.67%(8/48)(P<0.05)。结论消渴通淋汤治疗T2DM合并UTI可改善症状,促进免疫功能恢复,抑制炎症因子表达,效果确切,安全性良好,还可降低复发风险。

OBJECTIVE To observe the clinical effect of Xiaoketonglin decoction on treatment of the type 2 diabetes mellitus(T2DM)patients complicated with urinary tract infection(UTI)and analyze the influence on serum C-reactive protein(CRP),high mobility group protein B1(HMGB1)and soluble triggering receptor expressed on myeloid cells(sTREM-1).METHODS A total of 96 T2DM patients complicated with UTI who were treated in Hengshui People′s Hospital from Mar.2020 to Mar.2023 were recruited as the research subjects and were randomly divided into the control group and the traditional Chinese medicine(TCM)group,with 48 cases in each group.The control group was treated with piperacillin sodium and sulbactam sodium,while the TCM group was given additional Xiaoketonglin decoction on basis of the treatment of the control group.Both groups were treated for 2 weeks and followed up for 6 months.The curative effect and improvement of clinical symptoms were compared between the two groups after the treatment for 2 weeks.The immune function indexes and inflammatory factors were compared before the treatment and after the treatment for 2 weeks.The adverse reactions during the treatment and recurrence rates after the follow-up for 6 months were observed and compared.RESULTS The total effective rate of the TCM group was 95.83%(46/48)after the treatment for 2 weeks,higher than 77.08%(38/48)of the control group(P<0.05).The time periods of improvement of frequent micturition,urgent urination,difficulty and pain in micturition,hematuria and hypogastralgia were shorter in the TCM group than in the control group(P<0.05).The levels of whole blood CD_(4)^(+)and CD_(4)^(+)/CD_(8)^(+)of the two groups were higher after the treatment for 2 weeks than before the treatment(P<0.05)and the levels of the above indexes of the TCM group were higher than those of the cotnrol group(P<0.05).The levels of whole blood CD_(8)^(+),serum CRP,HMGB1 and sTREM-1 of the two groups were lower after the treatment for 2 weeks than before the treatment(P<0.05),and the levels of the above indexes of the TCM group were lower than those of the control group(P<0.05).There were no abnormal test results of blood routine indexes,stool routine indexes,liver function indexes and renal function indexes between the two groups during the treatment period.The result of the 6-month follow-up showed that the recurrence rate of the TCM group was 2.08%(1/48),lower than 16.67%(8/48)of the control group(P<0.05).CONCLUSIONS Xiaoketonglin decoction can improve the symptoms of the T2DM patients complicated with UTI,promote the recovery of immune function,and inhibit the expressions of inflammatory factors.It is highly effective and safe and can reduce the risk of recurrence.