益肾清热通淋法治疗中老年女性尿路感染的疗效分析

目的 观察益肾清热通淋法对肾虚湿热型中老年女性尿路感染的临床疗效。方法 将90例肾虚湿热型中老年女性尿路感染患者随机分为治疗组和对照组，每组45例。对照组给予敏感抗生素规范治疗，2周后改为口服低剂量抗生素再治疗4周；治疗组给予敏感抗生素规范治疗2周后停用，同时给予益肾清热通淋汤口服。两组总疗程均为6周。观察两组患者中医证候积分变化，并检测尿细菌学、尿常规、外周血T淋巴细胞亚群（CD4+、CD8+和CD4+/CD8+），治疗结束后随访6个月观察尿路感染复发情况。结果 治疗组患者的中医证候疗效显著优于对照组（P＜0.05）。治疗组患者的尿白细胞计数恢复正常时间和6个月内尿路感染复发次数均显著低于对照组（P＜0.05）。治疗组患者治疗后外周血CD4+、CD4+/CD8+均较治疗前显著提高，且治疗前后CD4+、CD4+/CD8+差值显著大于对照组（P＜0.05）。结论 中医益肾清热通淋法能有效改善肾虚湿热型中老年女性尿路感染患者的临床症状，控制病情进展，其作用机制与改善患者细胞免疫功能有关。

Clinical Efficacy of Kidney-nourishing and Heat-clearing Tonglin Decoction for Treatment of Urinary Tract Infection in Middle-Aged and Elderly Women

Objective To investigate the clinical efficacy of kidney-nourishing and heat-clearing Tonglin Decoction for the treatment of kidney-deficiency and damp-heat type urinary tract infection in middle-aged and elderly women. Methods A total of 90 middle-aged and elderly women with kidney-deficiency and damp-heat type urinary tract infection were randomly divided into treatment group (n=45) and control group (n=45). After 2 weeks of standard treatment with effective antibiotics, the control group was orally given low-dose antibiotics for 4 weeks, while the treatment group was orally given kidney-nourishing and heat-clearing Tonglin decoction for 4 weeks. The course of treatment was 6 weeks for both groups. The changes in traditional Chinese medicine (TCM) syndrome score were observed, and urine bacteriology, routine urine test, and peripheral blood T cell subsets (CD4+, CD8+, and CD4+/CD8+) were determined. After treatment, the recurrence of urinary tract infection was examined during 6 months of follow-up. Results The treatment group had a significantly more improvement in TCM syndrome than the control group (P<0.05). And the treatment group had significantly shorter time to normal white blood cell count in urine and fewer cases of recurrence of urinal tract infection within 6 months than the control group (P<0.05). Furthermore, the treatment group had significantly higher percentage of CD4+ T cells and CD4+/CD8+ ratio after treatment (P<0.05) and showed significantly more changes in the percentage of CD4+ T cells and CD4+/CD8+ ratio than the control group (P<0.05). Conclusion For middle-aged and elderly women with urinal tract infection, kidney-nourishing and heat-clearing Tonglin Decoction can effectively improve clinical syndromes and control the disease. Its mechanism of action is related to improving the cellular immune function of these patients.