目的 觀察萆薢分清丸聯(lián)合乳酸左氧氟沙星治療急性下尿路感染的臨床療效及其安全性.方法 選取2013年2月—2014年2月上海市徐匯區(qū)康健街道社區(qū)衛(wèi)生服務(wù)中心收治的急性下尿路感染患者74例,隨機(jī)分為對照組和治療組,每組37例.對照組口服給予乳酸左氧氟沙星片0.2 g/次,2次/d.治療組在對照組基礎(chǔ)上口服加用萆薢分清丸6 g/次,2次/d.一個(gè)治療療程為1周,兩組均連續(xù)治療2個(gè)療程.觀察兩組的臨床療效、癥狀體征消失時(shí)間、尿白細(xì)胞和紅細(xì)胞計(jì)數(shù)、中段尿細(xì)菌培養(yǎng)轉(zhuǎn)陰率、中醫(yī)癥狀體征積分及藥物及不良反應(yīng).結(jié)果 治療后,治療組和對照組的總有效率分別為94.59%、83.78%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05).治療組的尿道刺激癥狀消失時(shí)間、下腹疼痛消失時(shí)間、肉眼血尿消失時(shí)間均明顯少于對照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05、0.01).治療后,兩組患者尿常規(guī)中白細(xì)胞和紅細(xì)胞計(jì)數(shù)均顯著減少,但治療組較對照組減少更加明顯,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P< 0.05、0.01).兩組治療前后中段尿細(xì)菌培養(yǎng)轉(zhuǎn)陰率比較,治療組轉(zhuǎn)陰率為83.33%,對照組為76.47%,差異不具有統(tǒng)計(jì)學(xué)意義.兩組均能改善患者的尿細(xì)菌學(xué)指標(biāo),同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P< 0.05、0.01).治療后,兩組中醫(yī)癥狀體征積分均有明顯改善,差異均具有統(tǒng)計(jì)學(xué)意義(P< 0.05);兩組治療后的積分和差值比較差異均具有統(tǒng)計(jì)學(xué)意義(P< 0.05).結(jié)論 萆薢分清丸聯(lián)合乳酸左氧氟沙星治療急性下尿路感染有良好的臨床療效,能明顯改善患者的臨床癥狀體征和實(shí)驗(yàn)室檢查指標(biāo),值得臨床推廣應(yīng)用.

Objective To observe the efficacy and security of Bixie Fenqing Pill combined with levofloxacin lactate in treatment of acute lower urinary tract infection. Methods The patients with acute lower urinary tract infection (74 cases) in Kangjian Community Health Service Center of Xuhui District from February 2013 to February 2014 were randomly divided into control and treatment groups, and each group had 37 cases. The patients in the control group were po administered with Levofloxacin Lactate Tablets 0.2 g/time, two times daily. The patients in the treatment group were po administered with Bixie Fenqing Pill at the basis of the control group, 6 g/time, two times daily. A course lasted 1 week, and the patients in two groups were treated for two courses. After the treatment, the clinical efficacy, disappear time of clinical symptoms, white blood cell and red blood cell counts in urine, urine bacterial culture negative rate, the scores of TCM syndromes, and adverse reactions evaluated were observed. Results After treatment, the total effective rate of treated group and control group were 94.59% and 83.78%, respectively, and there were differences between two groups (P <0.05). Urethral stimulation symptom disappeared time, underbelly pain disappeared time, and gross hematuria disappeared time of patients in treatment group were significantly less than those of patients in the control group, and there were differences between two groups (P <0.05, 0.01). After treatment, routine urine white blood cells and red blood cell count in two groups were significantly reduced, and index in the treatment group were obviously lower than those in the control group with significant difference between two groups (P <0.05, 0.01). Urine bacterial culture negative rates of treated group and control group were 83.33% and 76.47%, respectively, but there was no statistically difference between two groups. The scores of TCM syndromes of two groups after treatment were obviously improved, and the differences were statistically significant in the same group before and after treatment (P <0.05). After treatment, there were differences of the scores of TCM syndromes and difference between two groups (P <0.05). Conclusion Bixie Fenqing Pill combined with levofloxacin lactate has the good clinical effect in treatment of acute lower urinary tract infection, can significantly improve clinical symptom and laboratory index, which is worth clinical promotion.