目的 观察萆薢分清丸联合乳酸左氧氟沙星治疗急性下尿路感染的临床疗效及其安全性.方法 选取2013年2月—2014年2月上海市徐汇区康健街道社区卫生服务中心收治的急性下尿路感染患者74例,随机分为对照组和治疗组,每组37例.对照组口服给予乳酸左氧氟沙星片0.2 g/次,2次/d.治疗组在对照组基础上口服加用萆薢分清丸6 g/次,2次/d.一个治疗疗程为1周,两组均连续治疗2个疗程.观察两组的临床疗效、症状体征消失时间、尿白细胞和红细胞计数、中段尿细菌培养转阴率、中医症状体征积分及药物及不良反应.结果 治疗后,治疗组和对照组的总有效率分别为94.59%、83.78%,两组比较差异具有统计学意义(P< 0.05).治疗组的尿道刺激症状消失时间、下腹疼痛消失时间、肉眼血尿消失时间均明显少于对照组,两组比较差异具有统计学意义(P< 0.05、0.01).治疗后,两组患者尿常规中白细胞和红细胞计数均显著减少,但治疗组较对照组减少更加明显,两组比较差异具有统计学意义(P< 0.05、0.01).两组治疗前后中段尿细菌培养转阴率比较,治疗组转阴率为83.33%,对照组为76.47%,差异不具有统计学意义.两组均能改善患者的尿细菌学指标,同组治疗前后差异有统计学意义(P< 0.05、0.01).治疗后,两组中医症状体征积分均有明显改善,差异均具有统计学意义(P< 0.05);两组治疗后的积分和差值比较差异均具有统计学意义(P< 0.05).结论 萆薢分清丸联合乳酸左氧氟沙星治疗急性下尿路感染有良好的临床疗效,能明显改善患者的临床症状体征和实验室检查指标,值得临床推广应用.

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.