本文選題：絕經(jīng)后女性　切入點(diǎn)：復(fù)發(fā)性尿路感染　出處：《北京中醫(yī)藥大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:研究穴位埋線結(jié)合抗菌藥治療絕經(jīng)后女性復(fù)發(fā)性泌尿系感染的臨床療效。方法:所有病例均為2015年10月至2016年10月,來(lái)自北京中醫(yī)藥大學(xué)第三附屬醫(yī)院泌尿科門診中,符合調(diào)查病例標(biāo)準(zhǔn)的患者。根據(jù)本研究的納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn)進(jìn)行嚴(yán)格篩選,將最終納入的60例絕經(jīng)后復(fù)發(fā)性泌尿系感染患者隨機(jī)等分為治療組和對(duì)照組。對(duì)照組根據(jù)藥敏試驗(yàn)結(jié)果選擇相對(duì)應(yīng)的敏感抗菌藥,若尿中段培養(yǎng)陰性者,予鹽酸左氧氟沙星膠囊治療,治療組在抗菌藥的基礎(chǔ)上加用穴位埋線療法,療程均為6周,治療結(jié)束后隨訪6個(gè)月觀察復(fù)發(fā)率。分別收集治療組和對(duì)照組在干預(yù)前后的中醫(yī)癥狀積分,中段尿培養(yǎng)及尿白細(xì)胞檢查,并監(jiān)測(cè)不良反應(yīng),分析并統(tǒng)計(jì)兩組臨床療效和安全性。結(jié)果:1.療效結(jié)果:治療組30例患者,痊愈為12例,基本痊愈為10例,有效為5例,無(wú)效為2例,脫落一例,治愈率為75.9%,總有效率為93.1%;對(duì)照組30例患者,痊愈為8例,基本痊愈為9例,有效為7例,無(wú)效為5例,脫落一例,治愈率為58.6%,總有效率82.8%,治療組綜合療效優(yōu)于對(duì)照組,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2.臨床癥狀評(píng)定:治療組和對(duì)照組在治療后臨床常見(jiàn)癥狀評(píng)分,及癥狀總積分與治療前相比,均有所降低,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后,患者反饋,治療組癥狀緩解較對(duì)照組明顯,但臨床常見(jiàn)癥狀積分的比較無(wú)統(tǒng)計(jì)學(xué)差異(P=0.229,0.05);3.客觀指標(biāo)評(píng)定:兩組患者的尿常規(guī)檢測(cè)中,治療后尿白細(xì)胞數(shù)均較治療前明顯減少,差異有統(tǒng)計(jì)學(xué)意義(P0.01);分別對(duì)比兩組治療前后尿白細(xì)胞計(jì)數(shù)變化,差異無(wú)統(tǒng)計(jì)學(xué)意義(P=0.957,0.05);分別對(duì)比兩組治療前后尿白細(xì)胞分級(jí)變化,有顯著性差異,治療均有效,P均0.01,但是治療后組間比較,兩組療效差異不顯著。4.比較治療組及對(duì)照組患者尿培養(yǎng)結(jié)果,分析其細(xì)菌種類分布得出結(jié)論:治療組患者感染大腸埃希菌為72.4%,糞腸球菌10.3%,肺炎克雷伯菌6.9%,其他10.3%;對(duì)照組患者感染大腸埃希菌為65.5%,糞腸球菌13.8%,肺炎克雷伯菌6.9%,其他13.8%�？梢�(jiàn)復(fù)發(fā)性尿路感染中,大腸埃希菌仍占主要部分。5.復(fù)發(fā)率比較:對(duì)參與本研究的患者在療程結(jié)束后,進(jìn)行6個(gè)月隨訪,試驗(yàn)組6個(gè)月內(nèi)復(fù)發(fā)率為10.3%,明顯低于對(duì)照組的24.1%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P0.01)。結(jié)論:穴位埋線聯(lián)合抗菌藥治療絕經(jīng)后女性復(fù)發(fā)性泌尿系感染在改善癥狀上優(yōu)于單獨(dú)使用抗菌藥,能有效控制本病遠(yuǎn)期復(fù)發(fā),而且操作簡(jiǎn)便,療程較合理,費(fèi)用低廉,經(jīng)濟(jì)效益明顯,臨床上值得推廣。
[Abstract]:Objective: to study the clinical efficacy of acupoint catgut embedding combined with antimicrobial agents in the treatment of recurrent urinary tract infection in postmenopausal women. Methods: from October 2015 to October 2016, all the patients were from the outpatient department of urology, the third affiliated Hospital of Beijing University of traditional Chinese Medicine. According to the inclusion criteria and exclusion criteria of this study, Sixty patients with recurrent urinary tract infection after menopause were randomly divided into treatment group and control group. The control group selected the corresponding sensitive antibiotics according to the results of drug sensitivity test. Levofloxacin hydrochloride capsule was given. The treatment group was treated with acupoint catgut embedding therapy on the basis of antimicrobial agents. The course of treatment was 6 weeks. After 6 months of follow-up, the recurrence rate was observed. The scores of TCM symptoms, urine culture and urine leukocyte examination were collected before and after intervention in the treatment group and the control group, and the adverse reactions were monitored. Results: in the treatment group, 12 cases were cured, 10 cases were basically cured, 5 cases were effective, 2 cases were ineffective, and 1 case was shed. The cure rate was 75.9 and the total effective rate was 93.1. In the control group, 8 cases were cured, 9 cases were basically cured, 7 cases were effective, 5 cases were ineffective, 1 case was lost, the cure rate was 58.6%, and the total effective rate was 82.8%. The comprehensive curative effect of the treatment group was better than that of the control group. Clinical symptom evaluation: the scores of common symptoms and the total score of symptoms in the treatment group and the control group were decreased after treatment compared with those before treatment, and the difference between the two groups was statistically significant (P 0.05). The symptom relief in the treatment group was more obvious than that in the control group, but there was no statistical difference in the scores of common symptoms in the treatment group. Objective index evaluation: in the routine urine examination of the two groups, the number of urinary white blood cells after treatment was significantly reduced compared with that before treatment. The difference was statistically significant (P 0.01), the change of urinary white blood cell count was not statistically significant before and after treatment, and there was significant difference between the two groups before and after treatment. There was no significant difference between the two groups after treatment. 4. The results of urine culture in the treatment group and the control group were compared. It is concluded that in the treatment group, the infection rate of Escherichia coli was 72.4, Enterococcus faecalis 10.3am, Klebsiella pneumoniae 6.9. and other 10.3.The control group was infected with Escherichia coli, Enterococcus faecalis 13.8am, Klebsiella pneumoniae 6.9b. He was 13.8. in the case of recurrent urinary tract infections, Escherichia coli still accounted for the main part of .5.Compared with the recurrence rate, the patients who participated in this study were followed up for 6 months after the end of the course of treatment. The relapse rate in the test group was 10.3 months, which was significantly lower than that in the control group (24.1%). The difference between the two groups was statistically significant (P 0.01). Conclusion: the treatment of recurrent urinary tract infection in postmenopausal women with acupoint catgut implantation combined with antimicrobial agents is better than using antibacterial drugs alone in improving the symptoms of recurrent urinary tract infection in postmenopausal women. It can effectively control the long term recurrence of the disease, and it is easy to operate, reasonable course of treatment, low cost, obvious economic benefit, and is worth popularizing clinically.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.9

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