Individualized Traditional Chinese Medicine treatment antibiotics for recurrent urinary tract infections: a multicenter, randomized controlled study.

G U Xiangchen, Qiu Meisi, Xie Lin, Chen Min, Deng Yueyi, Zhang Changming, Jian Guihua, Wang Chen, Wang Yi
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Abstract

Objective: To systematically assess the effects of individualized Chinese medicines on recurrent urinary tract infections (rUTIs).

Methods: This study recruited 230 adult female patients in the remission phase of rUTIs from five hospitals in China. The patients were randomly allocated to two groups: an individualized Chinese medicine group (n = 114) and a control group (n = 116). Patients in the Chinese medicine group received individualized Chinese herbs, which were evaluated for syndrome differentiation. Patients in the control group received antibiotic treatment combined with a Chinese medicine placebo. The duration of treatment was three courses of four weeks each, with a three-month subsequent follow-up. UTI recurrence rate, Traditional Chinese Medicine (TCM) syndrome scores, 36-item Short Form Survey (SF-36) score, and urine secretory immunoglobulin A (SIgA) were measured and analyzed before and after treatment in each group.

Results: Patients from the Chinese medicine group exhibited significant decreases in both short- and long-term UTI recurrence rates compared with the control group (P < 0.05). The changes in TCM syndrome scores between the Chinese medicine and control groups were significant (P < 0.05). The changes in the average SF-36 quality-of-life scores in the Chinese medicine group were also significantly higher than those in the control group after treatment (P < 0.05). The Chinese medicine group also demonstrated a significant increase in urine SIgA expression.

Conclusion: Taken together, compared to the often-used long-term antimicrobial prophylaxis during the remission stage of rUTIs, treating patients with an individualized Chinese medicine decoction by syndrome differentiation could effectively reduce the recurrence rate, improve the patients' TCM syndrome scores and quality of life, and enhance immunity, which in turn helps to prevent antibiotic resistance.

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个体化中医治疗抗生素治疗复发性尿路感染:一项多中心随机对照研究。
目的:系统评估个体化中药对复发性尿路感染(rUTIs)的影响:系统评估个体化中药对复发性尿路感染(rUTIs)的影响:本研究从中国五家医院招募了 230 名处于复发性尿路感染缓解期的成年女性患者。这些患者被随机分配到两组:个体化中药组(114 人)和对照组(116 人)。中药组患者接受个体化中草药治疗,并对中草药进行证候分型评估。对照组患者接受抗生素治疗,同时服用中药安慰剂。疗程为三个疗程,每个疗程四周,随后随访三个月。对每组患者治疗前后的尿毒症复发率、中医综合征评分、36项简表调查(SF-36)评分和尿液分泌型免疫球蛋白A(SIgA)进行测量和分析:结果:与对照组相比,中药组患者的短期和长期尿毒症复发率均显著下降(P 0.05)。中药组和对照组的中医证候评分变化显著(P 0.05)。治疗后,中药组 SF-36 生活质量平均评分的变化也明显高于对照组(P 0.05)。中药组的尿 SIgA 表达也有明显增加:综上所述,与急性尿路感染缓解期常用的长期抗菌药物预防治疗相比,采用个体化中药分证煎煮治疗可有效降低复发率,改善患者的中医证候评分和生活质量,提高免疫力,从而有助于预防抗生素耐药性。
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