中医辨治再发性尿路感染1例
the Treatment of Recurrent Urinary Tract Infection through Traditional Chinese Medicine
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1.上海中医药大学附属岳阳中西医结合医院肾内科 上海 201203
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王怡, 姚天文. 中医辨治再发性尿路感染1例[DB/OL].(2023-10-31)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43403042&Fpath=home&index=0
WANG Yi, YAO TianWen. the Treatment of Recurrent Urinary Tract Infection through Traditional Chinese Medicine[DB/OL].(2023-10-31)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43403042&Fpath=home&index=0
王怡, 姚天文. 中医辨治再发性尿路感染1例[DB/OL].(2023-10-31)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43403042&Fpath=home&index=0 DOI:
WANG Yi, YAO TianWen. the Treatment of Recurrent Urinary Tract Infection through Traditional Chinese Medicine[DB/OL].(2023-10-31)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=43403042&Fpath=home&index=0 DOI:
病史摘要,2,患者绝经后女性,反复尿频、尿急伴有左下腹疼痛不适2年余,每年发作2~3次,每次劳累后症状明显加重,无明显发热和尿道口疼痛。患者尿常规检查中白细胞最高(++),中段尿培养阴性,曾先后经验性使用静脉或口服左氧氟沙星、头孢克洛等多种抗生素治疗,症情稍有好转后自行停药。刻下:患者神疲乏力,尿频尿急,夜尿频多,左下腹轻度疼痛,腰酸,胃纳一般,大便尚调,夜尿3次,夜寐一般。舌红,苔薄黄,脉弦。中医诊断 劳淋(肾气亏虚,湿热下注)西医诊断 再发性尿路感染干预措施 治以益肾培本,清利湿热,首诊方拟知柏地黄汤合二仙汤加减。二诊时,患者肾精不足、湿热内蕴较前改善,但出现瘀血内停,故在首诊的基础上停用生熟地、龟板等滋腻之品,并加用当归、川芎、红花等行气活血之品。三诊时,患者脾胃亏虚的症状逐渐加重,故处方时停用当归、川芎、红花等行气活血化药物,以及穿心莲、龙胆草等清热败胃药物,加用茯苓、山药、砂仁等健脾益气、化湿行气之品,以更好的顾护胃气。疗效转归 好转。在近半年的随访过程中,患者胃口、二便、腰酸等症状均较前明显好转,尿路感染亦未再复发。
Summary of case history, The patient was a postmenopausal woman with recurrent frequency and urgency of urination accompanied by pain and discomfort in the left lower abdomen for more than 2 years, which occurred 2-3 times a year. The symptoms were significantly aggravated after each fatigue, without obvious fever and pain at the urethral orifice. The patient had the highest white blood cell in urine routine examination (++), and the middle urine culture was negative. She had been empirically treated with intravenous or oral levofloxacin, cefaclor and other antibiotics. She stopped taking them when her symptoms improved slightly. Engrave: the patient was tired, frequent and urgent urination, frequent urination at night, mild pain in the left lower abdomen, lumbar acid, stomach generally, stool is still modulated, night urine 3 times, night sleep generally. Red tongue, thin yellow moss, pulse string.,TCM diagnosis, stranguria due to overstrain (deficiency of kidney qi and downward flow of damp-heat),Western medicine diagnosis, recurrent urinary tract infection,Therapeutic methods, tonify qi of kidney and clear heat and dampness,Clinical outcomes, Improved. In the follow-up process of nearly half a year, the patient's appetite, stool, lumbar acid and other symptoms were significantly better than before, urinary tract infection did not relapse.
再发性尿路感染中医药二仙汤
recurrenturinary tract infectiontraditional Chinese medicineerxian decoction
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