老年患者尿路感染临床特点及中医辨证治疗

目的探讨老年患者尿路感染的临床特点、发病机理和中医分段辨证治疗。方法根据老年患者全身和局部的免疫防御功能下降而易患尿路感染且有症状不典型、复杂性、病情较严重等特点,阐明了该病的发病机制是以脾肾虚衰（正虚）为本,以湿热蕴结下焦（感邪）为标,即正虚邪实,故在临床治疗上应重视调理整体功能状况,采用急性发作阶段和非急性发作期2个阶段分别施以清热、化湿、通淋、止血,补益脾肾、佐以通淋等辨证治疗,标本兼顾。结果中医药治疗老年尿路感染采用分期论治,具有疗效高、不良反应少、远期疗效稳定的特点。结论中医药治疗老年尿路感染具有较大的潜力和优势,值得进一步研究。

Clinical Traits and Treatment of Urinary Tract Infection Based on TCM Symptom Differentiation among Elderly Patients

OBJECTIVE To discuss the clinical traits,pathogenesis and TCM stepwise treatments of urinary tract infection(UTI) based on symptom differentiation among elderly patients.METHODS Because of the whole and the partial immune defense function descending,the elderly patients easily suffered from UTI,which was characterized by non-typical symptom,complex and serious condition.In the aspects of the pathogenesis of UTI among elderly patients,the principal aspect of which was the deficiency of the kidney and spleen(weakened body resistance)and the secondary incidental was accumulated damp-heat in the lower warmer(affected pathogenic factor),viz weaken healthy qi and excessive pathogenic factor.Hence during the clinical treatment we should attach importance to regulate entire faculty condition.Considering the acute attack stage and non-acute phase,we will differently inflict therapies of clearing away the heat-evil,dissolving dampness,treating stranguria,hemostasis,and invigorating spleen and kidney assisted by treating stranguria and so on,according to differentiation of symptoms and treatments,in which way we could give attention to both the principal and the secondary aspects of a disease.RESULTS The TCM stepwise therapy of UTI among elderly patients had the characteristics of high efficacy,few side reactions and stable long-term curative effects.CONCLUSIONS The TCM therapy of UTI among elderly patients has more potentiality and predominance,which deserves further study.