The Clinical Experience Of Professor Yang Minghui In Treating Recurrent Urinary Tract Infection In Postmenopausal Female Patients

Objective To summarize the academic thought and clinical experience ofProfessor Yang Minghui in treating recurrent urinary tract infection (RUTI) inpostmenopausal female patients. To observe the clinical effect of clearing heat anddetoxicating and liver recuperating followed by invigorating kidney and strengtheningspleen and promoting blood circulation, and to further investigate the incidence andmechanism of RUTI by test and analysis of some immunological index.Methods To study Professor Yang’s academic thinking and analyze clinicalexperience in treating RUTI in postmenopausal female patients and accordingly carryout clinical research on RUTI.112postmenopausal female patients with RUTI wererandomized into2groups: the Chinese Medicine group(CMG) of57cases were treatedwith Chinese herb decoction (250ml bid) of clearing heat and detoxicating and liverrecuperating followed by Chinese herb decoction (250ml bid) of invigorating kidneyand strengthening spleen and promoting blood circulation；the controlled group(CG) of55cases were treated with antibiotics according to guidelines. Therapy duration in bothgroup was less than four weeks. Clinical parameters included symptoms, signs andurine test, peripheral blood CD4+/CD8+T-lymphocyte counts and urinary secretoryimmunoglobulin A (SIgA) level.Results By QingReJieDuTiaoGan at the acute stage and BuShenJianPiHuoXue atthe ease stage, the cure rate and the total effective rate in CMG was70.2%and98.3%respectively, and in CG was52.7%and90.9%respectively, the difference btween CMGand CG was statistically significant (P<0.05). Common symptom index scores wereimproved in both groups after treatment(P＞0.05), but symptoms including dribblingurine, abdominal bulge, backache and fatigue were further improved in CMG than inCG(P<0.05). Average urinary white blood cell count in both group after treatment were significantly decreased (P<0.05), but there was no significant difference between CMGand CG groups after treatment (P>0.05). Parameters including peripheral blood CD4+T lymphocyte count, CD4+T/CD8+T ratio, and urinary SIgA level in the urine in CMGand CG were all lower than normal group(NG)(P<0.05) while CD8+T lymphocytecount was higher(P<0.05). After treatment, CD4+T lymphocyte count, CD8+Tlymphocyte count, CD4+/CD8+and urinary SIg level in CMG all changedsignificantly(P<0.05) while in CG had no significant change and those parameters weresignificantly different between CMG and CG(P<0.05). Compared with CG, therecurrence rate within six months in CMG was lower (11.1%vs37.5%, P <0.05).Conclusions According to Professor Yang’s principle of differentiating disease incoincidence with differentiation of symptoms and differentiating symptoms givingconsideration to differentiation of disease, we treat reccurent urinary tract infection inpostmenopausal women in combination of disease and symotoms step by step. As aresult, not only the infection can be controlled and the patients’ immunity recovered, butalso the symptoms and signs be improved thoroughly and effectively, and bettershort-term and long-term prognosis acquired without obvious side-effect.