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

doi:10.19852/j.cnki.jtcm.20231024.001

Abstract

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.

Key words: urinary tract infections, medicine, Chinese traditional, syndrome differentiation, quality of life, immunoglobulin A, secretory, randomized controlled trial

GU Xiangchen, QIU Meisi, XIE Lin, CHEN Min, DENG Yueyi, ZHANG Changming, JIAN Guihua, WANG Chen, WANG Yi. Individualized Traditional Chinese Medicine treatment vs antibiotics for recurrent urinary tract infections: a multicenter, randomized controlled study[J]. Journal of Traditional Chinese Medicine, 2024, 44(3): 524-529.

Figures/Tables 6

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Group	n	Age (years)	Disease course (months)
Chinese medicine	114	61.00 (55.50, 64.00)	54.00 (33.00, 125.00)
Control	116	60.00 (56.00, 66.00)	45.00 (25.00, 121.00)
P value		0.956	0.437

Group	n	Age (years)	Disease course (months)
Chinese medicine	114	61.00 (55.50, 64.00)	54.00 (33.00, 125.00)
Control	116	60.00 (56.00, 66.00)	45.00 (25.00, 121.00)
P value		0.956	0.437

Group	n	No recurrent cases (n)	Recurrent cases within 12 weeks (n)	Recurrent cases during follow-up (n)	CR rate (%)
Chinese medicine	114	85	18	11	74.56^a
Control	116	49	31	36	42.24

Group	n	No recurrent cases (n)	Recurrent cases within 12 weeks (n)	Recurrent cases during follow-up (n)	CR rate (%)
Chinese medicine	114	85	18	11	74.56^a
Control	116	49	31	36	42.24

Group	n	Scores before	Scores after	Changes in TCM syndrome score
Chinese medicine	96	10.4±3.8	3.6±2.6^a	6.8±2.9^b
Control	85	9.7±3.3	5.5±3.6^a	4.2±2.4

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