通讯作者: 林燕, liny7154@163.com

DOI：10.12201/bmr.202605.00042

Analysis of the Pathogenesis and Treatment of Perimenopausal Recurrent Urinary Tract Infection from the Perspective of “positive deficiency and evil suppression”

• 摘要：复发性尿路感染是围绝经期女性的常见疾病,如何有效降低其复发率是临床难点。结合该病迁延反复的临床特点与绝经前后“肾气渐衰,阴阳失衡”的生理转变,以“正虚邪伏”理论为核心,系统阐释其病机。明确围绝经期雌激素水平下降所致机体退行性改变及宿主防御功能减退为“正虚”的核心,而致病菌的适应性进化与潜藏为“邪伏”的现代医学体现。据此构建了“分期辨治”策略：急性期祛邪存正,清中佐润；缓解期扶正祛邪,补中寓清。该策略既体现了中医“治病求本”、“愈后防复”的思想,其有效性亦得到现代药理学研究的佐证,为降低疾病复发提供了思路和依据。

  关键词： 复发性尿路感染; 围绝经期; 伏邪理论; 病机; 分期辨治

   

  Abstract: Recurrent urinary tract infection (RUTI) is a common disease in perimenopausal women, and how to effectively reduce its recurrence rate remains a clinical difficulty. Combining the clinical feature of protracted and recurrent episodes of the disease with the physiological change of gradual decline of kidney qi and imbalance of yin and yang around menopause, this study systematically expounds its pathogenesis with the theory of deficiency of vital qi and lingering pathogenic factors as the core. It is clarified that the decline of host defense function caused by decreased estrogen levels in perimenopause constitutes the core of vital qi deficiency, while the adaptive evolution and latent existence of pathogenic bacteria represent the modern medical manifestation of lingering pathogenic factors. A strategy of stage-based syndrome differentiation and treatment is thus constructed: eliminating pathogenic factors and preserving vital qi with heat-clearing therapy combined with moistening in the acute phase, and strengthening vital qi to eliminate pathogenic factors with tonifying therapy incorporated with heat-clearing in the remission phase. This strategy not only embodies the TCM concepts of treating diseases based on pathogenesis and preventing recurrence after cure, but also is supported by modern pharmacological studies, thereby providing ideas and evidence for reducing the recurrence of the disease.

  Key words: Recurrent urinary tract infection; Perimenopausal period; Theory of suppressing evil; Pathogenesis; Stage-based differentiation and treatment

  提交时间：2026-05-11

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• 序号	提交日期	编号	操作
  1	2026-04-30	10.12201/bmr.202605.00042V1	下载

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