OBJECTIVE To investigate the efficacy of Ningmitai Capsules combined with cefoperazone/sulbactam on the treatment of type 2 diabetes mellitus (T2DM) complicated with urinary tract infections (UTIs) and its impact on soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), microRNA (miRNA)-34 b and Toll-like receptor-4 (TLR4), so as to provide a new combined regimen for clinical treatment of such patients.

METHODS From May 2022 to May 2024, 122 patients with T2DM complicated with UTIs treated at the Affiliated People′s Hospital of Shandong First Medical University were randomly divided into a conventional group and a combination group by the odd-even randomization method, with 61 cases in each group. The conventional group was treated with cefoperazone/sulbactam, whereas the combination group received Ningmitai capsules in combination with cefoperazone/sulbactam. The efficacy, improvement time of related symptoms, T lymphocyte subsets (CD₃⁺, CD₄⁺, CD₄⁺/CD₈⁺), sTREM-1, miRNA-34b, TLR4 levels and occurrence of adverse reactions were compared between the two groups.

RESULTS The total effective rate in the combination group was higher than that in the conventional group after treatment (93.44% vs. 80.33%, χ²=4.604, P=0.032). There were statistically significant differences between the two groups in the time for urine routine to return to normal, disappearance of urinary irritation symptoms, conversion of urine pathogens to negative and defervescence (P < 0.05). After treatment, the levels of CD₃⁺, CD₄⁺ and CD₄⁺/CD₈⁺ in both groups were lower than those before treatment (P < 0.05), and the levels in the combination group were higher than those in the conventional group (P < 0.05). Moreover, the levels of sTREM-1, miRNA-34b and TLR4 in both groups decreased after treatment (P < 0.05), and the levels in the combination group were lower than those in the conventional group (P < 0.05). During the treatment period, no severe adverse reactions were observed in either group, and laboratory test results for blood routine and hepatic and renal functions showed no abnormalities.

CONCLUSION The application of Ningmitai capsules combined with cefoperazone/sulbactam in the treatment of T2DM complicated with UTIs has good efficacy, can effectively control infections, shorten the time for symptom relief, improve immune function and attenuate inflammation level with high safety.