小儿遗尿颗粒与盐酸甲氯芬酯胶囊对照治疗肾气不足型小儿遗尿症Ⅲ期临床试验

目的:评价小儿遗尿颗粒治疗肾气不足型小儿遗尿症的有效性与安全性。方法:采用分层区组随机、双盲双模拟、平行对照、多中心试验的方法进行临床研究。结果:小儿遗尿颗粒对治疗肾气不足型小儿遗尿症的临床痊愈率26.33%,显效率50.30%,总有效率为76.63%;对照组的临床痊愈率为21.30%,显效率50.00%,总有效率为71.30%。非劣效检验结果显示,试验组疗效不劣于对照组。对中医证候的临床痊愈率20.71%,显效率41.42%,总有效率为62.13%;对照组的临床痊愈率为16.67%,显效率37.04%,总有效率为53.71%。两组比较,差异无统计学意义。两组遗尿次数、睡眠深度等单项症状与异常舌脉的治疗前后组内比较,差异均有统计学意义。本试验对照组发生ALT疗后异转和异常加重各1例,占1.75%。结论:小儿遗尿颗粒对肾气不足型小儿遗尿症的治疗效果不劣于对照药盐酸甲氯芬酯胶囊,且临床应用未见不良反应发生。     

补肾止遗方联合穴位贴敷治疗脾肾气虚型小儿遗尿的效果

目的观察自拟补肾止遗方联合穴位贴敷治疗脾肾气虚型小儿遗尿的临床效果。方法选择2019年1-10月石家庄市妇幼保健院儿童保健科收治的小儿遗尿患儿80例,采用随机数字表法分为观察组和对照组,各40例。对照组给予缩泉胶囊治疗,观察组给予自拟补肾止遗方联合穴位贴敷治疗。比较2组治疗前后遗尿次数、睡眠深度证候积分变化及临床疗效,随访6个月,比较2组6个月遗尿复发率。结果治疗4周,2组遗尿次数、睡眠深度积分均较治疗前降低(P<0.01),且观察组治疗后遗尿次数、睡眠深度积分均低于对照组(P<0.01)。观察组治疗总有效率为80.00%,高于对照组的60.00%(χ²=3.857,P=0.044)。观察组随访6个月复发率为5.00%,低于对照组的20.00%(χ²=4.114,P=0.042)。结论自拟补肾止遗方联合穴位贴敷可显著改善脾肾气虚型遗尿患儿临床症状,临床疗效满意,复发率低,且无明显不良反应,值得进一步应用与推广。     

自拟遗尿方配合耳穴贴压治疗小儿遗尿20例临床观察

目的观察自拟遗尿方配合耳穴贴压治疗小儿遗尿的临床疗效。方法将60例遗尿患儿随机分为对照组、中药组、中药加耳穴组,各20例。对照组以行为治疗为主,不予药物治疗;中药组在对照组治疗方法的基础上予自拟遗尿方治疗;中药加耳穴组在对照组治疗方法的基础上予自拟遗尿方配合耳穴贴压治疗。3组均以7 d为1个疗程,治疗10个疗程后判定疗效。结果对照组总有效率为70.0%,中药组为85.0%,中药加耳穴组为95.0%,3组间比较差异均有统计意义(P<0.05)。结论自拟遗尿方配合耳穴贴压治疗小儿遗尿临床疗效满意,且无明显不良反应,值得临床推广应用。     

温针灸治疗肾气虚型小儿遗尿临床观察

目的:观察温针灸治疗肾气虚型小儿遗尿的临床疗效.方法:以关元、气海、中极、肾俞、百会等穴温针灸治疗肾气虚型小儿遗尿93例,10次为1个疗程,2个疗程后统计疗效.结果:治愈72例(77.4%),显效18例(19.4%),无效3例(3.2%),总有效率96.8%.结论:温针灸治疗肾气虚型小儿遗尿疗效较好.     

中医治疗小儿遗尿

遗尿是小儿常见的多发病之一,严重影响患儿的身心健康与生长。遗尿多发于3岁以上儿童。本人数年来用中医中药治疗小儿遗尿11例,取得较为满意疗效。报告如下。 1 临床资料 本组11例,均为门诊病例。年龄最小3岁,最大13岁,5岁以下4例,5～10岁4例,10岁以上3例,11例均系原发性遗尿,夜间遗尿都有规律。中医辨证属脾肺气虚型4例,肾气虚弱型4例,肝经湿热型2例、心     

遗尿合剂治疗小儿遗尿42例临床分析

目的：观察遗尿合剂治疗小儿遗尿的临床疗效。方法：对符合诊断标准的42例遗尿患儿应用遗尿合剂进行治疗。结果：临床痊愈22例，有效16例，无效4例，总有效率90．48％。结论：遗尿合剂是治疗小儿遗尿的有效制剂。     

自拟遗尿合剂治疗小儿遗尿28例体会

目的观察自拟遗尿合剂治疗小儿遗尿的疗效。方法28例患儿均采用纯中药遗尿合剂治疗,每日1剂,7d为1个疗程,服用4～6个疗程或更长。结果所有患儿在服用不同疗程后均治愈。结论自拟遗尿合剂治疗小儿遗尿疗效满意,值得在临床应用。     

桑螵蛸散合缩泉丸配合针刺治疗小儿遗尿78例

目的:观察桑螵蛸散合缩泉丸配合针刺止遗穴治疗小儿遗尿的临床疗效。方法:78例遗尿患儿均给予桑螵蛸散合缩泉丸,1日1剂,水煎分3次温服;针刺止遗穴,根据患儿体质、病情、年龄制定针灸次数、留针时间和刺激强度。所有病例随访半年。结果:78例中治愈56例,有效22例,总有效率100%。结论:桑螵蛸散合缩泉丸配合针刺止遗穴治疗小儿遗尿疗效确切,值得临床推广。     

艾灸联合皮内针治疗小儿遗尿的疗效观察

目的:观察艾灸联合皮内针对小儿遗尿的治疗效果。方法:采用随机分组的方法,将患者分为治疗组和对照组,每组15例,治疗组采用艾灸联合皮内针疗法,对照组采用去氨加压素治疗。观察两组治疗效果并进行对比分析。结果:治疗组总有效率93.33%,对照组总有效率80.00%(P<0.05),具有统计学意义。结论:艾灸联合皮内针治疗小儿遗尿疗效明显,且安全可靠,患儿依从性好。     

“八穴一药”治遗尿

目的临床观察针刺配合药物治疗小儿遗尿的临床疗效。方法择遗尿患者98例应用针刺肾俞等腧穴配合单味中药,采用本法治疗3个疗程。结果患几经上法治疗1个月后,偶有遗尿,2个月后,诸症皆消,饮食正常,随访至今未见复发。结论表明应用本法治疗遗尿疗效确切,取穴较少,且无毒副作用,有待于进一步研究。     

Medical management of nocturnal enuresis

Nocturnal enuresis, or bedwetting, is the most common cause of urinary incontinence in children. It is known to have a significant psychosocial impact on the child as well as the family. Nocturnal enuresis typically presents as failure to become dry at night after successful daytime toilet training. It can be primary or secondary (developing after being successfully dry at night for at least 6 months). Children with nocturnal enuresis may have excessive nocturnal urine production, poor sleep arousal and/or reduced bladder capacity. Alarm therapy is the recommended first-line therapy, with treatment choices being influenced by the presence or absence of the abnormalities mentioned above. Children with nocturnal enuresis may also have daytime urinary urgency, frequency or incontinence of urine. This group (non-monosymptomatic nocturnal enuresis) requires a different clinical approach, with a focus on treating daytime bladder symptoms, which commonly involves pharmacotherapy with anticholinergic medications and urotherapy (including addressing bowel problems). This review discusses the current management of nocturnal enuresis using the terminologies recommended by the International Children's Continence Society.     

3种方案治疗儿童原发性遗尿症的药物经济学分析

目的：探讨3种方案药物治疗儿童原发性夜间遗尿症的经济效果。方法：152例患儿随机分为3组,分别给予醋酸去氨加压素（A组）、醋酸去氨加压素合并奥昔布宁（B组）和酸酸去氨加压素合并中药温肾止遗汤（C组）3种不同方案治疗。运用药物经济学中最小成本分析法（CMA）进行评价。结果：3种方案在临床疗效、不良反应发生率等方面无显著差异（P〉0.05）;药物治疗费用以B方案最低;而A方案复发率最高,与B、C两方案比较有显著差异（P〈0.05）。结论：醋酸去氨加压素合并奥昔布宁治疗方案复发率较低,成本低,更具经济学优势,而醋酸去氨加压素合并中药温肾止遗汤方案虽成本较高,但复发率最低,远期疗效理想。     

儿童原发性遗尿症药物治疗随机对照研究

目的:评估弥凝联和普鲁苯辛治疗儿童原发性遗尿症与单独使用氯丙嗪或弥凝治疗的疗效.方法:将54例原发性遗尿症患儿随机分为3组,分别为弥凝联合普鲁苯辛组、弥凝组、氯丙嗪组.计算治疗第1、3、6个月的遗尿频率,建立5级疗效反应,分别与基线水平做统计学比较.结果:联合治疗组与其它两组相比较遗尿频率最低.3组遗尿频率比较有统计学意义(P<0.05);无论单症状遗尿患儿还是复杂性遗尿患儿,联和治疗均显示疗效好,起效快.结论:弥凝联合普鲁苯辛治疗原发性遗尿症有很好的耐受性,比单独使用弥凝或氯丙嗪有明显的优势.     

Comparative tolerability of drug treatment for nocturnal enuresis in children.

Primary nocturnal enuresis is one of the most frequent complaints in paediatric and urologic practice. Physicians face the dilemma of whether or not to treat primary nocturnal enuresis since the trend towards spontaneous remission is countered by social disadvantages and reduced self esteem of the children affected and their families. We reviewed randomised, controlled trials investigating efficacy and adverse effects of current medical treatment for primary nocturnal enuresis. Only desmopressin and imipramine displayed significant effects in reducing wet nights: when compared with baseline bedwetting or placebo controls, 30-70% of the studied children achieved therapeutic success. For drugs such as indometacin or oxybutynin, convincing studies displaying a significant positive effect are still needed. However, considering the adverse effects profiles of desmopressin and imipramine it can be seen that imipramine is associated with about twice as many unwanted reactions. More importantly, a serious adverse effect of imipramine is sudden cardiac arrest. In general, adverse effects with desmopressin are rare and mild, but there have been a number of case reports of hyponatraemic hypervolaemia associated with coma and seizures. Of these, many cases were attributed to excess water intake before taking the drug and all children recovered fully. In summary, if medical treatment is considered, preference should be given to desmopressin.     

DICLOFENAC SODIUM IN THE TREATMENT OF PRIMARY NOCTURNAL ENURESIS: DOUBLE-BLIND CROSSOVER STUDY

The prostaglandin synthesis inhibitor diclofenac sodium has been compared with a placebo in the treatment of primary nocturnal enuresis in a double-blind crossover trial. Twenty patients were entered: 14 female, six male; age range 6-17 years. The results showed that diclofenac sodium was significantly more effective than placebo in the treatment of nocturnal enuresis.     

醒脾养儿颗粒结合心理行为疗法治疗小儿原发性夜间遗尿症的临床研究

目的观察苗药醒脾养儿颗粒结合心理行为疗法治疗小儿原发性夜间遗尿症的临床疗效及复发率。方法 157例确诊为原发性单一症状性夜间遗尿症的患儿,在家长和患儿同意进行2个月的治疗并坚持随访情况下,将其随机分为2组:①单纯心理行为治疗组70例;②联合治疗组87例,醒脾养儿颗粒口服结合心理行为疗法治疗。家长和患儿决定暂不治疗或延期治疗的64例患儿归为对照组,并定期随访。对3组患儿2个月治疗结束时,和停止治疗3个月后遗尿症的缓解情况进行比较分析。结果联合治疗组总有效率为72.09%,单纯心理行为治疗组总有效率为46.37%,两组比较差异有统计学意义,联合治疗组复发率为12.79%,明显低于单纯心理行为治疗组的26.47%,两者比较差异有统计学意义。结论醒脾养儿颗粒结合心理行为疗法治疗小儿原发性遗尿症疗效显著且复发率低,临床用药简单,无明显不良反应,易被广大遗尿症患儿接受,值得临床推广应用。     

Mode of action and relative value of imipramine and similar drugs in the treatment of nocturnal enuresis

Summary The present study was partly a clinical pharmacological analysis of the action of imipramine in nocturnal enuresis and partly an attempt to select children who would benefit most from this treatment. 61 fairly severe cases of nocturnal enuresis were studied as out-patients, divided by the criteria primary/secondary enuresis and with/without associated behavioural disturbances. The patients received imipramine, imipramine-N-oxide, emepronium, and a placebo in random sequence in a double-blind cross-over trial. There was no difference in effect between placebo and emepronium; after imipramine the frequency of enuresis fell to 58% of the figure during placebo treatment, i.e. 31% of the children became dry; imipramine-N-oxide reduced the number of wet nights only to 78% of the number on placebo, 18% of the children became dry. When the patients were classified into groups imipramine and imipramine-N-oxide were found to have had the greatest effect in cases of presumed psychogenic aetiology, a 65% reduction of the frequency of wet nights whilst taking the placebo. The most favourable results were in children with combined nocturnal and diurnal enuresis and in those with urinary frequency and imperative urgency. The effect was maintained during treatment for 3 months with the most suitable drug. The dose was 50 mg regardless of the body weight of the patient. There were no serious side effects. It was concluded that the psychopharmacological actions of imipramine and imipramine-N-oxide appear to be important in their effects on enuresis. Imipramine might have been the best drug because success may require the combination of antidepressant and anticholinergic activity. It was not possible to assess in detail its presumed effect on the level of sleep. Thus many children can be treated successfully and the final cure of enuresis may be hastened by breaking a vicious circle of psychological phenomena.     

缩泉胶囊治疗儿童遗尿症的系统评价

目的:系统评价缩泉胶囊治疗小儿遗尿症的有效性和安全性.方法:计算机检索Pubmed、The Cochrane Library、EMbase以及中国期刊全文数据库,收集使用缩泉胶囊治疗小儿遗尿症的随机对照试验,检索时限均从各数据库建库至2021年4月1日.评价纳入研究文献的质量,合并结果进行Meta分析.结果:共纳入11篇试验文献,合计患儿1163例.采用缩泉胶囊治疗的试验组的临床总有效率[RR=1.16,95％CI(1.09,1.23),P<0.001]、遗尿症复发情况[RR=0.41,95％CI(0.26,0.66),P=0.0002]得到提高和显著改善,并且不良反应的发生情况也显著低于对照组[RR=0.38,95％CI(0.18,0.80),P=0.01].比较两组的膀胱容量[SMD=0.80,95％CI(-0.39,1.98),P=0.19]和OABSS评分[SMD=-7.86,95％CI(-20.33,4.61),P=0.22]没有显著差异.结论:缩泉胶囊能有效治疗小儿遗尿症,并且安全性较高.     

缩泉丸联合托特罗定治疗小儿遗尿病的疗效观察

目的探讨缩泉丸联合酒石酸托特罗定片治疗小儿遗尿病的临床疗效。方法 2016年2月—2018年7月天津市蓟州区人民医院收治的190例小儿遗尿病患儿为研究对象,根据患者接受治疗方法的不同将其分为对照组和治疗组,每组各95例。对照组患儿口服酒石酸托特罗定片,2 mg/次,2次/d。治疗组患儿在对照组的基础上口服缩泉丸,3～6岁:3 g/次,6～12岁:6 g/次,2次/d。两组患儿连续治疗3个月。观察两组的临床疗效,比较两组的夜间遗尿次数、复发率。结果治疗后,对照组和治疗组的总有效率分别为70.53%、90.53%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组患儿夜间遗尿次数明显少于对照组,两组比较差异有统计学意义(P0.05)。治疗后,对照组和治疗组复发率分别为30.53%、8.42%,两组比较差异有统计学意义(P0.05)。结论缩泉丸联合酒石酸托特罗定片治疗小儿遗尿病具有较好的临床疗效,可减少夜间遗尿次数,降低复发率,安全性较好,具有一定的临床推广应用价值。