传统医药治疗小儿遗尿临床研究近况

目的 了解小儿遗尿的临床治疗近况,为选择合理的治疗方法提供参考.方法 使用数据库、图书馆资料,查阅2008年以来的文献,对传统医药治疗小儿遗尿的方法进行详细介绍.结果与结论 传统医药治疗小儿遗尿能取得较好的疗效,且内服外治,方法多样,疗效稳定,副作用小.临床可根据患儿实际情况,灵活选择治疗方法.     

中医综合疗法治疗小儿遗尿临床观察

目的探讨遗尿停汤剂合新型艾灸按摩治疗小儿遗尿肾气不足型的临床疗效和安全性。方法采用遗尿停汤剂合新型艾灸按摩治疗小儿遗尿肾气不足型30例,并设对照组对比。结果治疗组显控率优于对照组(P0.05),并无皮肤感染等不良反应。结论该疗法治疗小儿遗尿有较好临床疗效且安全无毒副作用。     

自拟中药配方治疗小儿遗尿的临床效果观察

目的探讨应用一种自拟中药配方治疗小儿遗尿,观察临床应用效果。方法将门诊就诊的5周岁以上、12周岁以内排除器质性疾病的原发性遗尿患儿接受自拟中药配方治疗,观察用药1个疗程、2个疗程、3个疗程、4个疗程的遗尿情况及追踪半年后的效果。结果自拟中药配方治疗小儿遗尿效果显著,总有效率达95．38％,无明显副作用。结论自拟中药配方可以作为小儿遗尿的治疗方法,具有科学性、实用性。     

近10年来中医外治法在小儿遗尿中的应用规律研究

搜集2006—2015年国内有关中医外治法治疗小儿遗尿的文献,进行应用规律研究,发现治疗小儿遗尿最常用的中医外治法为针刺、敷贴及推拿疗法,各种外治法皆主要选取足太阳膀胱经、任脉、足太阴脾经的穴位,取穴主要是三阴交、关元、中极、膀胱俞等,从而得出中医外治法治疗小儿遗尿从针刺、敷贴、推拿等入手,方法多样、不良反应小,值得临床推广。     

针刺治疗小儿遗尿40例临床观察

目的探讨针刺治疗小儿遗尿的临床疗效。方法选择2010年以来临床病例40例进行评价。结果 40例患者疗效良好,总有效率95%。结论针刺治疗小儿遗尿疗效显著。     

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.     

针灸治疗小儿遗尿10例的临床观察

目的：观察针灸对治疗小儿遗尿的临床疗效。方法：对10例小儿遗尿进行分析,针灸关元,三阴交,气海,中极,合谷等穴位,耳压外生殖器点,遗尿点,肾,膀胱,神门,内分泌,耳速根等穴位,上述治疗根据临床辨证再配以相应的穴位。结果：总有效率90%。结论：针灸治疗小儿遗尿效果好,无复发及不良反应。     

铺灸疗法治疗小儿遗尿18例

目的观察铺灸疗法治疗小儿遗尿的疗效。方法对18例小儿遗尿患儿行药物铺灸疗法,3个疗程后统计疗效。结果18例患者中,治愈16例,占88.9%;有效2例,占11.1%;无效0例。总有效率100%。结论铺灸疗法治疗小儿遗尿临床疗效肯定,操作简单,治疗过程无痛苦,患儿易接受,值得推广应用。     

针灸治疗肾气虚型小儿遗尿116例临床观察

目的:观察针灸治疗小儿遗尿的临床疗效.方法:将小儿遗尿肾气虚型患者240例随机分为治疗组和对照组各120例,分别给予针灸治疗和单独中成药口服治疗,疗程均为2周.结果:两组疾病疗效的总有效率分别为91.38%、77.67%,组间比较有显著性差异(P<0.05);两组治疗前后中医证候总评分分别降低11.47±4.86分、7.06±3.16分,组间比较有极显著性差异(P<0.01).结论:针灸治疗小儿遗尿的疗效优于单独口服中成药的治疗.     

吴立文教授从脾肾论治小儿遗尿的经验

吴立文教授根据小儿脾常不足、肾常虚的生理特点,擅长从脾肾论治小儿遗尿,并取得了较好疗效。从病因病机、辨证要点、遣方用药方面介绍了吴教授治疗小儿遗尿的经验,并附案例一则以资验证。     

小儿遗尿的论治与分析

依据临床常见症状,将小儿遗尿分为肝郁不舒、脾胃阴虚,肝胆湿热、火热内迫,脾肺不足、膀胱失约,脾肾两虚、下元虚寒,痰湿内蕴、统摄失司5型治疗,在临床上取得了显著疗效,并附案例以资验证。     

小儿遗尿经中医康复治疗的可行性及随访观察

目的:分析中医康复治疗小儿遗尿的疗效。方法:此次的研究对象选自于某院收治的遗尿症患儿,入院时间在2019年10月~2020年10月,入选患者总数为40例,将其随机分为研究组和对照组各20例,研究组采用针刺、推拿康复治疗与膀胱功能训练,对照组采用常规中医药治疗。对比两组患儿在治疗前后的遗尿症状评分、血浆抗利尿激素水平以及疗效和不良反应发生情况。结果:治疗前,两组患儿的遗尿症状评分和血浆抗利尿激素水平无明显差异(P>0.05);治疗后,两组患儿的遗尿症状评分均降低,血浆抗利尿激素均升高,且研究组患儿的遗尿症状评分低于对照组(P<0.05),血浆抗利尿激素水平高于对照组(P<0.05)。研究组治疗总有效率高于对照组(P<0.05),且两组的不良反应发生率无明显差异(P>0.05)。结论:中医康复治疗小儿遗尿,具有显著疗效,能有效改善患儿的遗尿症,减少遗尿的发生,并且不良反应少,治疗安全性高。     

Antiepileptic Drugs–Induced Enuresis in Children: An Overview

Objective: To evaluate enuresis-induced antiepileptic drugs in children. Data Sources: A PubMed search (1917 to July 2020) was performed using the following keywords and associated medical subject headings: antiepileptic drugs, enuresis, pediatric population, drug-induced enuresis, and epilepsy. Study Selection and Data Extraction: The search was conducted to find the role of antiepileptic drugs–induced enuresis in children in studies published in English. Data Synthesis: Enuresis or bedwetting is an underreported adverse drug reaction of antiepileptic drugs. Owing to that fact, it is a condition that is outgrown with age and also could cause embarrassment. As antiepileptic drugs sometimes need to be taken for a long duration until epilepsy relapses, the occurrence of enuresis in this situation can be troublesome for both the child and the caretaker. Even though enuresis is proposed to have a significant effect on the child’s psychology, it is still considered to be a condition that is outgrown with age. This article includes a review of antiepileptic drugs reported to have caused enuresis in children. Conclusions: If a child develops enuresis as an adverse drug reaction, this adds further challenges to their life. A better understanding of this potential adverse effect may help prevent unwanted stress. Though the exact mechanisms are not known, the hypothesis generated is from the occurred cases, most of which relapsed when the drug was withdrawn. Considering the gravity of epilepsy in children, more detailed studies need to be conducted on this adverse effect to ensure a safe and effective treatment in children.     

桑螵蛸散配合针刺疗法治疗小儿遗尿32例

目的观察桑螵蛸散加味配合针刺治疗小儿遗尿的疗效。方法对32例遗尿患儿,采用桑螵蛸散加味配合针刺疗法,7d为1个疗程,1—4个疗程后统计疗效。结果治愈23例,好转8例,无效1例,总有效率为96．9％。结论桑螵蛸散加味配合针刺治疗小儿遗尿疗效显著,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.     

秦艳虹教授治疗小儿遗尿症脾肾两虚型经验

秦艳虹教授根据小儿生理病理特点,并结合其多年的儿科临床经验,认为小儿遗尿症的病机为脾肾两虚、膀胱失约,故治宜温补脾肾、固摄止遗、先后天同治。秦教授以其自拟经验方止遗散配合艾灸、叫醒疗法内外结合治疗小儿遗尿症脾肾两虚型,临床疗效显著。附案例1则,以资验证。     

Drug therapy for nocturnal enuresis. Current treatment recommendations.

It is estimated that enuresis occurs in 5 to 7 million children in the United States. The treatment approach for enuresis is controversial, in large part due to a lack of consensus as to the exact cause of enuresis. Several factors either alone or together may contribute to this syndrome. In addition, there is strong evidence of a genetic component to enuresis. Pharmacotherapy continues to be the preferred treatment for both physicians and families. The most widely used drugs include antidepressants, anticholinergics, and desmopressin. The tricyclic antidepressant imipramine has been used extensively since the 1960s. The exact mechanism of action in enuresis is unknown although it appears to be related to the anticholinergic and antispasmodic effects of the drug. The most common adverse effects reported with imipramine include personality changes, insomnia, anorexia and anxiety. There has been renewed interest in antidiuretic treatment of enuresis. Researchers have found that enuretic children do not have the ability to reduce urine volume at night or concentrate the urine they produce during the night. Clinical trials with desmopressin administered by nasal inhalation report a marked reduction in enuretic episodes. Adverse effects were limited to nasal complaints, rhinitis, or epistaxis. Additional long term studies are needed to delineate desmopressin's role in therapy. Although the number of options for treatment of enuresis is expanding, criteria to predict patient response need to be defined.     

补肾健脾宣肺止遗汤治疗小儿遗尿45例

目的:观察补肾健脾宣肺止遗汤治疗小儿遗尿的临床疗效。方法:对45例遗尿患儿予自拟补肾健脾宣肺止遗汤治疗,7 d为1个疗程,治疗4～8个疗程后评定疗效。结果:痊愈32例,显效10例,无效3例,总有效率为93.3%。结论:补肾健脾宣肺止遗汤治疗小儿遗尿效果满意。     

推拿加针刺治疗小儿遗尿58例

目的:观察推拿加针刺治疗小儿遗尿的临床疗效。方法:对58例遗尿患儿采用推拿加针刺方法治疗。结果:痊愈50例,占86.2%;好转8例,占13.8%。总有效率100%。结论:推拿加针刺治疗小儿遗尿疗效显著,无不良反应,易被患儿及家长接受,值得推广。     

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.