小儿原发性遗尿症的治疗方法及疗效评价

Three kinds of Therapeutic Strategy and Their Efficacy Evaluation For Primary Nocturnal Enuresis

目的通过三种联合治疗方案治疗小儿原发性遗尿症(PEN),用队列研究(cohortstudy)的方法进行疗效评价,探讨PNE的最佳治疗方法。方法将213例患儿分为3组,2组为实验组,1组为对照组,均为71例。年龄为5～16岁,每周遗尿次数5～18次。实验一组接受针刺+穴位药物注射+膀胱功能训练;实验二组接受人工合成抗利尿激素(弥凝)+膀胱功能训练;对照组接受中药穴位外敷+膀胱功能训练。3组患儿治疗时间为1月,随访6月,比较3组患儿经治疗随访后夜间遗尿症状改善情况有无差异,何种治疗方案最佳。结果治疗1个月随访,实验一组治愈率为81.7%熏实验二组治愈率为83.1%熏对照组治愈率为60.6%,实验组和对照组之间有显著性差异(P<0.05);第3个月随访,实验一组治愈率为80.3%熏实验二组治愈率为76.1%熏两组之间无显著性差异,对照组治愈率为59.2%,实验组同对照组之间有显著性差异(P<0.05);第6个月随访熏实验一组治愈率为76.1%熏实验二组治愈率为59.2%熏对照组治愈率为57.7%。实验一组同实验二组及对照组有显著性差异(P<0.05)。结论三种联合治疗方案治疗小儿原发性遗尿症均有一定的效果,针刺+穴位药物注射+膀胱功能训练是最佳的治疗方案。

enuresis （PNE） byObjective To explore the best method to treat the pediatric primary nocturnal cohort research of three combined therapy. Methods 213 children with PNE were equally divided into three groups;Group 1.and Group H were experiment groups.Group Ⅲ was controlweek were group.Age ranged from 5 to 16 years old. Average age was 9. Enuresis times per 5-18.Group 1.was treated with acupuncture ＋point medicine injection ＋bladder function training; group Ⅱ was treated with artificial synthesized vesopressin （Minirin） ＋bladder function training; group Ⅲ was treated with Chinese traditional medicine point plaster ＋bladder function training. All 3 groups＂ patients treatment period was one month then,followed-up for 6 months observation on improvingdegree of PNE. By comparing the effects of the 3 methods in order to find up the best method. Results After one month treatment, the cure rates of the group 1., group Ⅱ and group Ⅲ were 81.7%, 83.1% and 60.6% respectively. There was significant difference between experiment groups and control group （P〈0.05）. After 3 months followed-up, the cure rates of group 1.and group Ⅱ were 80.3% and 76.1% respectively. There was no significant difference between group 1.and Ⅱ （P〉0.05）. The cure rate of group Ⅲ was 59.2%. There was significant difference between experiment groups and control group （P〈0.05）. After 6 months followed-up, the cure rates of the group 1., group Ⅱ and group Ⅲ were 76.1%, 59.2% and 57.7% respectively. As compared with experiment group Ⅱ and control group,the experiment group 1.had higher cure rate （P〈0.05）.ConclusionThree therapeutic strategies all have definite efficacy for PNE.Nevertheless the acupuncture ＋point medicine injection ＋bladder function training is the best way.