内服补肾类中药治疗小儿遗尿症的系统评价

Systematic evaluation of the treatment for enurisis in children with the kidney-nourishing herbs for internal use

目的评价内服补肾类中药治疗小儿遗尿症的有效性和安全性,为临床研究提供循证参考。方法检索内服补肾类中药治疗小儿遗尿症的临床研究文献,对符合纳入标准的研究文献进行质量评价和资料提取。数据采用Cochrane协作网提供的专用软件Revman4.2进行Meta分析和系统评价,对不能进行Meta分析的数据进行描述性分析,客观评价内服补肾类中药治疗小儿遗尿症的疗效。结果检出符合纳入标准的文献8篇。纳入文献质量7篇为C级,1篇为B级,Jadad评分为1分的6篇,2分的1篇,4分的1篇。Meta分析结果显示:补肾类中药和行为疗法相结合,则治愈率优于西医组,而好转率两者差异无统计学意义(P>0.05);单纯用补肾类中药,治愈率和好转率均与西医组差异无统计意义(P>0.05)。结论单纯内服补肾类中药治疗小儿遗尿症疗效不肯定,而与行为疗法相结合治愈率优于西医组;所纳入研究的文献质量不高,为C级和B级证据,有待高质量大样本、多中心的随机对照研究的进一步证实。

Objective To assess the effect and safety of kidney-nourishing herbs for internal use in treatment of enurisis in children, so that clinical treatment decision can be made based on objective believable evaluation of the treatment. Methods All the artiicies about RCT of the kidney-nourishing herbs for internal use for enurisis in children were searched for based on the method of evidence-based medicine. The articles that met the inclusion criteria were evaluated by the quality and Jadad scale. Then the data were collected and analysed by Revman 4. 2 software. The data were described if they could not be meta-analyzed. So we assessed the efficiency of the internal used herbs for the treatment of enuresis in children. Results Eight RCTs were included in this review from sixty literatures on controlled studies. The quality of the included studies is seven in C class, one in B class. Jadad scores of 2 points is in one, 4 points in one and 1 in six. Meta analyses showed： the cure rate of the treatment of internal herbs combined with behavior therapy was higher than that of the western medicine. But the upturn rate had no difference. The internal used herbs had no significent differences in the cure rate and upturn rate compared with the western medicine. The treatment of unlimited therapy and period had similar result to that of the internal used herbs. Conclusions The effects of the herbs nourishing the kidney for singly internal use are not affirmative. But the cure rate is higher than the western medicine when the herbs are combined with the behavior therapy. The qualities of the included studies are Clevel or B-level evidence. It needs to be further assessed by high-quality, large-sample and multi-center RCTs.