推拿治疗儿童原发性遗尿近期和远期疗效的临床观察

Clinical observation of massage therapy for children with primary enuresis in recent and forward curative effect

目的:观测推拿与口服醋酸去氨加压素(DDAVP)两种治疗方法对儿童原发性遗尿症(PNE)的近期和远期疗效,并进行比较。方法:50例PNE患儿于治疗前测定夜间尿量及夜间尿渗透压,随机分为两组,25例患儿给予口服醋酸去氨加压素(DDAVP)治疗;25例患儿给予推拿手法治疗。25例正常儿童测定夜间尿量及夜间尿渗透压,作为对照组。分别观察1个疗程后以及治疗结束3个月后疗效。目的:观测推拿与口服醋酸去氨加压素(DDAVP)两种治疗方法对儿童原发性遗尿症(PNE)的近期和远期疗效,并进行比较。方法:50例PNE患儿于治疗前测定夜间尿量及夜间尿渗透压,随机分为两组,25例患儿给予口服醋酸去氨加压素(DDAVP)治疗;25例患儿给予推拿手法治疗。25例正常儿童测定夜间尿量及夜间尿渗透压,作为对照组。分别观察1个疗程后以及治疗结束3个月后疗效。结果:治疗后推拿组患儿夜间尿量(145.92±80.23)ml,夜间尿渗透压(799.32±129.63)mOsm/L;药物组夜间尿量(158.40±102.54)ml,夜间尿渗透压(775.57±164.73)mOsm/L;两组比较无显著性差异(P>0.05);两组治愈率比较无显著性差异(P>0.05)。治疗结束后3个月复查,两组治愈率有显著性差异(P<0.05)。药物治疗组中有7人治疗无效,治疗前测得夜间尿量,夜间尿渗透压与有效的18人对比,有显著差异(P<0.05);与正常儿童比较,无显著性差异(P>0.05)。结论:口服DDAVP与推拿治疗小儿原发性遗尿症,远期疗效比较,推拿效果优于口服DDAVP。推拿手法对于改善夜间尿量、夜间尿渗透压无异常的PNE患儿,效果显著;口服DDAVP对于改善该类患儿症状效果不显著。

Objective ： This subject is used for comparison both short-term and long-term efficacy between the Tui-Na treatment and the drug DDAVP treatment for Children Primary Nocturnal Enuresis.Methods ： Nocturnal urine volume and urine osmolality were determined in 50 children with primary nocturnal enuresis before the treatment. 25 children will take the oral administration of DDAVP. The other 25 chil- dren will take the Tui-Na treatment. Nocturnal urine volume and osmolality were examined in 25 normal controls. Run same test to 50 PNE children at the end of the first course, After 3 months, run the test again.Resldt ： The average level of nocturnal urine osmolality in the Tui- Na group was （799.32±129.63） mOsm/L vs （775.57±164.73） mOsm/L in the DDAVP group after the treatment. The average level of nocturnal ltrine wJlume the Tui-Na group was （145.92±80.23）ml vs （158.40±102.54）ml in the DDAVP group after the treatment. There is no significant differences between the two groups （P〉0.05）. Tui-Na group have better long-term efficacy than the other group （P〈0.05）. 7 children from the DDAVP group were not be cured and their data is no significant differences from the normal control group （P〉0.05）. Conclusions ： Tui-Na treatment is the better method for the PNE children, it keeps high cure rate in a long time. The DDAVP don＇t work if the PNE children have normal nocturnal urine osmolality and nocturnal urine volume, but they can be treated by Tui-Na manipulation.