健脾固肾止遗方联合穴位贴敷治疗儿童夜遗尿35例临床观察

Jianpi Gushen Zhiyi prescription combined with acupoint application in the treatment of children’s nocturnal enuresis:a clinical observation of 35 cases

目的观察健脾固肾止遗方联合穴位贴敷治疗儿童夜遗尿的临床疗效。方法选择2016年8月至2018年10月在郑州儿童医院就诊的70例儿童夜遗尿采用随机数字表法分为研究组与对照组,各35例。对照组给予去氨升压素片治疗,研究组给予中药内服+穴位贴敷治疗。两组均连续治疗3个月后比较两组治疗前后的中医症候积分、遗尿次数、膀胱容量壁厚指数(BVWI)、膀胱容量及复发情况。结果研究组总有效率为91.43%,明显优于对照组(P<0.05)。研究组治疗前中医证候积分:睡中遗尿治疗前(3.28±0.75)分,治疗后(1.47±0.64)分,t=12.567,P<0.001,其他中医症候积分治疗后均显著低于治疗前。研究组治疗前遗尿次数(6.32±1.37)次/周,治疗后(1.22±0.77)次/周,t=21.160,P<0.001;研究组治疗前BVWI(78.71±12.16)mL/mm,治疗后(52.36±10.11)mL/mm,t=15.091,P<0.001。两组病儿治疗后遗尿次数和BVWI均显著低于治疗前。研究组治疗前膀胱容量(202.07±22.54)mL,治疗后(291.33±19.09)mL,t=19.191,P<0.001,两组病儿治疗后膀胱容量较治疗前明显增加,且研究组各项指标改善程度显著优于对照组(P<0.05),研究组治疗结束后3个月和6个月复发率分别为3.13%、9.38%,明显低于对照组(P<0.05)。结论健脾固肾止遗方联合穴位贴敷治疗儿童夜遗尿可有效缓解病儿的临床症状、减少遗尿次数,提高膀胱容量、降低复发率且安全可靠。

Objective To observe the efficacy of Jianpi Gushen Zhiyi Prescription combined with acupoint application in the treat ment of children’s nocturnal enuresis(NE).Methods A total of 70 children with NE treated in Zhengzhou Children’s Hospital from August 2016 to October 2018 were assigned into study group and control group by random number table method,35 cases in each group.The control group was treated with desmopressin tablets,and the study group was treated with traditional Chinese medi cine plus Acupoint application.After 3 months of continuous treatment,the TCM symptom scores,enuresis frequency,bladder vol ume wall thickness index(BVWI),bladder volume and recurrence were compared between the two groups before and after treat ment.Results The total effective rate of the study group was 91.43%,which was significantly better than that of the control group(P<0.05).In the study group,the scores of TCM syndrome(score)were(3.28±0.75)before treatment and(1.47±0.64)after treat ment for enuresis during sleep(t=12.567,P<0.001).The scores of other TCM symptoms after treatment were significantly lower than those before treatment.In the study group,the enuresis frequencies were(6.32±1.37)times/week before treatment and(1.22±0.77)times/weekafter treatment(t=21.160,P<0.001);BVWI was(78.71±12.16)mL/mm before treatment and was(52.36±10.11)mL/mm after treatment(t=15.091,P<0.001).The enuresis frequency and BVWI after treatment in both groups were signifi cantly lower than those before treatment.The bladder volumes of the study group were(202.07±22.54)mL before treatment and(291.33±19.09)mL after treatment(t=19.191,P<0.001)The bladder volumes of the two groups after treatment were significant ly higher than those before treatment,and the improvement degree of each index of the study group was significantly better than that of the control group(P<0.05).The recurrence rates at 3 and 6 months after treatment were 3.13%and 9.38%respectively,which were significantly lower than those in the control group(P<0.05).Conclusion Jianpi Gushen Zhiyi Prescription combined with acupoint application can effectively alleviate the clinical symptoms of children,reduce the frequency of enuresis,increase blad der capacity,and reduce recurrence rate,which is safe and reliable.