培元止遗汤联合耳穴压豆、推拿治疗儿童夜遗尿

Clinical effect of Peiyuan Zhiyi Decoction combined with the ear point pressing and massage therapies in the treatment of children with nocturnal enuresis

目的观察培元止遗汤联合耳穴压豆及推拿疗法治疗夜遗尿患儿的临床效果。方法将100例夜遗尿患儿随机分为对照组与观察组,各50例,对照组予去氨加压素治疗,观察组予培元止遗汤联合耳穴压豆、推拿治疗,记录尿比重、膀胱容量等相关指标,对比治疗前后两组患儿尿流动力学变化情况,观察临床疗效及复发情况。结果治疗后,观察组最大尿流率时逼尿肌压力(Pdet)显著低于对照组(P<0.05),最大尿流率(MFR)、膀胱初尿意容量(FS)显著高于对照组(P<0.05);观察组尿比重、膀胱容量、尿床次数均显著优于对照组(P<0.05);观察组夜间遗尿、尿清量多、熟睡不醒、形寒肢冷4项中医症状评分均显著低于对照组(P<0.05);观察组少儿主观生活质量问卷(ISLQ)评分显著高于对照组(P<0.05);观察组总有效率96%,高于对照组82%(P<0.05);随访6个月,观察组夜遗尿复发率10%,显著低于对照组26%(P<0.05)。结论培元止遗汤联合耳穴压豆及推拿疗法可显著改善夜遗尿患儿尿流动力学及临床症状,提高临床疗效,恢复患儿生活质量,且复发率低。

Objective To observe the clinical effect of Peiyuan Zhiyi Decoction combined with the ear point pressing and massage therapies in the treatment of children with nocturnal enuresis.Methods A total of 100 children with nocturnal enuresis were randomly divided into a control group and an observation group,with 50 cases in each group.The control group was treated with desmopressin,while the observation group was treated with Peiyuan Zhiyi Decoction combined with the therapies of ear point pressing and massage.The relevant indexes such as urine specific gravity and bladder volume were recorded,and the changes of urodynamics before and after treatment were compared between the two groups,and the clinical efficacy and recurrence were observed.Results After treatment,the detrusor pressure (Pdet) at the maximum urine flow rate of the observation group was significantly lower than that of the control group (P<0.05),while the maximum urine flow rate (MFR) and the first sensation of bladder filling (FS) were significantly higher than those of the control group (P<0.05).Urine specific gravity,bladder volume and bed wetting times in the observation group were significantly better than those in the control group (P<0.05),while the scores of four TCM symptoms of nocturnal enuresis,excessive urine clearance,deep sleep and cold limbs in the observation group were significantly lower than those in the control group (P<0.05).The infantile subjective life quality questionnaire (ISLQ) score of the observation group was significantly higher than that of the control group (P<0.05).The total effective rate of the observation group (96%) was higher than that of the control group (82%) (P<0.05).After 6 months of follow-up,the recurrence rate of nocturnal enuresis in the observation group (10%) was significantly lower than that in the control group (26%) (P<0.05).Conclusion Peiyuan Zhiyi Decoction combined with the ear point pressing and massage therapies can significantly improve the urodynamics and clinical symptoms of children with nocturnal enuresis,improve the clinical efficacy,restore their quality of life,with a lower recurrence rate.