温肾健脾推拿法替代去氨加压素结构性撤药治疗儿童单症状性遗尿症的临床研究

A clinical study on treating monosymptomatic enuresis in children by massage for warming kidney and strengthening spleen instead of structural withdrawal of desmopressin

目的:探析温肾健脾推拿法替代去氨加压素结构性撤药对儿童单症状遗尿症的临床效果。方法:选取2020年9月-2021年9月至广东医科大学顺德妇女儿童医院接受治疗的单症状性遗尿症患儿80例作为研究对象,按计算机分组法将所有患儿随机分为观察组和对照组,每组40例,对照组仅采用去氨加压素口服治疗,观察组患儿予去氨加压素治疗3个月后用温肾健脾推拿法继续治疗,对比两组患儿治疗后的治愈率、有效率,对比其治疗后中医主症(遗尿次数、睡眠深度、形寒肢冷)改善情况,统计其夜间睡眠觉醒次数及病情复发率。结果:两组患儿的治疗有效率差异无统计学意义(P>0.05),观察组治愈率高于对照组,治疗后遗尿次数、睡眠深度、形寒肢冷等中医主症积分低于对照组,对应的夜间觉醒次数低于对照组,病情复发率低于对照组,以上数据的差异均具有统计学意义(P<0.05)。结论:温肾健脾推拿法可在去氨加压素规范治疗3个月后代替结构性撤药治疗单症状性遗尿症患儿,能够促进患儿症状改善,减少其夜间觉醒次数及病情复发率,临床价值较高,建议进一步推广应用。

Objective:To explore the clinical effect of massage for warming kidney and strengthening spleen instead of structural withdrawal of desmopressin on monosymptomatic enuresis.Methods:A total of 80 cases from September 2020 to September 2021 were selected as the research objects and were randomly divided into the observation group and the control group according to computer grouping method,with 40 cases in each group.The control group only received oral treatment with desmopressin.The observation group were treated with desmopressin for three months and then continued to be treated by massage for warming kidney and strengthening spleen.Results:There was no significant difference in clinical efficacy between the two groups(P>0.05).The cured rate in the observation group was higher than the control group(P<0.05).The scores of TCM main syndromes such as enuresis times,sleep depth and cold limbs after treatment in the observation group were lower than those in the control group,and the times of night awakening were less than the control group.The recurrence rate in the observation group was lower than the control group,and the differences of the above indicators were statistically significant(P<0.05).Conclusion:Massage for warming kidney and strengthening spleen can replace the structural drug withdrawal of desmopressin in the treatment of monosymptomatic enuresis after 3 months of standard treatment with desmopressin,which can ameliorate the symptoms,and reduce the times of nocturnal awakening and the recurrence rate of the disease.Its clinical value is high,and it is suggested to be further popularized and applied.