温肾益脾法配合推拿治疗小儿遗尿临床研究

目的:探讨温肾益脾法配合推拿治疗小儿脾气亏虚型遗尿的临床疗效与安全性。方法:选取脾气亏虚型遗尿症患儿74例,按随机数字表法分别对照组和研究组,每组37例,对照组予以盐酸甲氯芬酯胶囊口服,研究组在西医治疗基础上予以温肾益脾法配合推拿治疗,15 d为1个疗程,测定治疗后两组患儿血管升压素(antidiuretichormone,ADH)水平,记录临床症状,对比临床疗效、睡眠觉醒状况及不良反应发生情况。结果:与治疗前及对照组治疗后比较,两组患儿治疗后血浆ADH3降低,血浆ADH1升高,尿床、神疲乏力、食欲不振、便溏、自汗等中医证候积分降低,遗尿次数、残余尿量降低,膀胱容量升高,差异有统计学意义(P0.05);研究组睡眠觉醒水平优于对照组(P0.05);对照组有效率为70.27%,研究组有效率为91.89%,两组比较,差异有统计学意义(P0.05);两组均无明显不良反应。结论:温肾益脾法配合推拿治疗小儿脾气亏虚型遗尿疗效确切,可改善临床症状,提高夜间ADH水平,安全性好。

Wenshenyipi Combined with Massage in the Treatment of Spleen Qi Deficiency Enuresis in Children and Its Influence on Sleep Arousal Levels of Children

Objective:To investigate the clinical effect of Wenshenyipi combined with massage in the treatment of spleen Qi deficiency enuresis in children.Methods:74 cases of spleen Qi deficiency enuresis in children were selected and randomly divided into 2 groups,each of 37 cases.The control group was received Meclofenoxate Hydrochloride Capsules,and the study group was treated with Wenshenyipi combined with massage on the basis of the control group,15 days for a course.After treatment,the levels of antidiuretichormone(ADH) in the two groups and the clinical symptoms were recorded,the clinical efficacy,sleep wake and adverse reactions were compared.Results:Compared with before treatment,the levels of plasma ADH3 decreased in the two groups after treatment,levels of plasma ADH1 increased,enuresis,lassitude,anorexia,diarrhea,sweating and other symptom scores decreased,the number and residual urine enuresis decreased,bladder capacity increased (P ＜ 0.05),compared with the control group,the levels of plasma ADH3 were lower,levels of ADH1 were higher,enuresis,lassitude,anorexia,diarrhea,sweating and other symptom scores were lower,the number and volume of residual urine enuresis were lower,bladder capacity were higher (P ＜ 0.05).The sleep arousal level of the study group was better than that of the control group (P ＜ 0.05).The effective rate of the study group was 91.89％,better than that of the control group 70.27％ (P ＜0.05).There was no obvious adverse reaction between the two groups.Conclusion:Wenshenyipi combined with massage therapy in the treatment of spleen Qi deficiency enuresis in children has exact effect,which can improve clinical symptoms,improve the night ADH level with high security.