基于小儿遗尿症临床症候群选用缩泉胶囊和醒脾养儿颗粒的疗效观察
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摘要
目的小儿遗尿症是临床常见多发病,目前西医治疗遗尿效果欠佳,本研究旨在比较目前广泛使用的中成药缩泉胶囊和醒脾养儿颗粒治疗不同临床症候群的小儿遗尿症的疗效,以指导临床根据临床症候群合理选择药物。方法参照中医小儿遗尿症诊疗标准,根据患者临床症状及辅助检查结果等临床症候群的不同,将2017年6月1日—11月31日期间在上海儿童医学中心肾脏风湿科门诊就诊的21例遗尿症患儿分为肾气不足型(10例)和脾肺气虚型(11例)2组,2组均无糖尿病癫痫等基础疾病;其中肾气不足组主要入选症候群为生长发育情况及尿路症状,选用缩泉胶囊进行治疗;而脾肺气虚组则为消化道症状、体重、齿痕及舌苔,选用醒脾养儿颗粒进行治疗;2种药物的治疗总疗程均为3个月,观察药物起效时间以及药物不良反应和复发情况,比较2组的临床疗效。结果缩泉胶囊组10例,完全效应4例,部分效应3例,无效3例,总有效率为70.00%(7/10);醒脾养儿颗粒组11例,完全效应4例,部分效应4例,无效3例,有效率为72.72%(8/11),根据临床症候群选药的2组疗效明显,差异无统计学意义(P>0.05),观察3个月无复发,未发生明显的不良反应。结论根据患儿的临床症状(遗尿、尿路及消化道疾病)、体重、生长发育情况等进行简单的初步辨证,可以较合理选用缩泉胶囊或醒脾养儿颗粒治疗遗尿症,简单便捷,具有良好的临床实用性。
Objective Enuresis is a common and frequently occurring disease,and the treatment effect of western medicine is not so satisfied.The purpose of this study is to compare the curative effect of Suoquan and Xingpi Yanger granule in children with different clinical syndromes,so as to guide clinicians to select appropriate drugs according to clinical syndromes.Methods According to the clinical symptoms,auxiliary examination results and therapeutic standards of TCM syndrome for pediatric enuresis,21 enuresis children without basic diseases,such as diabetes and epilepsy,were divided into deficiency of kidney-qi group(n = 10),and deficiency of spleen and lung-qi group(n = 11),who were treated in the Department of Rheumatism of Shanghai Children's Medical Center from June 1 to November 31 in 2017.The deficiency of kidney-qi group,with admission syndrome of growing development and urinary symptoms,was treated with Suoquan capsule for 3 months;the deficiency of spleen and lung-qi group,with admission syndrome of gastrointestinal symptoms,body weight,tooth marks and tongue coating,was treated with Xingpi Yanger granule for 3 months.And the therapeutic effects,adverse drug reactions and recurrence rate were observed.Results In the deficiency of kidney-qi group,4 cases were CR,3 cases were PR,and 3 cases were PD,with a total effective rate of 70.00%(7/10).In the deficiency of spleen and lung-qi group,4 cases were CR,4 cases were PR,and 3 cases were PD,with a total effective rate of72.72%(8/11).There was no significant difference in the curative effect between the two groups(P > 0.05).Three months follow-up did not observed the obvious adverse reaction and recurrence case.Conclusion The rational use of Suoquan capsule or Xingpi Yanger granule in the treatment of infantile enuresis according to the clinical signs(enuresis,urinary and gastrointestinal symptoms),body weight and growth status will achieve the desired result.The method,with good clinical practicality,is simple and convenient.
Objective Enuresis is a common and frequently occurring disease,and the treatment effect of western medicine is not so satisfied.The purpose of this study is to compare the curative effect of Suoquan and Xingpi Yanger granule in children with different clinical syndromes,so as to guide clinicians to select appropriate drugs according to clinical syndromes.Methods According to the clinical symptoms,auxiliary examination results and therapeutic standards of TCM syndrome for pediatric enuresis,21 enuresis children without basic diseases,such as diabetes and epilepsy,were divided into deficiency of kidney-qi group(n = 10),and deficiency of spleen and lung-qi group(n = 11),who were treated in the Department of Rheumatism of Shanghai Children's Medical Center from June 1 to November 31 in 2017.The deficiency of kidney-qi group,with admission syndrome of growing development and urinary symptoms,was treated with Suoquan capsule for 3 months;the deficiency of spleen and lung-qi group,with admission syndrome of gastrointestinal symptoms,body weight,tooth marks and tongue coating,was treated with Xingpi Yanger granule for 3 months.And the therapeutic effects,adverse drug reactions and recurrence rate were observed.Results In the deficiency of kidney-qi group,4 cases were CR,3 cases were PR,and 3 cases were PD,with a total effective rate of 70.00%(7/10).In the deficiency of spleen and lung-qi group,4 cases were CR,4 cases were PR,and 3 cases were PD,with a total effective rate of72.72%(8/11).There was no significant difference in the curative effect between the two groups(P > 0.05).Three months follow-up did not observed the obvious adverse reaction and recurrence case.Conclusion The rational use of Suoquan capsule or Xingpi Yanger granule in the treatment of infantile enuresis according to the clinical signs(enuresis,urinary and gastrointestinal symptoms),body weight and growth status will achieve the desired result.The method,with good clinical practicality,is simple and convenient.
引文
[1]AUSTIN P F,BAUER S B,BOWER W,et al.The standardization of terminology of lower urinary tract function in children and adolescents:update report from the standardization committee of the International Children's Continence Society[J].J Urol,2014,191(6):1863-1865.
[2]潘晓芬,雷辛衍,林国模,等.6-11岁尿症儿童心理行为问题及相关因素研究[J].中国儿童保健杂志,2016,24(5):525-528.
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[5]刘小梅,申慧贞,廖鸣慧,等.儿童遗尿症中西医治疗情况调查[J].北京医学,2016,38(8):789-761.
[6]程红云,孙潇君.温肾益脾法配合艾灸治疗脾肾两虚型小儿遗尿临床观察[J].中医药信息,2014,31(1):104-106.
[7]程燕,谭泽云,易小兰,等.缩泉胶囊治疗小儿原发性单纯性遗尿症随机双盲多中心临床试验[J].中医药导报,2017,23(5):57-60.
[8]郭翠翠,吕学云,张玉琨,等.沙丁胺醇联合醒脾养儿颗粒治疗儿童夜遗尿疗效观察[J].中国中西医结合儿科学,2015,7(6):581-583.
[9]武志春.自拟温肾健脾散配合小儿推拿治疗小儿遗尿症临床分析[J].河北医学,2014,20(12):2134-2135.
[10]吴珊珊,龚晓猛,张美,等.缩泉丸中益智仁盐炙前后对肾阳虚大鼠肾脏功能的改善作用[J].中国实验方剂学杂志,2016,22(5):1-4.
[11]操红缨,邝兆进,谈博,等.补肾中药复方对老年大鼠尿道功能和膀胱逼尿肌β-AR的影响[J].中药材,2015,38(4):794-797.
[12]赖焕玲,陈鹏宇,段晓瑾,等.缩泉丸对膀胱过度活动症大鼠膀胱充盈期盆神经放电的影响[J].中国病理生理杂志,2016,32(1):151-155.
[13]KURT O,YAZICI C M,PAKETCI C,et al.Nocturnal enuresis with spina bifida occulta:Does it interfere behavioral management success?[J].Int Urol Nephrol,2015,47(9):1485-1491.
[14]周冰新,杨燕珍,曾月桂.去氨加压素联合醒脾养儿颗粒治疗小儿遗尿症效果观察[J].白求恩医学杂志,2016,14(6):689-691.
[15]周力平.西咪替丁联合醒脾养儿颗粒治疗小儿病毒性腹泻的疗效观察[J].中外医学研究,2015,12(5):126-127.
[16]易波.醒脾养儿颗粒联合腹肌锻炼治疗小儿遗尿48例疗效评价[J].中国药业,2016,25(2):46-48.
[17]余益萍,田永波,刘颖,等.醒脾养儿颗粒治疗小儿原发性夜间遗尿症的临床观察[J].中国药房,2017,28(6):738-741.
[2]潘晓芬,雷辛衍,林国模,等.6-11岁尿症儿童心理行为问题及相关因素研究[J].中国儿童保健杂志,2016,24(5):525-528.
[3]初梅,曹力,陈朝英,等.醋酸去氨加压素中长程疗法治疗儿童原发性单症状夜遗尿症疗效研究[J].中国实用儿科杂志,2017,32(11):861-865.
[4]中国儿童遗尿疾病管理协作组.中国儿童单症状性夜遗尿疾病管理专家共识[J].临床儿科杂志,2014,32(10):970-974.
[5]刘小梅,申慧贞,廖鸣慧,等.儿童遗尿症中西医治疗情况调查[J].北京医学,2016,38(8):789-761.
[6]程红云,孙潇君.温肾益脾法配合艾灸治疗脾肾两虚型小儿遗尿临床观察[J].中医药信息,2014,31(1):104-106.
[7]程燕,谭泽云,易小兰,等.缩泉胶囊治疗小儿原发性单纯性遗尿症随机双盲多中心临床试验[J].中医药导报,2017,23(5):57-60.
[8]郭翠翠,吕学云,张玉琨,等.沙丁胺醇联合醒脾养儿颗粒治疗儿童夜遗尿疗效观察[J].中国中西医结合儿科学,2015,7(6):581-583.
[9]武志春.自拟温肾健脾散配合小儿推拿治疗小儿遗尿症临床分析[J].河北医学,2014,20(12):2134-2135.
[10]吴珊珊,龚晓猛,张美,等.缩泉丸中益智仁盐炙前后对肾阳虚大鼠肾脏功能的改善作用[J].中国实验方剂学杂志,2016,22(5):1-4.
[11]操红缨,邝兆进,谈博,等.补肾中药复方对老年大鼠尿道功能和膀胱逼尿肌β-AR的影响[J].中药材,2015,38(4):794-797.
[12]赖焕玲,陈鹏宇,段晓瑾,等.缩泉丸对膀胱过度活动症大鼠膀胱充盈期盆神经放电的影响[J].中国病理生理杂志,2016,32(1):151-155.
[13]KURT O,YAZICI C M,PAKETCI C,et al.Nocturnal enuresis with spina bifida occulta:Does it interfere behavioral management success?[J].Int Urol Nephrol,2015,47(9):1485-1491.
[14]周冰新,杨燕珍,曾月桂.去氨加压素联合醒脾养儿颗粒治疗小儿遗尿症效果观察[J].白求恩医学杂志,2016,14(6):689-691.
[15]周力平.西咪替丁联合醒脾养儿颗粒治疗小儿病毒性腹泻的疗效观察[J].中外医学研究,2015,12(5):126-127.
[16]易波.醒脾养儿颗粒联合腹肌锻炼治疗小儿遗尿48例疗效评价[J].中国药业,2016,25(2):46-48.
[17]余益萍,田永波,刘颖,等.醒脾养儿颗粒治疗小儿原发性夜间遗尿症的临床观察[J].中国药房,2017,28(6):738-741.
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