| OBJECTIVE: To preliminarily observe the applicability of TCM treatment plan in syndrome differentiation and classification of children with primary enuresis,clinical efficacy of prescriptions and drug safety,and explore the distribution relationship between TCM syndrome types and Western medicine types,so as to provide a reference for clinical treatment of children with primary enuresis.METHODS: This study collected 84 enuresis children who met the inclusion criteria from the pediatrics department of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine from January 2022 to January 2023,and randomly divided the enuresis children into experimental group and control group with 42 cases in each group according to the ratio of 1:1 by random number table method.The experimental group was given the corresponding traditional Chinese medicine prescription and basic treatment(including diet and the rest of adjustment,awakening training and psychotherapy);The control group received basic treatment,and the course of treatment was 8 weeks.After enrollment,the total score of main disease,total score of secondary disease and total score of TCM syndromes at each follow-up point(before treatment,2 weeks,4weeks,6 weeks,8 weeks)was evaluated.Urinary diaries were recorded at the same time,the distribution of TCM syndrome types and Western medicine types were analyzed,and adverse events occurred during treatment were observed.At the end of 6 months treatment,the children with the complete improvement were followed up to see if enuresis recurred.Statistical analysis(SPSS 25.0)was used to compare the improvement of TCM syndrome scores and the effective rate of the two groups before and after treatment.Results: 1.General evaluation: There was no statistical difference between the two groups of children before treatment in terms of age,gender distribution,number of enuresis,and Chinese medicine evidence points(P > 0.05),which were comparable.2.Evaluation of efficacy:(1)Evaluation of disease efficacy: the total effective rate was 85% in the test group and 63.15% in the control group,with statistical differences between the two groups(P< 0.05),and the efficacy of the test group was better than that of the control group.(2)Evaluation of the efficacy of Chinese medicine symptoms:(1)primary symptom: two groups of children with primary symptom total score no statistical difference before treatment(P > 0.05),comparable;After2 weeks of treatment,there was no statistical significance,but after 4 weeks of treatment,both groups could improve the main symptoms(P < 0.05),and after 4 weeks of treatment,the therapeutic effect of the experimental group was better than that of the control group.(2)times disease: two groups of children with disease of total score no statistical difference before treatment(P > 0.05),comparable;Both groups could effectively improve secondary symptoms(P < 0.05),and after 4weeks of treatment,the therapeutic effect of experimental group was better than that of control group.(3)Total scores of TCM syndromes: the total scores of TCM syndromes in both groups were improved after 4 weeks(P < 0.05),and the test group was better than the control group(P < 0.05).(4)TCM syndrome score difference: at the end point of treatment,the scores of TCM syndrome in the two groups were statistically significant compared with the difference before treatment(P <0.05).(5)The total effective rate of the experimental group was 87.5%,and that of the control group was 71.6%.There was a statistical difference between the two groups(P < 0.05),and the experimental group was better than the control group.3.Distribution of TCM types and Western medicine types: 1.There were no statistical differences in the distribution of Western medicine types and TCM types in terms of gender and age,which were comparable.2.Among the enuresis children who completed the urination diary on time,there were 15 cases(20%)of lung depression and brain blocking syndrome,19 cases(25.33%)of lower jiao dampness-heat syndrome,16 cases(21.33%)of lung qi deficiency syndrome,25 cases(33.34%)of kidney qi deficiency.3.In children with enuresis,nocturnal polyuria was dominated by TCM evidence of kidney qi deficiency(43.75%)and lung spleen qi deficiency(28.12%);reduced bladder capacity was dominated by lower jiao damp-heat(35.29%),followed by the lung depression and cerebral closure(29.41%);mixed type was dominated by lower jiao damp-heat and kidney qi deficiency,normal type was dominated by lung depression and cerebral closure,and kidney qi deficiency was the least.The MVV and TVV corresponding to the four types of evidence was analyzed by ANOVA,which yielded statistically significant differences in MVV and TVV in all four types of evidence(P < 0.05).4.Safety evaluation: no adverse events occurred in children in both groups during the implementation of the study protocol.CONCLUSION: In this study,TCM diagnosis and treatment scheme improved the total scores of TCM main symptoms,total scores of secondary symptoms and TCM syndrome scores of children with enuresis,and the experimental group was better than the control group after 4 weeks of treatment.Short-term efficacy was improved in both groups,and the experimental group was better than the control group.In the treatment process of the two groups,no serious adverse events occurred in the children.Therefore,the idea of studying the treatment of enuresis by TCM diagnosis and treatment scheme in this study is worthy of further research and promotion.Through the class analysis of TCM syndromes and Western syndromes,it was concluded that the common clinical classification of Western syndromes was nocturnal polyuria,and most of the corresponding TCM syndromes were renal qi deficiency. |
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