摘要
目的研究奥昔布宁联合去氨加压素治疗小儿夜间遗尿症(NE)的疗效和安全性,并对与治疗疗效相关的关键因素进行分析。方法将有效入选的108例患儿随机分为对照组54例和试验组54例。2组患儿用药前均接受包括生活习惯及方式指导、心理行为疏导等常规基础治疗。对照组患儿在入睡前1 h给以醋酸去氨加压素片0.01 mg·kg^(-1),口服,每天1次。试验组患儿在对照组用药基础上,联合使用盐酸奥昔布宁片0.25 mg·kg^(-1),口服,每天1次。所有患儿需治疗满90 d。治疗完成后根据患儿改善情况,判定用药的临床疗效。对患儿的晨尿渗透压、每日盐摄入量等指标进行检测。分析患儿治疗有效率,分析体质量指数(BMI)、性别、晨尿渗透压和每日盐摄入量与疗效的相关性。结果治疗完成后,试验组和对照组的总有效率分别为88.89%(48例/54例)和53.70%(29例/54例),差异有统计学意义(P<0.05)。治疗完成3个月后回访,试验组和对照组的复发率分别为31.25%(15例/48例)和58.62%(17例/29例),差异有统计学意义(P<0.05)。对照组中,治疗无效的患儿相比治疗有效患儿具有较高的BMI水平,较高的尿液渗透压以及较高的每日盐分摄入量(P<0.05)。而试验组不存在此种差异性。治疗过程中试验组和对照组总药物不良反应发生率为37.04%和50.00%,差异无统计学意义(P>0.05)。结论奥昔布宁联合去氨加压素治疗对小儿夜间遗尿症患儿可提高临床疗效,降低复发率。对于肥胖、尿液渗透压偏高和盐分摄入量偏高的患儿尤其应该选择联合用药方案。
Objective To study the efficacy and safety of oxybutynin combined with desmopressin in treatment of nocturnal enuresis(NE)in children and analyze the critical factors associated with the treatment efficacy.Methods The 108 effectively enrolled children were randomly divided into control group of 54 cases and treatment group of 54 cases.The children in both groups received conventional basic treatment,including lifestyle and manner guidance and psychological and behavioural advice before medication.Children in control group were given desmopressin acetate tablets 0.01 mg·kg^(-1),po,qd,1 h before sleep.On the basis of control group,children in treatment group were given oxybutynin hydrochloride tablets 0.25 mg·kg^(-1),po,qd.The clinical efficacy of the drugs was determined according to the improvement of the children after the completion of the treatment.The morning urine osmolality and daily salt intake of the children were measured.The correlation between body mass index(BMI),gender,morning urine osmolality and daily salt intake and treatment efficacy was analyzed.Results After the completion of treatment,the total effective rate of treatment group and control group were 88.89%(48 cases/54cases)and 53.70%(29 cases/54 cases),respectively,with statistically significant differences(P<0.05).At the return visit 3 months after the completion of treatment,the recurrence rates in treatment group and control group were31.25%(15 cases/48 cases)and 58.62%(17 cases/29 cases),respectively,and the difference was statistically significant(P<0.05).In the control group,children who did not respond to treatment had higher BMI levels,higher urine osmotic pressure,and higher daily salt intake than those who did(P<0.05).There was no such difference in treatment group.The overall adverse reaction rates during treatment in treatment group and control group were 37.04%and 50.00%,with no significant differences(P>0.05).Conclusion Oxybutynin combined with desmopressin in the treatment of children with NE can improve clinical efficacy and
作者
张晔
潮敏
ZHANG Ye;CHAO Min(Department of Urology,Anhui Provincial Children's Hospital,Hefei 230000,Anhui Province,China)
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2022年第20期2415-2418,共4页
The Chinese Journal of Clinical Pharmacology
基金
安徽省卫生健康委科研计划基金资助项目(2019SEY006)。
