Efficacy of Bei Qi umbilical patch combined with behavioral intervention on nocturnal enuresis in children
Objective It is to investigate the efficacy of Bei Qi umbilical patch combined with behavioral intervention in the treatment of nocturnal enuresis and its effect on the brain-bladder function axis in children.Methods Sixty children with chief complaints of nocturnal enuresis who attended the Department of Developmental and Behavioral Pediatrics of Shanghai Children's Medical Center from February to August 2023 were randomly divided into 30 cases in the treatment group and 30 cases in the control group.The treatment group was treated with Bei Qi umbilical patch combined with behavioral interven-tion,and the control group was treated with behavioral intervention alone,and both groups were treated for 8 weeks.The times of urine loss per week and the improvement rate of urine loss after 8 weeks of treatment were compared between the two groups before treatment,after 4 weeks and after 8 weeks of treatment,the changes in the brain-bladder function axis in-dexes(urinary arousal score,maximum day/night bladder capacity,minimum day/night bladder capacity,average day/night bladder capacity,first urine volume in the next morning,total water consumption per unit of body surface area,day-time urinary output,nighttime urinary output)and maximum voided volume(MVV)/age expected bladder capacity(EBC),total voided volume(TVV)/EBC before and after the treatment were observed in the two groups.Results The times of urine loss per week after 4 weeks of treatment were significantly lower than those before treatment,while the times after 8 weeks of treatment were significantly lower than those after 4 weeks of treatment in the two groups,and the times of urine loss per week after 4 and 8 weeks of treatment in the treatment group were significantly lower than those in the control group at the same time period,the differences were all statistically significant(all P<0.05).The total effective rate of the treatment group was63.4％(19/30),and that of the control group was 30.0％,the total effective rate of the treatment group was significantly higher than that of the control group(x2=6.698,P<0.05,Cohen's d=0.70).After8 weeks of treatment,the urinary arousal score of the treatment group was significantly lower than that of the control group(t=2.808,P<0.05,Cohen's d=0.73);there were no statistically significant differences in the maximum and minimum daytime bladder capacity,average daytime bladder capacity,maximum and minimum night bladder capacity,average night bladder capacity,and the first urine volume in the next morning between the two groups and between before and after treatment in each group(all P>0.05);the daytime urinary output per unit of body surface area was significantly increased(t=2.672,P<0.05,Cohen's d=0.51),and nighttime urinary output per unit of body surface area was significantly decreased com-pared with those before treatment in the treatment group(t=2.543,P<0.05 Cohen's d=0.67);the nighttime urinary output per unit of body surface area was significantly decreased compared with that before treatment in the control group(t=2.238,P<0.05,Cohen's d=0.36),and there was no significant change in daytime urine output compared with the be-fore treatment(P>0.05).After 8 weeks of treatment,MVV/EBC was significantly increased compared with before treat-ment in both groups,but the differences were not statistically significant between the two groups and between before and af-ter treatment in each group(all P>0.05);TVV/EBC was significantly decreased compared with before treatment in both groups(both P<0.05).Conclusion Active behavioral intervention can improve the indexes of brain-bladder function axis in children with nocturnal enuresis,and the combined treatment with Bei Qi umbilical patch can further improve the enure-sis symptoms of the children,mainly to improve the urinary-arousal function.
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