CAJ | 학술논문

目的随机对照研究、评估生物反馈治疗儿童原发性遗尿症(PNE)的疗效.方法 120例PNE患儿采用随机数字表分组法随机分为生物反馈治疗组和行为疗法组.两组均接受3个月治疗,于治疗结束时(第一次)、治疗结束后6个月(第二次)进行随访,分别评判其近期和远期疗效.结果治疗结束时行为疗法组治愈率和有效率分别为36.7％和51.7％；生物反馈组治愈率和有效率分别为63.3％和91.6％.生物反馈治疗组治愈率和有效率显著高于行为疗法组(P＜0.05,P＜0.01).治疗结束6个月后,行为疗法组治愈率、有效率和复发率分别为32.7％、50.9％和10.9％;生物反馈组治愈率、有效率和复发率分别为62.1％,88.0％和5.2％.生物反馈组治愈率、有效率显著高于行为疗法组(P＜0.05,P＜0.01),两组复发率差异无统计学意义(P=0.26).行为疗法组两次随访时功能性膀胱容量减小患儿构成比例分别为34.5％、36.3％,功能性膀胱容量减小人数比例较治疗前(60.0％)显著减少(P＜0.01)；生物反馈组功能性膀胱容量减小患儿构成比例分别为10.3％、19.0％,功能性膀胱容量减小人数比例较治疗前(45.0％)显著减少(P＜0.01).结论功能性膀胱容量减小是PNE患儿的主要发病机制之一.生物反馈训练是治疗儿童PNE的有效方法,尤其在合并有功能性膀胱容量减小的患儿.因此,生物反馈训练可以在临床推广应用.
목적 수궤대조연구、평고생물반궤치료인동원발성유뇨증(PNE)적료효.방법 120례PNE환인채용수궤수자표분조법수궤분위생물반궤치료조화행위요법조.량조균접수3개월치료,우치료결속시(제일차)、치료결속후6개월(제이차)진행수방,분별평판기근기화원기료효.결과 치료결속시행위요법조치유솔화유효솔분별위36.7％화51.7％；생물반궤조치유솔화유효솔분별위63.3％화91.6％.생물반궤치료조치유솔화유효솔현저고우행위요법조(P＜0.05,P＜0.01).치료결속6개월후,행위요법조치유솔、유효솔화복발솔분별위32.7％、50.9％화10.9％;생물반궤조치유솔、유효솔화복발솔분별위62.1％,88.0％화5.2％.생물반궤조치유솔、유효솔현저고우행위요법조(P＜0.05,P＜0.01),량조복발솔차이무통계학의의(P=0.26).행위요법조량차수방시공능성방광용량감소환인구성비례분별위34.5％、36.3％,공능성방광용량감소인수비례교치료전(60.0％)현저감소(P＜0.01)；생물반궤조공능성방광용량감소환인구성비례분별위10.3％、19.0％,공능성방광용량감소인수비례교치료전(45.0％)현저감소(P＜0.01).결론 공능성방광용량감소시PNE환인적주요발병궤제지일.생물반궤훈련시치료인동PNE적유효방법,우기재합병유공능성방광용량감소적환인.인차,생물반궤훈련가이재림상추엄응용.
Objective To assess the efficacy of biofeedback treatment of children with primary enuresis (PNE).Methods One hundred and twenty cases of PNE were randomly divided into of two groups:biofeedback treatment group and behavioral therapy group.All children received treatment for 3 months.The short-term and long-term efficacy,the follow-up test were used at the end of treatment and at 6 months after the end of treatment.Results At end of treatment,the rate of cure and effective were 36.7％ and 51.7％,respectively for behavioral group; while the cure rate and total efficiency was 63.3％ and 91.6％ in the biofeedback group,respectively (P＜0.05,P＜0.01).After 6 months of treatment,the cure rate,total efficiency and the recurrence rate were 32.7％,50.9％ and 10.9％ in the group with behavioral therapy; in biofeedback group,the cure rate,the total efficiency and recurrence rates were 62.1％,88.0％ and 5.2％ (P＜0.05,P＜0.01).However,the recurrence rate between the two groups had no significant difference (P =0.26).The proportions of children with detrusor instability at follow-up in the behavioral therapy group were 45.5％,43.6％ respectively (before treatment 51.7％).These were not statistically significant (P=0.50,P=0.39) ; the proportions of children in the biofeedback group with detrusor instability during follow up were 38.3％ and 34.5％ (before treatment 46.7％) (P =0.42,P =0.38).The proportion of children with reduced functional bladder capacity in the behavioral therapy group was 34.5％,36.3％ from 60％ before treatment (60.0 ％) (P＜0.01) ; for the biofeedback group,this proportion was 10.3 ％ and 19.0 ％,as compared to 45％ before treatment (P＜0.01).Conclusions Reduced functional bladder capacity is one of the pathogenesis of children with PNE.Biofeedback training is an effective method for treatment of PNE children who have a bladder with reduced functional capacity.