Radmayr C, Schlager A, Studen M, Bartsch G
Department of Urology, University of Innsbruck, Austria.
Eur Urol. 2001 Aug;40(2):201-5. doi: 10.1159/000049773.
Several treatment modalities for children suffering from monosymptomatic nocturnal enuresis are available, but desmopressin is a well-established option. On the other hand, alternative nonpharmacological therapies such as laser acupuncture are more frequently requested by the parents. To our knowledge, there is no prospective randomized trial which evaluated the efficacy of such an alternative approach in comparison with the widespread use of desmopressin.
Forty children aged over 5 years presenting with primary nocturnal enuresis underwent a previous evaluation of their voiding function to assure normal voiding patterns and a high nighttime urine production. Then the children were randomized into two groups: group A children were treated with desmopressin alone, and group B children underwent laser acupuncture. All children were investigated after a minimum follow-up period of 6 month to evaluate the duration of the response.
The children of both groups had an initial mean frequency of 5.5 wet nights per week. After a minimum follow-up period of 6 months reevaluation revealed a complete success rate of 75% in the desmopressin-treated group. Additional 10% of the children had a reduction of their wet nights of more than 50%. On the other hand, 6 months after laser acupuncture, 65% of the randomized children were completely dry. Another 10% had a reduction of the enuresis frequency of more than 50% per week. 20% of the children in the desmopressin-treated group did not respond at all as compared with 15% in the acupuncture-treated group. Statistical evaluation revealed no significant differences among the response rates in both groups.
Im comparison with pharmacological therapy using desmopressin, our study shows that laser acupuncture should be taken into account as an alternative, noninvasive, painless, cost-effective, and short-term therapy for children with primary nocturnal enuresis in case of a normal bladder function and high nighttime urine production. Success rates indicated no statistically significant differences between the well-established desmopressin therapy and the alternative laser acupuncture.
对于患有单症状性夜间遗尿症的儿童，有多种治疗方式可供选择，但去氨加压素是一种公认的选择。另一方面，家长们更频繁地要求采用激光针灸等替代性非药物疗法。据我们所知，尚无前瞻性随机试验评估这种替代方法与广泛使用的去氨加压素相比的疗效。
40名5岁以上患有原发性夜间遗尿症的儿童先前已接受排尿功能评估，以确保排尿模式正常且夜间尿量较大。然后将这些儿童随机分为两组：A组儿童仅接受去氨加压素治疗，B组儿童接受激光针灸治疗。所有儿童在至少随访6个月后接受调查，以评估反应持续时间。
两组儿童最初每周尿床的平均次数均为5.5次。在至少随访6个月后重新评估发现，去氨加压素治疗组的完全成功率为75%。另外10%的儿童尿床次数减少了50%以上。另一方面，激光针灸治疗6个月后，65%的随机分组儿童完全不再尿床。另外10%的儿童每周遗尿频率降低了50%以上。去氨加压素治疗组中有20%的儿童完全没有反应，而针灸治疗组为15%。统计学评估显示两组的反应率之间无显著差异。
与使用去氨加压素的药物治疗相比，我们的研究表明，对于膀胱功能正常且夜间尿量较大的原发性夜间遗尿症儿童，激光针灸应被视为一种替代性的、非侵入性的、无痛的、经济高效的短期治疗方法。成功率表明，公认的去氨加压素疗法与替代性激光针灸之间无统计学显著差异。
