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去氨加压素与联合治疗(去氨加压素+奥昔布宁)对小儿夜间遗尿症的疗效比较

Comparative response of Desmopressin versus Combination Therapy (Desmopressin + Oxybutynin) in Children with Nocturnal Enuresis.

作者信息

Kazi Asiya, Moorani Kemchand N, Zehra Shabih, Zaidi Ijaz Hussain

机构信息

Dr. Asiya Kazi, MBBS, Pharmacology Department, Bahria University Medical & Dental College, Sailors Street, Adjacent PNS Shifa, Defence Phase 2, Karachi, Pakistan.

Prof. Dr. Khemchand N. Moorani, MBBS, MCPS, FCPS. Department of Paediatric Nephrology, National Institute of Child Health and Human Development (NICHD), Karachi, Pakistan.

出版信息

Pak J Med Sci. 2020 Sep-Oct;36(6):1263-1269. doi: 10.12669/pjms.36.6.1957.

Abstract

OBJECTIVE

To assess the safety as well as efficacy of desmopressin monotherapy alone and in combination (desmopressin + oxybutynin) in treating nocturnal urinary incontinence among children with 7 to 13 years.

METHODS

This randomized controlled trial has been carried out in National Institute of Child Health from September 2018 to March 2019 with the utilization of convenient sampling technique. Data has been collected after taking ethical approval and informed consent of the Parents with complete confidentiality. The sample size was 84 and equal number of patients was divided in two groups. Group-I was given desmopressin at monotherapy at a dose of 0.2 mg and Group-II was given desmopressin and oxybutynin at the dose of 0.2 mg desmopressin and 5 mg oxybutynin patients were diagnosed on the basis of history. Routine lab investigation included Urine DR and ultrasound abdomen.

RESULTS

In this study significant differences between two groups were found with respect to socio economic status, lack of education of parents (P Less than 0.05). The frequency, urgency and incontinence of this ailment was significantly controlled by combination therapy (desmopressin + oxybutynin) as compared to desmopressin as monotherapy (P Less than 0.05) as patient was followed after one, two and three monthly basis.

CONCLUSION

Desmopressin combination with oxybutynin is more effective as compared to monotherapy treatment. The affectivity of the combination therapy was very high with least side effects and all the children recovered from the condition at third month of treatment. Furthermore, headache was observed to be common with monotherapy and loss of appetite was observed with combination therapy.

摘要

目的

评估去氨加压素单药治疗以及联合治疗(去氨加压素+奥昔布宁)对7至13岁儿童夜间尿失禁的安全性和疗效。

方法

本随机对照试验于2018年9月至2019年3月在国家儿童健康研究所开展,采用便利抽样技术。在获得伦理批准并征得家长知情同意后收集数据,且严格保密。样本量为84例,将患者平均分为两组。第一组接受剂量为0.2毫克的去氨加压素单药治疗,第二组接受剂量为0.2毫克去氨加压素和5毫克奥昔布宁的联合治疗,患者根据病史进行诊断。常规实验室检查包括尿常规和腹部超声。

结果

在本研究中,两组在社会经济地位、家长受教育程度方面存在显著差异(P<0.05)。与去氨加压素单药治疗相比,联合治疗(去氨加压素+奥昔布宁)能更显著地控制该疾病的尿频、尿急和尿失禁症状(P<0.05),因为对患者进行了每月一次、两次和三次的随访。

结论

与单药治疗相比,去氨加压素联合奥昔布宁更有效。联合治疗的有效性非常高,副作用最少,所有儿童在治疗第三个月时病情均康复。此外,观察到单药治疗时头痛较为常见,联合治疗时出现食欲不振。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67e2/7501033/651f6a1fea43/PJMS-36-1263-g001.jpg

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