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目的探讨遗尿症的最佳药物治疗方案。方法研究对象为1999—2006年就诊于深圳市人民医院“儿童遗尿专科门诊”的患儿,将重型遗尿症患儿在相同的行为治疗的基础上,随机分为5组:去氨加压素(DDAVP)组、阿米替林组、奥昔布宁组、阿米替林+奥昔布宁组、阿米替林+奥昔布宁组+DDAVP组。药物治疗12周,逐步减量停药,随访分析疗效。结果重型遗尿症治疗结束后3个月的随访显示:DDAVP组治愈率为65.0%,阿米替林组的治愈率为60.5%,奥昔布宁组为58.7%,这3组之间差异无统计学意义;而阿米替林+奥昔布宁组的治愈率为80.8%,阿米替林+奥昔布宁组+DDAVP组的治愈率高达92.0%,与其它4组差异均有统计学意义。结论由于重型遗尿症的多元性发病机制,联合用药的疗效明显优于单独用药。
Objective To explore the best medical treatment of enuresis. Methods From 1999 to 2006, the subjects were enrolled in this study. Children with severe enuresis were randomly divided into 5 groups on the basis of the same behavioral therapy: deaminated (DDAVP) group, amitriptyline group, oxybutynin group, amitriptyline + oxybutynin group, amitriptyline + oxybutynin group + DDAVP group. Drug treatment for 12 weeks, gradually reducing withdrawal, follow-up analysis of curative effect. Results Three months after the completion of treatment of severe enuresis, the follow-up showed that the cure rate was 65.0% in DDAVP group, 60.5% in Amitriptyline group and 58.7% in Oxybutynin group, with no difference between the three groups Statistical analysis showed that the cure rate was 80.8% in the amitriptyline + oxybutynin group and 92.0% in the amitriptyline + oxybutynin group + DDAVP group, with statistically significant differences from the other 4 groups Significance of learning. Conclusion Due to the multiple pathogenesis of enuresis, the efficacy of combination therapy is superior to that of single drug alone.