目的 探討醒脾養(yǎng)兒顆粒聯(lián)合托特羅定治療兒童膀胱過度活動癥的臨床療效。方法 選取2022年12月—2024年3月在鄭州大學附屬兒童醫(yī)院（河南省兒童醫(yī)院鄭州兒童醫(yī)院）診治的膀胱過度活動癥兒童72例進行回顧性分析，按治療方式的不同分成對照組（36例）和治療組（36例）。對照組患兒口服酒石酸托特羅定片，5～9歲兒童1 mg/次，2次/d，10～12歲兒童2 mg/次，2次/d；治療組在對照組的基礎(chǔ)上口服醒脾養(yǎng)兒顆粒，6 g/次，2次/d。兩組患兒均治療14 d。觀察兩組患兒臨床療效，比較治療前后兩組患兒24 h排尿次數(shù)、夜間排尿次數(shù)、24 h尿急次數(shù)、單次排尿量，膀胱過度活動癥評分量表（OABSS）評分和生活質(zhì)量指數(shù)（QOL）評分，及尿流動力學指標排尿后殘留尿（PVR）、最大膀胱容量（MCC）和最大尿流率（Q_max）水平。結(jié)果 治療后，對照組和治療組患兒臨床總有效率分別為77.78%和94.44%，兩組比較差異具有統(tǒng)計學意義（P＜0.05）。經(jīng)治療，兩組患兒24 h排尿次數(shù)、夜間排尿次數(shù)、24 h尿急次數(shù)均較治療前顯著減少，而單次排尿量顯著升高（P＜0.05），且治療組各指標較對照組改善的更為顯著（P＜0.05）。經(jīng)治療，兩組患兒OABSS評分和QOL評分均較治療前顯著降低（P＜0.05），且治療組評分較對照組降低的更為顯著（P＜0.05）。經(jīng)治療，兩組患兒尿流動力學指標MCC和Q_max水平均較治療前明顯升高，而PVR水平明顯降低（P＜0.05），且治療組尿流動力學指標水平較對照組改善的更為顯著（P＜0.05）。結(jié)論 醒脾養(yǎng)兒顆粒聯(lián)合托特羅定治療兒童膀胱過度活動癥療效顯著，不僅能夠顯著改善患兒尿急、尿頻、夜尿等臨床癥狀，同時還能夠改善患兒生存質(zhì)量并促進尿流動力學指標的修復。

Objective Exploring the efficacy of Xingpi Yang’er Granules combined with tolterodine in treatment of overactive bladder in children. Methods The clinical data of children (72 cases) with overactive bladder in Henan Children’s Hospital from December 2022 to March 2024 were analyzed retrospectively. They were divided into control (36 cases) and treatment (36 cases) group based on different treatments. Children in the control group were po administered with Tolterodine Tartrate Tablets, 1 mg/time for 5 — 9 years old children, 2 mg/time for 10 — 12 years old children, twice daily. Children in the treatment group were po administered with Xingpi Yang’er Granules, 6 g/time, twice daily. Children in two groups were treated for 14 d. After treatment, the clinical evaluations were evaluated, the 24 h voiding frequency, night voiding frequency, 24 h urgency frequency, single voiding volume, the scores of OABSS and QOL, the levels of urinary flow dynamics indexes MCC, Qmax and PVR in two groups before and after treatment were compared. Results After treatment, the total clinical effective rates in the control group and the treatment group were 77.78% and 94.44% respectively, and the difference between the two groups was statistically significant (P < 0.05). After treatment, the number of 24 h urination, night urination, and 24 h urgency urination were significantly reduced in two groups compared with before treatment, while the volume of single urination was significantly increased (P < 0.05), and the improvement of each indicator in the treatment group was more significant than that in the control group (P < 0.05). After treatment, the OABSS score and QOL score in two groups were significantly lower than before treatment (P < 0.05), and the scores in the treatment group were more significantly lower than that in the control group (P < 0.05). After treatment, the levels of urodynamic indicators MCC and Q_max in two groups were significantly higher than before treatment, while the level of PVR was significantly lower (P < 0.05), and the level of urodynamic indicators in the treatment group was more significantly improved than that in the control group (P < 0.05). Conclusion The combination of Xingpi Yang’er Granules and tolterodine has significant therapeutic effects on children with overactive bladder. It can not only significantly improve clinical symptoms such as urgency, frequency, and nocturia in children, but also improve their quality of life and promote the repair of urodynamic indicators.

R985

河南省高等學校重點科研項目（19A320017）;河南省醫(yī)學科技攻關(guān)計劃聯(lián)合共建項目（2018020602）