目的 探讨醒脾养儿颗粒联合托特罗定治疗儿童膀胱过度活动症的临床疗效。方法 选取2022年12月—2024年3月在郑州大学附属儿童医院（河南省儿童医院郑州儿童医院）诊治的膀胱过度活动症儿童72例进行回顾性分析，按治疗方式的不同分成对照组（36例）和治疗组（36例）。对照组患儿口服酒石酸托特罗定片，5～9岁儿童1 mg/次，2次/d，10～12岁儿童2 mg/次，2次/d；治疗组在对照组的基础上口服醒脾养儿颗粒，6 g/次，2次/d。两组患儿均治疗14 d。观察两组患儿临床疗效，比较治疗前后两组患儿24 h排尿次数、夜间排尿次数、24 h尿急次数、单次排尿量，膀胱过度活动症评分量表（OABSS）评分和生活质量指数（QOL）评分，及尿流动力学指标排尿后残留尿（PVR）、最大膀胱容量（MCC）和最大尿流率（Q_max）水平。结果 治疗后，对照组和治疗组患儿临床总有效率分别为77.78%和94.44%，两组比较差异具有统计学意义（P＜0.05）。经治疗，两组患儿24 h排尿次数、夜间排尿次数、24 h尿急次数均较治疗前显著减少，而单次排尿量显著升高（P＜0.05），且治疗组各指标较对照组改善的更为显著（P＜0.05）。经治疗，两组患儿OABSS评分和QOL评分均较治疗前显著降低（P＜0.05），且治疗组评分较对照组降低的更为显著（P＜0.05）。经治疗，两组患儿尿流动力学指标MCC和Q_max水平均较治疗前明显升高，而PVR水平明显降低（P＜0.05），且治疗组尿流动力学指标水平较对照组改善的更为显著（P＜0.05）。结论 醒脾养儿颗粒联合托特罗定治疗儿童膀胱过度活动症疗效显著，不仅能够显著改善患儿尿急、尿频、夜尿等临床症状，同时还能够改善患儿生存质量并促进尿流动力学指标的修复。

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

河南省高等学校重点科研项目（19A320017）;河南省医学科技攻关计划联合共建项目（2018020602）