殊群体的健康状况不容乐观。因此，为成为一个健康的高校教师，首先从自身做起，树立正确的健康意识，克服不良的生活习惯，保持健康的生活方式，进行积极的自我尝试学会调节情绪，维护心理平衡，悦纳自己，积极参与其他社会活动、体育锻炼，寻求多方面支持；其次，学校要定期为教师做体检，特别是政府和社会要全面关注年轻教师的生理、心理健康，和社会应激能力，采取各种针对性的预防干预措施，对预防亚健康状态的发生，防治疾病，提高教师的整体健康水平具有重要的现实意义。
The health status of special groups remains concerning. Therefore, to become a healthy university teacher, one must first start with oneself by establishing proper health awareness, overcoming unhealthy habits, maintaining a healthy lifestyle, actively attempting self-regulation of emotions, preserving psychological balance, accepting oneself, and actively participating in social activities and physical exercise while seeking multifaceted support. Secondly, schools should conduct regular health check-ups for teachers. In particular, the government and society should comprehensively address the physical and mental health of young teachers, as well as their social stress resilience, by implementing targeted preventive interventions. This approach holds significant practical importance for preventing suboptimal health conditions, combating diseases, and improving the overall health level of teachers.

参考文献
References

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[4] CHEN Guo-yuan, LIU Wei-dong, YANG Lei. Research on the current status of "sub-health" among teachers and preventive measures. Occupation and Health, 2000, 15: 101-103
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（收稿日期：2011年10月3日） (Received: October 3, 2011)

中医药治疗小儿遗尿症系统评价 Systematic Review of Traditional Chinese Medicine in Treating Pediatric Enuresis

戎萍 $^{1}$ ，赵玉生 $^{1}$ ，马融 $^{1}$ ，胡思源 $^{1}$ ，钟成梁 $^{1}$ ，赵金生 $^{2}$
RONG Ping $^{1}$ , ZHAO Yu-sheng $^{1}$ , MA Rong $^{1}$ , HU Si-yuan $^{1}$ , ZHONG Cheng-liang $^{1}$ , ZHAO Jin-sheng $^{2}$ （ $^{1}$ 天津中医药大学第一附属医院，天津 300193； $^{2}$ 天津中医药大学，天津 300193）
( $^{1}$ First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China; $^{2}$ Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China)

Abstract

摘要：目的：分析中医药治疗小儿遗尿症的疗效。方法：计算机检索1979年至2011年1月20日期间国内各种医学期刊。纳人以小儿遗尿症患者为研究对象、中药或中成药与西药治疗效果的随机对照试验，由 2 名评价者独立提取资料并交叉核对，而后按照Cochrane Handbook 5．0进行质量评估，并运用RevMan 5．0．2软件进行Meta分析。结果：最终纳入 7 个随机对照试验，共 1476 例患儿，Meta分析结果显示，可以认为中医药相对阳性西药对于小儿遗尿症的疾病疗效、中医证候疗效方面有一定的优势，且安全性可靠。结论：尚需更多大样本、高质量的随机对照试验来进一步证实中医药治疗小儿遗尿症的疗效。
Objective: To analyze the efficacy of traditional Chinese medicine (TCM) in treating pediatric enuresis. Methods: Computerized searches were conducted on various domestic medical journals from 1979 to January 20, 2011. Randomized controlled trials (RCTs) comparing the therapeutic effects of TCM or Chinese patent medicines with Western medicine in pediatric enuresis patients were included. Two reviewers independently extracted data and cross-checked the results. Quality assessment was performed according to the Cochrane Handbook 5.0, and Meta-analysis was conducted using RevMan 5.0.2 software. Results: A total of 7 RCTs involving 1,476 children were ultimately included. Meta-analysis results indicated that TCM may have certain advantages over positive Western medicine controls in terms of disease efficacy and TCM syndrome efficacy for pediatric enuresis, with reliable safety. Conclusion: More large-sample, high-quality randomized controlled trials are needed to further confirm the efficacy of TCM in treating pediatric enuresis.

关键词：中医药；小儿遗尿症；随机对照试验；系统评价
Keywords: Traditional Chinese Medicine; Pediatric Enuresis; Randomized Controlled Trial; Systematic Review
基金资助：儿科中药新药临床评价研究技术平台规范化建设（No．2011ZX09302－006－03）
Funding: Standardized Construction of Clinical Evaluation Research Technology Platform for New Pediatric TCM Drugs (No. 2011ZX09302-006-03)

Systematic evaluation of literatures of TCM on nocturnal enuresis in children

RONG Ping $^{1}$ ，ZHAO Yu－sheng $^{1}$ ，MA Rong $^{1}$ ，HU Si－yuan $^{1}$ ，ZHONG Cheng－liang $^{1}$ ，ZHAO Jin－sheng $^{2}$ （ $^{1}$ Affiliated Hospital of Tianjin University of TCM，Tianjin 300193，China； $^{2}$ Tianjin University of TCM，Tianjin 300193，China）

Abstract

Objective：To analysis the curative effect of the traditional Chinese medicine on nocturnal enuresis in children． Methods：To retrieve all sorts of domestic medical journals from 1979 to 2011．1．20 by computer．With these nocturnal enuresis children into in patients as the research object，traditional Chinese medicine and western medicine therapy or Chinese patent
Objective: To analyze the curative effect of traditional Chinese medicine on nocturnal enuresis in children. Methods: Retrieve various domestic medical journals from 1979 to January 20, 2011, using computerized searches. With pediatric nocturnal enuresis patients as the research subjects, compare traditional Chinese medicine therapy with Western medicine treatment or Chinese patent..

medicine effect of randomized controlled trials，by two independent evaluators extraction material and cross check，and then according to the Cochrane Handbook 5.0 analyse the quality of these researches，and the RevMan 5．0．2 software Meta to analysis． Results： 7 randomized controlled trials were brought，including 1476 patients，Meta analysis shows that，traditional Chinese medicine for these children has certain advantages in curative effect compared with positive western medicine，and is safety and reliable．Conclusion：More large sample，high quality of randomized controlled trials are needed to further proof the curative effect of traditional Chinese medicine on nocturnal enuresis children．
Evaluation of randomized controlled trials on the efficacy of traditional Chinese medicine in treating pediatric enuresis was conducted by two independent reviewers who extracted data and performed cross-verification. The quality of the studies was assessed according to the Cochrane Handbook 5.0, followed by Meta-analysis using RevMan 5.0.2 software. Results: Seven randomized controlled trials involving 1,476 patients were included. Meta-analysis demonstrated that traditional Chinese medicine exhibits certain therapeutic advantages over conventional Western medicine for pediatric enuresis, with proven safety and reliability. Conclusion: Larger-scale, high-quality randomized controlled trials are required to further validate the efficacy of traditional Chinese medicine in treating children with nocturnal enuresis.

Key words：TCM；Nocturnal enuresis in children；Randomized controlled trial；System evaluation
Keywords: TCM; Nocturnal enuresis in children; Randomized controlled trial; Systematic review
Fund assistance：Standardization Construction in Clinical Evaluation Research Technology Platform of Chinese Herbal＇s
Fund assistance: Standardization Construction in Clinical Evaluation Research Technology Platform of Chinese Herbal's
New Medicine in Pediatric（No．2011ZX09302－006－03）
New Medicine in Pediatrics (No. 2011ZX09302-006-03)

目前国际上广泛接受的2006年国际小儿尿控协会提出的遗尿症定义是， 5 岁以上儿童不能从睡眠中醒来而反复发生无意识排尿行为

^{[1]}

。其 5 岁时发病率为

15 % - 20 %

，7岁时发病率为

10 %

，虽然每年以

15 %

的比例自然消退，但仍然有

1 % - 2 %

的患儿症状持续到成人，给患儿身心健康带来严重影响。男孩较女孩多见

^{[2]}

。一般认为，遗传、睡眠觉醒障碍、抗利尿激素分泌异常、膀胱功能障碍，以及心理因素等，都可能与遗尿症的发病有关。
The internationally widely accepted definition of enuresis proposed by the International Children's Continence Society in 2006 is the repeated involuntary urination during sleep in children over the age of 5 who fail to wake up

^{[1]}

. The incidence rate is

15 % - 20 %

at age 5 and

10 %

at age 7. Although the condition naturally resolves at a rate of

15 %

per year, approximately

1 % - 2 %

of affected children continue to experience symptoms into adulthood, significantly impacting their physical and mental health. The condition is more common in boys than girls

^{[2]}

. It is generally believed that factors such as genetics, sleep arousal disorders, abnormal secretion of antidiuretic hormone, bladder dysfunction, and psychological factors may contribute to the onset of enuresis.

去氨加压素（DDAVP，弥凝）作为治疗遗尿症的首选西药，其疗效肯定，但治疗后仅有

30 %

的患者完全有效，且停药复发率高，价格昂贵，需要限制水分的摄入等限制，影响了药物的推广和疗效

^{[3]}

。相对西药，中医药治疗小儿遗尿症历史悠久，报道取得较好的效果，且复发率较低，不良反应少。但因中医临床研究对方法学的重视仍不够，临床试验的规范性较差，对中医药临床疗效缺乏客观、科学的评价，影响了研究结论的推广和国外医学的承认。鉴于此，本研究按照系统评价的方法，比较中药、中成药与西药治疗小儿遗尿症的有效性和安全性。
Desmopressin (DDAVP, Minirin), as the first-line Western medication for treating enuresis, has confirmed efficacy. However, only

30 %

of patients achieve complete effectiveness after treatment, and the recurrence rate after discontinuation is high. Additionally, its high cost, the need for fluid intake restrictions, and other limitations hinder its widespread use and therapeutic outcomes

^{[3]}

. In contrast, traditional Chinese medicine (TCM) has a long history of treating pediatric enuresis, with reported better outcomes, lower recurrence rates, and fewer adverse effects. However, due to insufficient attention to methodology in TCM clinical research, poor standardization of clinical trials, and a lack of objective and scientific evaluation of TCM's clinical efficacy, the promotion of research findings and recognition by international medical communities are limited. Given this, this study systematically evaluates the effectiveness and safety of Chinese herbal medicine and proprietary Chinese medicines compared to Western medications in treating pediatric enuresis.

资料与方法 Materials and Methods

1．研究对象检索中国生物医学文献数据库（1979年1月－2011年1月）、中国知网（1979年1月－ 2011年1月）、维普数据库（1989年1月－2011年1月）和万方数字化期刊群（1998年1月－2011年1月）上的中医药治疗小儿遗尿症的所有的随机对照试验或半随机对照试验或自称是随机对照试验。所有检索均截至2011年1月20日。
1. Study Subjects All randomized controlled trials (RCTs), quasi-randomized controlled trials, or self-proclaimed RCTs on TCM treatment for pediatric enuresis were retrieved from the Chinese Biomedical Literature Database (January 1979–January 2011), China National Knowledge Infrastructure (January 1979–January 2011), VIP Database (January 1989–January 2011), and Wanfang Digital Journal Database (January 1998–January 2011). All searches were conducted up to January 20, 2011.

2．纳入标准（1）文献的内容提示有中医药治疗小儿遗尿症的临床研究报道；（2）文献中的分组法出现＂随机＂、＂对照＂的字样，无论其是否使用盲法；（3）试验组均采用中药或中成药治疗，不合并使用其他治疗方法；对照组采用弥凝或盐酸甲氯芬酯或安慰剂治疗；（4）研究对象只有 1 个治疗组和 1 个对照组；（5）主要结局指标是有效事件的发生率。
2. Inclusion Criteria (1) The literature must report clinical research on TCM treatment for pediatric enuresis. (2) The grouping method in the literature must mention "randomized" or "controlled," regardless of whether blinding was used. (3) The treatment group must use Chinese herbal medicine or proprietary Chinese medicines without combining other therapies, while the control group must use Minirin, meclofenoxate hydrochloride, or a placebo. (4) The study must include only one treatment group and one control group. (5) The primary outcome measure must be the incidence of effective events.

3．排除标准（1）疗效评定未详细公布治疗结果 3. Exclusion criteria (1) Studies that did not provide detailed treatment outcomes for efficacy evaluation;

者；（2）无明确的西医或中医诊断标准者。 (2) Studies lacking clear Western or traditional Chinese medicine diagnostic criteria.
4．质量评价根据Cochrane Reviewer＇s Handbook 5．0．2评价标准，分别按分配序列的产生、隐蔽分组、盲法、失访和意向性分析情况评估每个 RCT 的质量，将每项分为＂恰当＂、＂不恰当＂、＂不清楚＂ 3 个等级以

A

、

B

、

C

来进行判定。意见不一致时通过和第 3 位评价者讨论决定。
4. Quality assessment According to the Cochrane Reviewer's Handbook 5.0.2 evaluation criteria, the quality of each RCT was assessed based on the generation of allocation sequences, concealment of allocation, blinding, loss to follow-up, and intention-to-treat analysis. Each item was categorized into three levels: "adequate," "inadequate," or "unclear," represented by

A

B

, and

C

, respectively. Discrepancies were resolved through discussion with a third evaluator.

5．研究方法 5. Research methods

5.1 疗效指标的选择在中医药治疗小儿遗尿症的研究中，主要采用临床疗效、中医证候疗效作为疗效判定指标，根据国家或行业公认的疗效判定标准一般将其分为治愈、显效、有效、无效 4 级。将等级资料合并为二分类资料，即试验组治愈、显效、有效合并为有效进行统计分析。
5.1 Selection of Efficacy Indicators In studies on traditional Chinese medicine (TCM) for treating pediatric enuresis, clinical efficacy and TCM syndrome efficacy are primarily used as evaluation criteria. Based on nationally or industry-recognized standards, efficacy is generally classified into four levels: cured, markedly effective, effective, and ineffective. Ordinal data are combined into binary data, where cured, markedly effective, and effective outcomes in the experimental group are merged as "effective" for statistical analysis.
5.2 统计软件及其数据分析采用Cochrane协作网提供的RevMan 5．0．2软件进行数据分析。计数资料用优势比

(O R)

，计量资料采用加权均数差（WMD），两者均以

95 %

CI表示。采用

χ^{2}

检验分析，显著性水平设定为

α = 0.01

。
5.2 Statistical Software and Data Analysis Data analysis was performed using RevMan 5.0.2 software provided by the Cochrane Collaboration. Dichotomous data were expressed as odds ratios (OR), while continuous data were presented as weighted mean differences (WMD), both with 95% confidence intervals (CI). Heterogeneity was assessed using the I² test, with the significance level set at P < 0.05.
5.3 异质性检验无临床异质性测量结果采用固定效应模型（

P > 0.1

或

I^{2} < 50 %

）；若异质性明显，查找原因，去除对研究影响较大的研究后进行比较；若未找出临床和方法学异质性，则采用随机效应模型进行合并分析，并谨慎解释研究结果。
5.3 Heterogeneity Test For measurement outcomes without clinical heterogeneity, a fixed-effects model (

P > 0.1

I^{2} < 50 %

) was used. If significant heterogeneity was observed, potential causes were investigated, and studies with substantial influence were excluded before comparison. If no clinical or methodological heterogeneity was identified, a random-effects model was employed for pooled analysis, with results interpreted cautiously.
5.4 发表性偏倚检测对潜在的发表偏倚采用＂漏斗图＂进行分析。
5.4 Publication Bias Detection Potential publication bias was analyzed using a "funnel plot."

结果 Results

1．文献概况 11篇符合纳人标准的文献中排除 2篇未详细公布治疗结果的文献、 2 篇没有明确诊断标准的文献。得到采用随机对照方法，符合研究标准的中医药治疗小儿遗尿症的临床研究共 7 篇。 7 篇文献中有 1 篇将遗尿患儿分为了功能性、器质性、原发性、继发性，其余 6 篇文献的研究对象均为原发性小儿遗尿症患儿。有2篇文献自行设置了计分方法，按分数的高低对遗尿患儿的病情进行了轻、中、重度的分级，有 1 篇文献只对患儿的病情进行了分级，但未
1. Literature Overview Among the 11 articles meeting the inclusion criteria, 2 were excluded due to insufficiently detailed treatment outcomes, and 2 lacked clear diagnostic standards. A total of 7 clinical studies using randomized controlled methods and meeting the research criteria for traditional Chinese medicine treatment of pediatric enuresis were identified. Among these 7 articles, 1 classified enuretic children into functional, organic, primary, and secondary types, while the remaining 6 focused solely on primary pediatric enuresis. Two articles established their own scoring methods to grade the severity of enuresis (mild, moderate, or severe) based on scores, and 1 article graded the severity of the condition without specifying the method.

描述分级方法。 Description of grading methods.

1.1 患者情况见表1。7篇文献共纳入 1476 例病人；年龄 4 岁以上；病程 3 个月 -10 年不等，其中 3 篇未提及， 1 篇描述不清；有 5 篇文献对研究对象的基线进行了描述，另外 2 篇未提及；诊断标准不统一；有 2篇文献详细说明了纳入标准， 2 篇文献制定了排除标准，其余文献未提及。
1.1 Patient Characteristics See Table 1. A total of 1,476 patients were included across 7 studies; all participants were aged 4 years or older; disease duration ranged from 3 months to 10 years (3 studies did not report this information, while 1 provided unclear descriptions); 5 studies described baseline characteristics of participants, while 2 did not mention them; diagnostic criteria were inconsistent; 2 studies specified inclusion criteria in detail, 2 established exclusion criteria, and the remaining studies did not mention these criteria.
1.2 干预措施见表2。所有文献对照组均为阳性西药对照，无安慰剂组。其中试验组有 2 篇采用中成药治疗， 5 篇采用中药自拟方治疗；对照组 2 篇采用弥凝治疗， 5 篇采用盐酸甲氯芬酯治疗。
1.2 Interventions See Table 2. All control groups in the literature used positive Western medicine controls, with no placebo groups. Among them, the experimental group included 2 studies using Chinese patent medicines and 5 studies using self-formulated Chinese herbal prescriptions; the control group included 2 studies using Minirin treatment and 5 studies using Meclofenoxate Hydrochloride treatment.
1.3 结局指标 7篇文献均选用有效事件发生率作为结局指标，所采用的疗效判断标准以自拟标准最多。另有 2 篇文献还采用了遗尿次数等作为评价指标。
1.3 Outcome Measures All seven studies selected the incidence of effective events as the outcome measure, with most using self-developed criteria for efficacy evaluation. Additionally, two studies also adopted metrics such as the frequency of bedwetting as evaluation indicators.
1.4 纳入文献质量见表3。7篇文献对于隐蔽分组、盲法、失访和意向性分析均未描述，只有 2 篇
1.4 Quality of Included Literature See Table 3. None of the 7 articles described allocation concealment, blinding, loss to follow-up, or intention-to-treat analysis, with only 2 articles mentioning...

文献既描述了随机序列的产生，又设立了盲法， 1 篇文献仅限定了盲法。实行随机对照试验的整体质量偏低。
The literature describes both the generation of random sequences and the establishment of blinding, with one study only specifying blinding. The overall quality of the implemented randomized controlled trials is relatively low.

2．疗效及安全性分析 2. Efficacy and Safety Analysis

2.1 小儿遗尿宁颗粒组与盐酸甲氯芬酯组对照 2 篇文献均报道了两组治疗肾气不足型小儿遗尿症的疾病有效率及中医证候有效率，各研究间无统计学异质性差异（

P = 0.63, I^{2} = 0 %

）及（

P = 0.29, I^{2} = 11 %

），故采用固定效应模型进行Meta分析。图1－图2结果显示，与单纯盐酸甲氯芬酯治疗组相比，小儿遗尿宁颗粒对肾气不足型小儿遗尿症的治疗效果不劣于对照药盐酸甲氯芬酯胶囊：

O R = 1.28, 95 % CI [0.80, 2.06], P = 0.30

。
2.1 Comparison between Xiaoer Yiniaoning Granule Group and Meclofenoxate Hydrochloride Group Both included studies reported the disease efficacy rate and TCM syndrome efficacy rate for treating enuresis in children with kidney qi deficiency. No statistical heterogeneity was observed among the studies (

P = 0.63, I^{2} = 0 %

and

P = 0.29, I^{2} = 11 %

), so a fixed-effects model was used for Meta-analysis. Figures 1–2 show that, compared with the meclofenoxate hydrochloride monotherapy group, Xiaoer Yiniaoning Granule demonstrated non-inferior efficacy in treating enuresis in children with kidney qi deficiency relative to the control drug meclofenoxate hydrochloride capsules:

O R = 1.28, 95 % CI [0.80, 2.06], P = 0.30

Study or Subgroup	Experimental		Control		Weight	Odds Ratio M－H，Fixed，95\％Cl Odds Ratio M－H, Fixed, 95% CI	Odds Ratio
Study or Subgroup	Events	Total	Events	Total	Weight	Odds Ratio M－H，Fixed，95\％Cl Odds Ratio M－H, Fixed, 95% CI	M－H，Fixed，95\％Cl M-H, Fixed, 95% CI
张婁荣 2009 Zhang Lou Rong 2009	66	70	22	23	6．5\％ 6.5%	0.75 ［0．08，7．07］ 0.75 [0.08, 7.07]		－
胡思源 Hu Siyuan	259	338	77	108	93．5\％ 93.5%	1.32 ［0．81，2．15］ 1.32 [0.81, 2.15]		－
Total（95\％CI） Total (95% CI)		408		131	100．0\％ 100.0%	1.28 ［0．80，2．06］ 1.28 [0.80, 2.06]
Total events	325		99
Heterogeneity： Ch $^{2} = 0.23 df = 1 (P = 0.63); I^{2} = 0 %$ Heterogeneity: Ch $^{2} = 0.23 df = 1 (P = 0.63); I^{2} = 0 %$
0.1								1	Favours experimental

图1 小儿遗尿宁颗粒与盐酸甲氯芬酯对照疾病疗效森林图
Figure 1 Forest plot comparing disease efficacy between Xiaoer Yiniaoning Granules and Meclofenoxate Hydrochloride

表1 纳入各研究患儿的基本情况 Table 1 Basic characteristics of children included in each study

纳入研究 Included studies	男／总（例） Male/Total (cases)		年龄（岁） Age (years)	病程 Course of disease	诊断标准 Diagnostic criteria
万力生等（2004年） $^{[4]}$ Wan Lisheng et al. (2004) $^{[4]}$	155／300 155/300		5－14 5-14	未描述 Not described	国家中医药管理局《中医病证诊断疗效标准》（1994年） Diagnostic and Therapeutic Criteria of Traditional Chinese Medicine Diseases and Syndromes (1994) by the State Administration of Traditional Chinese Medicine
苏文等（2010年） $^{[5]}$ Su Wen et al. (2010) $^{[5]}$	51／90 51/90		5－17 5-17	6个月－10年 6 months - 10 years	国家中医药管理局《中医病证诊断疗效标准》（1994年） Diagnostic and Therapeutic Efficacy Standards of Traditional Chinese Medicine Diseases and Syndromes (1994) by the State Administration of Traditional Chinese Medicine
易竞阳等（2007年） $^{[6]}$ Yi Jingyang et al. (2007) $^{[6]}$	69／90 69/90		5－15 5-15	未描述 Not described	国家中医药管理局《中医病证诊断疗效标准》（1994年） Diagnostic and Therapeutic Efficacy Criteria for Traditional Chinese Medicine Diseases and Syndromes (1994) by the State Administration of Traditional Chinese Medicine
胡思源等（2008年） $^{[7]}$ Hu Siyuan et al. (2008) $^{[7]}$	不详／446 Unknown/446		5－14 5-14	不详 Unknown	左启华主编《儿科学》（第3版） Zuo Qihua (Editor-in-Chief) "Pediatrics" (3rd Edition)
张雪荣等（2009年） $^{[8]}$ Zhang Xuerong et al. (2009) $^{[8]}$	64／96 64/96		5－14 5-14	10个月－10年 10 months - 10 years	杨锡强，易著文主编《儿科学》 Yang Xiqiang, Yi Zhuwen, editors. "Pediatrics"
李荫昆（1998年） $^{[9]}$ Li Yinkun (1998) $^{[9]}$	35／56 35/56		4－15 4-15	3个月－6年 3 months - 6 years	陈贵廷等主编《实用中西医结合诊断治疗学》 "Practical Integrated Chinese and Western Medicine Diagnosis and Treatment" edited by Chen Guiting et al.
朱长君等（1994年） $^{[10]}$ Zhu Changjun et al. (1994) $^{[10]}$	不详／431 Unknown/431		＞5 >5	未描述 Not described	方药中主编《实用中医内科学》（第1版） Fang Yaozhong, editor-in-chief, "Practical Internal Medicine of Traditional Chinese Medicine" (1st edition)
表2 纳人各研究的干预措施及测量结果 Table 2 Interventions and measurement outcomes of included studies
纳人研究试验组／对照组（例） Included studies: Experimental group/Control group (cases)		组别 Group	服用药物 Medication administered		服用方法 Administration method	疗程 Treatment duration	观察指标 Observation indicators
万力生等（2004年） $^{[4]}$ Wan Lisheng et al. (2004) $^{[4]}$	250／20 250/20	试验组 Experimental group	温肾止遗合剂 Kidney-Warming and Enuresis-Stopping Herbal Mixture		每日1剂 One dose daily	8周 8 weeks	临床疗效；每日排 Clinical efficacy; daily voiding
万力生等（2004年） $^{[4]}$ Wan Lisheng et al. (2004) $^{[4]}$		对照组 Control group	弥凝 Desmopressin		0.1 mg ，Qd，睡前 $1 h ◻$ 服 0.1 mg, Qd, taken at bedtime $1 h ◻$		尿次数 Frequency of urination
苏文等（2010年） $^{[5]}$ Su Wen et al. (2010) $^{[5]}$	45／45 45/45	试验组 Experimental group	遗尿方 Nocturnal enuresis formula		温开水冲服， 2 次／d Take with warm water, twice daily	4－8周 4-8 weeks	临床疗效；每日排 Clinical efficacy; daily frequency
苏文等（2010年） $^{[5]}$ Su Wen et al. (2010) $^{[5]}$		对照组 Control group	弥凝 Minirin		0.1 mg ，Qd 0.1 mg, Qd		尿次数 Frequency of urination
易竞阳等（2007年） $^{[6]}$ Yi Jingyang et al. (2007) $^{[6]}$	60／30 60/30	试验组 Experimental group	鸡肠散 Chicken Intestine Powder		水煎 2 次，取 300 mL ，睡前 1 h 温服 Decoct twice to obtain 300 mL, take warm 1 hour before bedtime	15－30d 15–30 days	临床疗效 Clinical efficacy
易竞阳等（2007年） $^{[6]}$ Yi Jingyang et al. (2007) $^{[6]}$		对照组 Control group	盐酸甲氯芬酯 Mecofenoxate Hydrochloride		0.1 mg ，Tid 0.1 mg, Tid
胡思源等（2008年） $^{[7]}$ Hu Siyuan et al. (2008) $^{[7]}$	338／108 338/108	试验组 Experimental group	小儿遗尿宁颗粒 Pediatric Enuresis Relief Granules		5－7岁： 5 g ，2次／d；7－14岁： $5 g,, 2$ 次／d Ages 5-7: 5 g, twice daily; Ages 7-14: $5 g,, 2$ times daily	28d 28 days	临床疗效、中医证 Clinical efficacy, TCM syndrome
胡思源等（2008年） $^{[7]}$ Hu Siyuan et al. (2008) $^{[7]}$		对照组 Control group	盐酸甲氯芬酯 Meclofenoxate Hydrochloride		100 mg ，Qd，睡前 $1 / 2 h$ 口服 100 mg, Qd, taken orally before bedtime		候疗效 Therapeutic effect
张雪荣等（2009年） $^{[8]}$ Zhang Xuerong et al. (2009) $^{[8]}$	70／23 70/23	试验组 Experimental group	小儿遗尿宁颗粒 Pediatric Enuresis-Ning Granules		5－7岁： 5 g ，2次／d；7－14岁： 5 g ，，2次／d 5-7 years old: 5 g, twice daily; 7-14 years old: 5 g, twice daily	28d 28 days	临床疗效、中医证 Clinical efficacy, TCM syndrome
张雪荣等（2009年） $^{[8]}$ Zhang Xuerong et al. (2009) $^{[8]}$		对照组 Control group	盐酸甲氯芬酯 Meclofenoxate hydrochloride		100 mg ，Qd，睡前 $1 / 2 h$ 口服 100 mg, Qd, taken orally before bedtime $1 / 2 h$		候疗效 Waiting for efficacy
李荫昆等（1998年） $^{[9]}$ Li Yinkun et al. (1998) $^{[9]}$	30／26 30/26	试验组 Test group	自拟益肾健脾汤 Self-formulated Yi Shen Jian Pi Decoction		1 剂／d，水煎分 3 次服 1 dose/day, decocted in water and divided into 3 doses	7 d 为 1 疗程，一般服 7 days as 1 treatment course, generally taken for	临床疗效 Clinical efficacy
李荫昆等（1998年） $^{[9]}$ Li Yinkun et al. (1998) $^{[9]}$		对照组 Control group	盐酸甲氯芬酯 Meclofenoxate hydrochloride		0．1g／d，Tid 0.1g/d, Tid	2、3个疗程 2-3 treatment courses
朱长君等（1994年） $^{[10]}$ Zhu Changjun et al. (1994) $^{[10]}$	318／113 318/113	试验组 Test group	自拟中药遗尿灵片 Self-formulated Chinese herbal medicine Enuresis Ling tablets		5－9岁：8片，Bid；10岁以上：10片，Bid Ages 5-9: 8 tablets, Bid; Ages 10 and above: 10 tablets, Bid	15 d 为 1 个疗程，观 15 days as one treatment course, observation	临床疗效 Clinical Efficacy
朱长君等（1994年） $^{[10]}$ Zhu Changjun et al. (1994) $^{[10]}$		对照组 Control group	盐酸甲氯芬酯 Meclofenoxate Hydrochloride		0.1 g ，Qd，睡前服用 0.1 g, Qd, taken before bedtime	察4个疗程 Observe for 4 treatment courses

纳入研究男／总（例）年龄（岁）病程诊断标准万力生等（2004年）^([4]) 155／300 5－14 未描述国家中医药管理局《中医病证诊断疗效标准》（1994年）苏文等（2010年）^([5]) 51／90 5－17 6个月－10年国家中医药管理局《中医病证诊断疗效标准》（1994年）易竞阳等（2007年）^([6]) 69／90 5－15 未描述国家中医药管理局《中医病证诊断疗效标准》（1994年）胡思源等（2008年）^([7]) 不详／446 5－14 不详左启华主编《儿科学》（第3版）张雪荣等（2009年）^([8]) 64／96 5－14 10个月－10年杨锡强，易著文主编《儿科学》李荫昆（1998年）^([9]) 35／56 4－15 3个月－6年陈贵廷等主编《实用中西医结合诊断治疗学》朱长君等（1994年）^([10]) 不详／431 ＞5 未描述方药中主编《实用中医内科学》（第1版）表2 纳人各研究的干预措施及测量结果纳人研究试验组／对照组（例）组别服用药物服用方法疗程观察指标万力生等（2004年）^([4]) 250／20 试验组温肾止遗合剂每日1剂 8周临床疗效；每日排对照组弥凝 0.1 mg ，Qd，睡前 1h◻ 服尿次数苏文等（2010年）^([5]) 45／45 试验组遗尿方温开水冲服， 2 次／d 4－8周临床疗效；每日排对照组弥凝 0.1 mg ，Qd 尿次数易竞阳等（2007年）^([6]) 60／30 试验组鸡肠散水煎 2 次，取 300 mL ，睡前 1 h 温服 15－30d 临床疗效对照组盐酸甲氯芬酯 0.1 mg ，Tid 胡思源等（2008年）^([7]) 338／108 试验组小儿遗尿宁颗粒 5－7岁： 5 g ，2次／d；7－14岁： 5g,,2 次／d 28d 临床疗效、中医证对照组盐酸甲氯芬酯 100 mg ，Qd，睡前 1//2h 口服候疗效张雪荣等（2009年）^([8]) 70／23 试验组小儿遗尿宁颗粒 5－7岁： 5 g ，2次／d；7－14岁： 5 g ，，2次／d 28d 临床疗效、中医证对照组盐酸甲氯芬酯 100 mg ，Qd，睡前 1//2h 口服候疗效李荫昆等（1998年）^([9]) 30／26 试验组自拟益肾健脾汤 1 剂／d，水煎分 3 次服 7 d 为 1 疗程，一般服临床疗效对照组盐酸甲氯芬酯 0．1g／d，Tid 2、3个疗程朱长君等（1994年）^([10]) 318／113 试验组自拟中药遗尿灵片 5－9岁：8片，Bid；10岁以上：10片，Bid 15 d 为 1 个疗程，观临床疗效对照组盐酸甲氯芬酯 0.1 g ，Qd，睡前服用察4个疗程

| 纳入研究 | 男／总（例） | | 年龄（岁） | 病程 | 诊断标准 | | | | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | | 万力生等（2004年）${ }^{[4]}$ | 155／300 | | 5－14 | 未描述 | 国家中医药管理局《中医病证诊断疗效标准》（1994年） | | | | 苏文等（2010年）${ }^{[5]}$ | 51／90 | | 5－17 | 6个月－10年 | 国家中医药管理局《中医病证诊断疗效标准》（1994年） | | | | 易竞阳等（2007年）${ }^{[6]}$ | 69／90 | | 5－15 | 未描述 | 国家中医药管理局《中医病证诊断疗效标准》（1994年） | | | | 胡思源等（2008年）${ }^{[7]}$ | 不详／446 | | 5－14 | 不详 | 左启华主编《儿科学》（第3版） | | | | 张雪荣等（2009年）${ }^{[8]}$ | 64／96 | | 5－14 | 10个月－10年 | 杨锡强，易著文主编《儿科学》 | | | | 李荫昆（1998年）${ }^{[9]}$ | 35／56 | | 4－15 | 3个月－6年 | 陈贵廷等主编《实用中西医结合诊断治疗学》 | | | | 朱长君等（1994年）${ }^{[10]}$ | 不详／431 | | ＞5 | 未描述 | 方药中主编《实用中医内科学》（第1版） | | | | 表2 纳人各研究的干预措施及测量结果 | | | | | | | | | 纳人研究试验组／对照组（例） | | 组别 | 服用药物 | | 服用方法 | 疗程 | 观察指标 | | 万力生等（2004年）${ }^{[4]}$ | 250／20 | 试验组 | 温肾止遗合剂 | | 每日1剂 | 8周 | 临床疗效；每日排 | | | | 对照组 | 弥凝 | | 0.1 mg ，Qd，睡前 $1 \mathrm{~h} \square$ 服 | | 尿次数 | | 苏文等（2010年）${ }^{[5]}$ | 45／45 | 试验组 | 遗尿方 | | 温开水冲服， 2 次／d | 4－8周 | 临床疗效；每日排 | | | | 对照组 | 弥凝 | | 0.1 mg ，Qd | | 尿次数 | | 易竞阳等（2007年）${ }^{[6]}$ | 60／30 | 试验组 | 鸡肠散 | | 水煎 2 次，取 300 mL ，睡前 1 h 温服 | 15－30d | 临床疗效 | | | | 对照组 | 盐酸甲氯芬酯 | | 0.1 mg ，Tid | | | | 胡思源等（2008年）${ }^{[7]}$ | 338／108 | 试验组 | 小儿遗尿宁颗粒 | | 5－7岁： 5 g ，2次／d；7－14岁： $5 \mathrm{~g},, 2$ 次／d | 28d | 临床疗效、中医证 | | | | 对照组 | 盐酸甲氯芬酯 | | 100 mg ，Qd，睡前 $1 / 2 \mathrm{~h}$ 口服 | | 候疗效 | | 张雪荣等（2009年）${ }^{[8]}$ | 70／23 | 试验组 | 小儿遗尿宁颗粒 | | 5－7岁： 5 g ，2次／d；7－14岁： 5 g ，，2次／d | 28d | 临床疗效、中医证 | | | | 对照组 | 盐酸甲氯芬酯 | | 100 mg ，Qd，睡前 $1 / 2 \mathrm{~h}$ 口服 | | 候疗效 | | 李荫昆等（1998年）${ }^{[9]}$ | 30／26 | 试验组 | 自拟益肾健脾汤 | | 1 剂／d，水煎分 3 次服 | 7 d 为 1 疗程，一般服 | 临床疗效 | | | | 对照组 | 盐酸甲氯芬酯 | | 0．1g／d，Tid | 2、3个疗程 | | | 朱长君等（1994年）${ }^{[10]}$ | 318／113 | 试验组 | 自拟中药遗尿灵片 | | 5－9岁：8片，Bid；10岁以上：10片，Bid | 15 d 为 1 个疗程，观 | 临床疗效 | | | | 对照组 | 盐酸甲氯芬酯 | | 0.1 g ，Qd，睡前服用 | 察4个疗程 | |

表3 纳入研究的质量评价 Table 3 Quality assessment of included studies

纳入研究 Included studies	随机方法 Randomization method	分配隐藏 Allocation concealment	盲法 Blinding	失访与意向性分析 Loss to Follow-up and Intention-to-Treat Analysis	质量等级 Quality Rating
万力生等（2004年） $^{[4]}$ Wan Lisheng et al. (2004) $^{[4]}$	未描述 Not described	无 None	无 None	无 None	C
苏文等（2010年） $^{[5]}$ Su Wen et al. (2010) $^{[5]}$	未描述 Not described	无 None	无 None	无 None	C
易竞阳等（2007年） $^{[6]}$ Yi Jingyang et al. (2007) $^{[6]}$	未描述 Not described	无 None	无 None	无 None	C
胡思源等（2008年） $^{[7]}$ Hu Siyuan et al. (2008) $^{[7]}$	分层区组随机 Stratified block randomization	无 No	双盲双模拟 Double-blind, double-dummy	无 No	B
张雪荣等（2009年） $^{[8]}$ Zhang Xuerong et al. (2009) $^{[8]}$	分层区组随机 Stratified block randomization	无 None	双盲双模拟 Double-blind, double-dummy	无 None	B
李荫昆等（1998年） $^{[9]}$ Li Yinkun et al. (1998) $^{[9]}$	未描述 Not described	无 None	无 None	无 None	C
朱长君等（1994年） $^{[10]}$ Zhu Changjun et al. (1994) $^{[10]}$	未描述 Not described	无 None	单盲 Single-blind	无 None	C

且在改善肾气不足型小儿遗尿症中医证候的总有效率方面具有优势：

O R = 1.52, 95 % CI [1.00, 2.29]

，

P = 0.05

。
Moreover, it has advantages in improving the total effective rate of traditional Chinese medicine syndromes for enuresis in children with kidney qi deficiency:

O R = 1.52, 95 % CI [1.00, 2.29]

P = 0.05

图2 小儿遗尿宁颗粒与盐酸甲氯芬酯对照中医证候疗效森林图
Figure 2 Forest plot comparing the efficacy of Xiao'er Yiniaoning Granules with Meclofenoxate Hydrochloride on traditional Chinese medicine syndromes
有 1 篇文献对安全性进行了描述，试验组 342 例及对照组 114 例中，共有发生不良事件者 9 例，试验组 6 例，对照组 3 例，两组不良事件发生率均为

2.63 %

。其中对照组发生 1 例治疗后ALT异常加重， 1 例疗后 ALT异常，经研究者判断可能与试验用药有关；试验组发生 5 例上感、 1 例腹痛，对照组发生 1 例发热，经研究者判断均与试验药物无关。试验组无药物不良反应，对照组不良反应发生率为

1.75 %

。两组不良事件及不良反应比较差异无统计学意义。两组用药前后生命体征指标及其差值的组间比较，差异也均无统计学意义。
One study documented safety outcomes, reporting a total of 9 adverse events among 342 cases in the experimental group and 114 cases in the control group (6 in the experimental group and 3 in the control group), with both groups showing an adverse event incidence rate of

2.63 %

. In the control group, one case exhibited aggravated abnormal ALT levels post-treatment, and another showed abnormal ALT levels after treatment, which investigators deemed potentially related to the trial medication. The experimental group reported 5 cases of upper respiratory infections and 1 case of abdominal pain, while the control group had 1 case of fever—all judged by investigators as unrelated to the trial drugs. No adverse drug reactions occurred in the experimental group, whereas the control group had an adverse reaction rate of

1.75 %

. No statistically significant differences were observed between the two groups in adverse events or adverse reactions. Similarly, comparisons of vital signs before and after treatment, as well as intergroup differences, showed no statistical significance.
2.2 自拟中药汤剂、自拟中药片组与盐酸甲氯芬酯组对照 3 篇文献设立了自拟中药汤剂组与盐酸甲氯芬酯组进行对照，评价治疗遗尿症的总有效率，各研究间无统计学异质性差异（

P = 0.65, I^{2} = 0 %

），故采用固定效应模型进行Meta分析。图3结果显示，与盐酸甲氯芬酯相比，自拟中药组在治疗遗尿症的总有效率方面更显著：

O R = 4.93, 95 % CI [3.15, 7.72]

P < 0.00001

。
2.2 Comparison of Customized Herbal Decoction, Customized Herbal Tablet Groups, and Meclofenoxate Hydrochloride Group Three studies compared customized herbal decoction groups with meclofenoxate hydrochloride groups to evaluate the total effective rate in treating enuresis. No statistical heterogeneity was observed among the studies (

P = 0.65, I^{2} = 0 %

), so a fixed-effects model was used for meta-analysis. Figure 3 results indicate that the customized herbal group demonstrated significantly higher total effectiveness in treating enuresis compared to meclofenoxate hydrochloride:

O R = 4.93, 95 % CI [3.15, 7.72]

P < 0.00001

有 1 篇文献对安全性进行描述，治疗组病人在治疗过程中无不良反应， 118 例病人服用中药遗尿灵片
One study described safety outcomes, noting no adverse reactions in the treatment group during the trial. A total of 118 patients were administered the Chinese herbal preparation Yiniaoling tablets.

图3 自拟中药与盐酸甲氯芬酯对照疾病疗效森林图 Figure 3 Forest Plot Comparing Disease Efficacy Between Customized Herbal Preparations and Meclofenoxate Hydrochloride

后，有不同程度的食欲增强（

37.11 %

），说明此药有帮助消化，健脾壮身之功能。
Afterwards, there was varying degrees of increased appetite (

37.11 %

), indicating that this medication aids digestion and strengthens the spleen and body.
2.3 自拟中药汤剂组与弥凝组对照 2 篇文献设立了自拟中药汤剂组与弥凝组进行对照，评价治疗遗尿症的总有效率，各研究间无统计学异质性差异（

P = 0.20, I^{2} = 39 %

），故采用固定效应模型进行Meta分析。图4结果显示， 2 个月的疗程结束后，与弥凝相比，自拟中药组在治疗遗尿症的总有效率方面并无显著优势：

O R = 0.59, 95 % CI [0.22, 1.59], P = 0.30

。
2.3 Comparison Between Self-Prepared Herbal Decoction Group and Desmopressin Group Two studies compared the self-prepared herbal decoction group with the desmopressin group to evaluate the total effective rate in treating enuresis. There was no statistical heterogeneity among the studies (

P = 0.20, I^{2} = 39 %

), so a fixed-effects model was used for the meta-analysis. Figure 4 shows that after a 2-month treatment period, the self-prepared herbal group did not demonstrate a significant advantage over desmopressin in terms of the total effective rate for treating enuresis:

O R = 0.59, 95 % CI [0.22, 1.59], P = 0.30

图4 自拟中药与弥凝对照疾病疗效森林图 Figure 4 Forest Plot Comparing the Efficacy of Self-Prepared Herbal Decoction and Desmopressin
有 1 篇文献在停药后半年对两组的疗效进行了比较，经统计学分析，得出温肾止遗组与弥凝组比较，有显著性差异（

P < 0.01

），这表明温肾止遗组的远期疗效优于弥凝组。
One study compared the efficacy of the two groups six months after discontinuation of treatment. Statistical analysis revealed a significant difference between the Kidney-Warming and Enuresis-Stopping group and the desmopressin group (

P < 0.01

), indicating that the long-term efficacy of the Kidney-Warming and Enuresis-Stopping group was superior to that of the desmopressin group.

3．发表性偏倚纳入研究的各组文献均低于5篇，所以无法描绘＂漏斗图＂进行发表性偏倚的描述

^{[11]}

，但不排除纳入研究存在发表性偏倚的可能。
3. Publication bias Since the number of studies included in each group was fewer than 5, it was impossible to construct a "funnel plot" to assess publication bias

^{[11]}

. However, the possibility of publication bias in the included studies cannot be ruled out.

讨论 Discussion

综上所述，笔者可以认为中医药相对阳性西药对于小儿遗尿症的疾病疗效、中医证候疗效方面有一定的优势，且安全可靠。但是Meta分析也有其局限性，它是把己有的研究报告被动的接受下来，Meta分析的研究者不可能控制他人研究的质量，因此难以保障其真实性，在解释结论时须慎重。就本研究而言，影响结论真实性的原因主要有以下几点。
In summary, the author concludes that traditional Chinese medicine (TCM) demonstrates certain advantages over positive Western medicine in terms of disease efficacy and TCM syndrome efficacy for pediatric enuresis, with reliable safety. However, Meta-analysis also has its limitations—it passively accepts existing research reports, and Meta-analysis researchers cannot control the quality of others' studies, making it difficult to ensure authenticity. Therefore, conclusions should be interpreted with caution. For this study, the main factors affecting the authenticity of the conclusions include the following:

1．纳人文献质量低一个说服力强、论证强度高的Meta分析的结论决定于是否有高质量的随机对照临床试验。而本研究对纳人分析的7篇文献总体上质量偏低。这些文献在研究方案设计上存在着很多不足，如缺乏样本含量的估算、随机化的可信度和质
1. Low quality of included literature The persuasiveness and strength of a Meta-analysis depend on the availability of high-quality randomized controlled clinical trials. However, the overall quality of the 7 studies included in this analysis was relatively low. These studies exhibited many shortcomings in research design, such as lack of sample size estimation, questionable randomization credibility, and quality control issues.

量令人质疑、未采用盲法等等，在之前的讨论中己详细阐述。因此我们不能排除治疗组与对照组之间疗效的明显差异可能与试验的方法学质量低下有关。
The questionable sample size, lack of blinding, and other issues have been discussed in detail earlier. Therefore, we cannot rule out the possibility that the significant difference in efficacy between the treatment and control groups may be related to the low methodological quality of the trials.

2．中医证型不明确辨证论治是中医学理论体系的主要特点之一，是认识疾病和处理疾病的基本原则。中药不同于西药，需要在通过辨证思维得出证候诊断的基础上来处理疾病。而本研究纳入的 7 篇文献只有 3 篇明确了中医证型，从而使疗效的确切性有所降低，往往以偏概全。
2. Unclear TCM Syndrome Patterns Syndrome differentiation and treatment is one of the main characteristics of TCM theory and a fundamental principle in understanding and managing diseases. Unlike Western medicine, TCM requires a diagnosis based on syndrome differentiation before treating a disease. Among the seven studies included in this review, only three clearly defined TCM syndrome patterns, which reduces the reliability of the efficacy results and often leads to overgeneralization.

3．中药复方加减治疗问题根据中医独特的理论体系和治疗特点，中医药辨证论治原则是强调治疗的个体化。7篇文献中只有3篇采用了中成药，其它 4 篇都是在原方为主的基础上有不同程度的加减变化，因此中药复方与对照的疗效差异可能与辨证与否有关。
3. Issues with Modified TCM Herbal Formulas According to the unique theoretical system and treatment principles of TCM, syndrome differentiation emphasizes individualized treatment. Among the seven studies, only three used proprietary Chinese medicines, while the other four employed varying degrees of modifications to the original formulas. Thus, the difference in efficacy between TCM herbal formulas and the control group may be related to whether syndrome differentiation was applied.

4．文献的真实可靠性本次研究纳人的 7 篇文献仅有 2 篇在个别疗效判断方面报导了阴性结果，大多治疗组有效率远高于对照组，其真实性值得怀疑。一方面是因为可能存在发表性偏倚，阳性结果的研究更容易发表，另一方面也不能排除极个别作者为了某种原因篡改试验数据，将阴性结果改为阳性。作为医学工作者应当尊重事实，通过科学、正当的途径为广大患者谋求最好的治疗方法。
4. Reliability of the Literature Among the seven studies included in this review, only two reported negative results in certain efficacy assessments, while the majority showed significantly higher effectiveness rates in the treatment group compared to the control group, raising doubts about their authenticity. On one hand, this could be due to publication bias, as studies with positive results are more likely to be published. On the other hand, it cannot be ruled out that a few authors may have altered trial data for certain reasons, converting negative results into positive ones. As medical professionals, we should respect facts and seek the best treatment methods for patients through scientific and ethical means.

上述问题影响了本研究Meta分析的真实性和可靠性。同时也提醒我们，在中医药循证医学逐步发展的时代，我们应提高研究人员的中医临床水平、科研素质及道德素质，学习和运用现代科技手段进行多学科参与的中医临床试验，依据循证医学的原则，结合中医辨证论治的特色，多采用RCT设计进行国际认可的、高质量的前瞻性、大样本、多中心、双盲、随机对照的临床研究，并撰写高质量的论文，以期提供可靠的证据，尤其是对重大疾病的辨证论治综合治疗方的有效性评价。这应成为中医临床科研的主流。
The aforementioned issues have affected the authenticity and reliability of the meta-analysis in this study. At the same time, they remind us that in the era of gradual development of evidence-based medicine in traditional Chinese medicine (TCM), we should enhance the clinical proficiency, research capabilities, and ethical standards of researchers. It is essential to learn and apply modern technological methods to conduct multidisciplinary TCM clinical trials. Following the principles of evidence-based medicine and integrating the characteristics of TCM syndrome differentiation and treatment, we should prioritize RCT designs for internationally recognized, high-quality prospective, large-sample, multicenter, double-blind, randomized controlled clinical studies. Additionally, high-quality papers should be written to provide reliable evidence, particularly for evaluating the effectiveness of comprehensive TCM treatment approaches for major diseases based on syndrome differentiation. This should become the mainstream of clinical research in TCM.

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（收稿日期：2011年9月15日） (Received: September 15, 2011)

通讯作者：胡思源，天津市南开区鞍山西道314号天津中医药大学第一附属医院药理基地，邮编：300193，电话：022－27432275
Corresponding author: Husiyuan, Pharmacology Base, First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, 314 Anshan West Road, Nankai District, Tianjin, 300193, China. Tel: 022-27432275
E－mail：husiyuan1963＠sina．com
E-mail: husiyuan1963@sina.com
注：Qd：每日1次；Bid：每日2次；Tid：每日3次。
Note: Qd: Once daily; Bid: Twice daily; Tid: Three times daily.

参 考 文 献References

中医药治疗小儿遗尿症系统评价 Systematic Review of Traditional Chinese Medicine in Treating Pediatric Enuresis

Abstract

Systematic evaluation of literatures of TCM on nocturnal enuresis in children

Abstract

资料与方法 Materials and Methods

5．研究方法 5. Research methods

结果 Results

描述分级方法。 Description of grading methods.

2．疗效及安全性分析 2. Efficacy and Safety Analysis

讨论 Discussion

参 考 文 献References

参考文献
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参考文献
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