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Effect of traditional Chinese and Western Medicine on Nocturnal Enuresis in Children and Its Influencing Factors: A Randomized Controlled Trial

Ma Y, Liu X, Shen Y

Pediatrics International 2017 Sep 10. doi: 10.1111/ped.13417. [Epub ahead of print]

Commentary by Konstantinos Kamperis

Addition of Suoquan to desmopressin improves efficacy in Chinese children with enuresis. Time to look into Chinese traditional medicine?

Alternative medicine is not commonly used in the western part of the world but is often first line treatment in Asian countries. Traditional Chinese medicine is often used in treating bedwetting in China but in lack of randomized controlled trials that prove their efficacy, these remedies are not accepted or implemented in our daily practice. The authors of this paper designed a study to test Suoquan, a traditional Chinese medicine for the treatment of enuresis in a randomized controlled fashion. To this end they recruited 369 children with enuresis aged 5-15 years, who were otherwise healthy.

Children were randomized to Suoquan as monotherapy, Suoquan combined with desmopressin and tested against standard behavioral therapy (urotherapy) and desmopressin as monotherapy. Endpoint for efficacy was the reduction in number of wet nights following two months of therapy. The authors were able to demonstrate that both desmopressin as monotherapy and desmopressin combined with Suoquan were superior to behavioral therapy. Although the authors find better complete response rates for the combination treatment the difference from desmopressin as monotherapy was not statistically significant. Suoquan is a formula consisting of three different plants and has previously been shown to possess antidiuretic properties but also improve bladder capacity by relaxation of the detrusor muscle.

Should we clinicians embark on using Chinese traditional medicine for treating bedwetting? Probably not yet, as further studies are needed to confirm safety and efficacy of these medications. The importance of this study by Ma et al relies on the fact that this is one of the few studies that attempt to test traditional Chinese medicine in a scientific way by performing a randomized controlled trial. We hope the authors continue down this path.