Juntendo Medical Journal
Online ISSN : 2188-2126
Print ISSN : 2187-9737
ISSN-L : 2187-9737
Current Topics: Update on Yokukansan
Yokukansan: A Treatment Option for Nocturnal Enuresis in Children by Improving Sleep Quality
YOSHIYUKI OHTOMODAISUKE UMINOSHINICHI NIIJIMASHUICHIRO FUJINAGATOSHIAKI SHIMIZU
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2014 Volume 60 Issue 6 Pages 536-542

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Abstract

Nocturnal enuresis (NE) is a common problem in children, and its prevalence rate is 20% among children aged 5; 15% of children recover in each subsequent year. However, this problem remains in approximately 0.5% of the adult population. The major pathogenic factors involved in NE are nocturnal polyuria, small bladder capacity and/or detrusor overactivity, as well as a high arousal threshold.
Desmopressin is the first-line medication for patients with dieresis-dependent nocturnal enuresis and its efficacy rate is nearly 70%. An enuresis alarm device is also commonly used, especially for patients with a small bladder capacity; it is effective for 65-70% of patients with NE.
For patients who do not respond to desmopressin or an enuresis alarm, anticholinergics or tricyclic antidepressants are used; however, they are beneficial only for some of them. Since several clinical studies have shown that disrupted sleep architecture in patients with NE might explain in part the etiology of the disease, we evaluated the sleep conditions in our refractory patients and started treatment with yokukansan.
Yokukansan was effective in two-thirds of the refractory cases with nocturnal enuresis by improving the quality of their sleep.

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