Question
How can pediatric enuresis be treated with traditional Chinese medicine? Are there any good herbal formulas to recommend?
Answer
(1) Enuresis is related to the nervous regulation system, including the primary urinary center in the cerebral cortex, brainstem, and spinal cord, as well as the nerves that control the bladder and urethra. Due to the underdevelopment of the functions of the brain and brainstem, there is insufficient control over the primary urinary center in the spinal cord, or there may be obstacles in the neural conduction pathways between the spinal cord and other nerves, leading to a loss of control over the bladder and urethra, thereby causing enuresis. (2) Enuresis is also related to the underdevelopment of bladder function, leading to a small bladder capacity, high sensitivity, and poor adaptability; insufficient perception during bladder filling and contraction, with the intensity of stimulation to the cerebral cortex being lower than the sleep-wake threshold; abnormal function of bladder pressure receptors, which cannot provide early warning information, causing bedwetting before waking up. (3) Enuresis is also related to incomplete closure function of the urethra, which may cause enuresis due to unstable urethra; urethral anomalies such as congenital stenosis may also lead to enuresis. (4) Enuresis is related to sleep-wake function disorders, which may be one of the main factors or causes of enuresis. The dysfunction may be due to incomplete perception of bladder filling and contraction or excessive fatigue leading to deep sleep, or due to incomplete micturition or underdevelopment. (5) Enuresis is also related to decreased secretion of antidiuretic hormone (ADH), with normal people secreting less ADH during the day than at night, and urine volume changing inversely with ADH secretion. Some children with enuresis may have increased urine volume at night due to insufficient ADH secretion.