袁斌 钱凌

    [摘要] 小儿遗尿症的发病机制十分复杂，目前认为主要涉及中枢神经系统、生理节律以及膀胱功能紊乱，但具体机制迄今尚未完全阐明。临床观察中发现儿童原发性遗尿症(PNE)与注意力缺陷多动障碍(ADHD)密切相关，但其具体相关性尚有待进一步研究揭示。目前研究表明多巴胺神经递质代谢通路障碍、精神心理因素等是ADHD与PNE的共同发病因素，睡眠觉醒障碍是ADHD导致PNE发生的重要原因。中医方面，ADHD日久可影响心、肝、脾、肺、肾五脏功能，引发脏腑阴阳失调，髓海失养，出现肺脾气虚、肾气虚弱、肝经湿热、心肾不交等病机，导致遗尿。

    [关键词] 注意力缺陷多动障碍；遗尿症；儿童；发病；相关性

    [中图分类号] R272 [文献标识码] A [文章编号] 1673-7210(2017)12(a)-0033-04

    [Abstract] So far the specific pathogenesis of enuresis in children has not been fully elucidated because of its complexity， it is accepted that central nervous system， circadian rhythm and dysfunction of bladder are mainly involved. Clinical observation finds ADHD is closely related to PNE. However， the specific relevance remains to be further studied and revealed. Recent studies show that disturbsance of metabolic pathway of dopamine transmitter and psychological factors are common risk factors of ADHD and enuresis. Sleep arousal disorders is an important reason for ADHD to cause PNE to happen. ADHD can affect the functions of the heart， liver， spleen， lung， kidney， leading to the imbalance of yin and yang in viscera ......