Enuresis, also known as nocturia, is the frequent or sometimes involuntary urination in sleep that occurs over the age of 3 years. The disease is divided into two main categories: organic and functional. Only a few children have organic enuresis due to uropathy, pinworm disease, spina bifida, etc. Most of them have functional enuresis due to dysfunction of the cerebral cortex and subcortical centers. The disease is most often seen in children under 10 years of age and can occasionally extend into the teenage years. Common causes include genetic factors, psychological factors and incorrect parenting methods. According to Chinese medicine, the occurrence of enuresis is closely related to the lungs, spleen and kidneys, with the relationship with the kidneys being particularly important. The kidney is deficient, the lower yuan is cold and deficient and cannot warm the bladder, so it cannot close the bladder and cannot control the water channels; the lung is deficient in spleen qi, the upper deficiency cannot control the lower and the lower deficiency cannot carry the upper, so it does not have the right to control the water channels, which results in urine loss. If it is not cured, it will often affect the physical and mental health and growth and development of children. Tui Na is effective in treating functional enuresis, and it is best to use it in the afternoon every day.
Clinical manifestations
(1) Kidney Qi deficiency: urine loss in sleep, awakening, long and clear urine, pale face, fatigue, cold limbs and cold fear, poor intelligence. Pale tongue with white coating, sunken and weak pulse.
(2) Lung and spleen qi deficiency: urine loss in sleep, frequent urination during the day, frequent colds, coughing, phlegm and wheezing, or shortness of breath and spontaneous sweating, less color, weakness of limbs, poor appetite, loose stools. The tongue is light with thin white coating and the pulse is sunken and weak.
(3) Damp-heat in the liver meridian: urine loss in sleep, yellow urine with little volume, impatience, night dreams or grinding teeth at night, heat in the heart of the hands and feet, red face and lips, thirst for water. Red tongue with yellow coating and string pulse.
[Massage Therapy
(1) Treatment principle: warming the kidneys and fixing astringency, strengthening the spleen and benefiting the lungs. If the kidney is deficient, it is advisable to warm the kidney yang and fix the urine; if the lung is deficient, it is advisable to tonify the lung and spleen and fix the urine; if the liver is damp and hot, it is advisable to clear the liver and diarrhea heat, slow down the urgency and stop the loss.
(2) Treatment steps
①Tonic for the spleen meridian: Apply pressure with the ribbed side of the thumb and push 300 times on the ribbed side of the thumb of the child.
②Tonic for the lung meridian: Apply pressure with the ribbed side of the thumb and push 300 times on the ribbed side of the ring finger of the child.
③Tonic kidney meridian: use the ribbed side of the thumb and push 300 times on the ribbed side of the little finger of the child.
④Knead the Dantian: use the palm root or the large fish interval to apply force and knead the small abdomen of the child 300 times in a clockwise direction.
⑤ abdominal massage: using the palm of the palm or the surface of the index, middle and ring fingers in the child’s abdomen for 10 minutes of circular stroking in a clockwise and counterclockwise direction.
(6) Chiropractic: with the child in the prone position, the operator uses chiropractic to lift the child’s sacrococcygeal area to the large vertebrae point, and repeatedly operates 3~5 times.
(7) Cross-rubbing the lumbosacral region: rub the lumbosacral region of the child with the palm of the hand, mainly at the kidney and eight s points, with heat penetration as the degree.
⑧ press and rub the Sanyinjiao: press and rub the Sanyinjiao point on the inner side of both lower limbs for 1 minute.
⑨ lifting the adductor muscles: with the child lying down and both lower limbs separated, the operator should lift the adductor muscles of the thighs on both sides of the child for 5-8 times. The technique should be light and heavy enough for the child to tolerate.
⑩If the kidney energy is insufficient
a. transport within the bagua: thumb ribbed surface pressure, in the child’s hand palm around the bagua points for 200 times.
b. Press and rub the Guan Yuan point: with the index finger or middle finger ribbed surface force, clockwise rub the Guanyuan point under the umbilicus of the child’s abdomen 100 times.
c. Knead the Baihui point: use the thumb or middle finger with ribbed surface pressure to knead 100 times clockwise at the intersection of the two ear tips in the middle of the child’s head.
If the lung and spleen are weak
a. Rub the Lung Yu and Spleen Yu points: press the Lung Yu and Spleen Yu points on the 3rd and 11th thoracic vertebrae on the child’s back, 1.5 inches below, with the force of the ribbed side of the index and middle fingers, 50 times each.
b. Press and rub the Guan Yuan point: using the ribbed side of the index or middle finger, rub the Guan Yuan point under the umbilicus of the child’s abdomen 100 times clockwise.
c. Mo Baihui point: Apply pressure with the ribbed side of the index finger, middle finger, and ring finger, and rub the point at the intersection of the two ear tips at the top of the child’s head in a clockwise direction for 50 times.
If the liver meridian is damp and hot
a. Clear the liver meridian: Apply pressure with the ribbed side of the thumb, and push the ribbed side of the child’s index finger straight to the knuckle from the fingertip 200 times.
b. Clear the heart meridian: Apply pressure with the ribbed side of the thumb, and push the ribbed side of the middle finger of the child from the fingertip straight to the knuckle 200 times.
c. Clearing the small intestine: apply pressure with the radial edge of the thumb, and push from the root to the tip of the finger 200 times at the ulnar edge of the little finger of the child.
d. Push the Minimen point: use the index and middle fingers from the upper edge of the medial side of the knee to the groin of the child 100 times.
(3) course of treatment: massage treatment once a day, preferably in the afternoon or evening, generally 1 to 2 months for a course of treatment.
Note]
(1) Urine loss must be treated early, and treatment should be adhered to when the child’s condition improves.
(2) Parents should patiently encourage their children to eliminate tension and gradually develop good urination habits.
(3) Do not drink water or other fluids before going to bed.
(4) Do not overexert the child during the day and do not overexcite him/her before bedtime.