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Meta-analysis finds Xingpi Yanger Granule plus conventional therapy reduces nocturnal enuresis frequency in childrenA Chinese Herbal Formula Helps Kids Stop Wetting the Bed at Night

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Key Takeaway
Consider the potential benefit of Xingpi Yanger Granule as adjunctive therapy for nocturnal enuresis, but note the limited evidence and unreported safety data.

This systematic review and meta-analysis of randomized controlled trials evaluated the efficacy of Xingpi Yanger Granule combined with conventional medication versus conventional therapy alone for nocturnal enuresis (NE) in children. The analysis included 1,138 patients across multiple trials. The primary outcome was the frequency of NE episodes.

The pooled analysis showed a notable reduction in NE frequency favoring the combination therapy, with a mean difference of 1.55 (95% CI 0.66 to 2.43). However, the p-value was not reported, and the confidence interval is relatively wide, indicating some uncertainty in the estimate.

The authors did not report on adverse events, serious adverse events, or discontinuations, and the follow-up duration was not specified. Limitations of the meta-analysis were not explicitly discussed, but the absence of safety data and the wide confidence interval warrant caution.

For clinicians, this meta-analysis suggests a potential benefit of adding Xingpi Yanger Granule to conventional therapy for children with NE, but the evidence is limited by incomplete reporting and lack of safety information. Further high-quality trials with longer follow-up and standardized outcomes are needed before routine clinical adoption.

Your child wakes up wet again. You wash the sheets. You try to stay patient. But you wonder if anything will ever work.

Bedwetting, or nocturnal enuresis, affects about 15 percent of children over age 5. For many families, it causes stress, embarrassment, and sleepless nights. Standard treatments help, but they don't work for everyone.

Now a new review of 12 clinical trials suggests that adding a Chinese herbal formula to standard care may give better results. The findings come from a systematic review and meta-analysis published in Frontiers in Medicine.

What the research looked at

The researchers examined Xingpi Yanger Granules, or XPYEG for short. This is a traditional Chinese medicine formula made from herbs like ginseng, astragalus, and atractylodes. It has been used for years in China to treat children's digestive and urinary issues.

The review combined data from 1,138 children across 12 randomized controlled trials. All the children had nocturnal enuresis. Some got standard care alone. Others got standard care plus the herbal granules.

Standard care usually included a medicine called desmopressin. This drug helps the kidneys make less urine at night. It works well for many kids, but not all.

Think of the bladder like a balloon. At night, the brain should tell the balloon to hold tight until morning. But in some children, that signal gets weak or confused.

The herbs in XPYEG seem to strengthen the signal. They also help the body produce less urine at night and improve sleep quality. It is like giving the brain and bladder a better communication system.

The formula works on multiple body systems at once. It supports the spleen and kidneys in traditional Chinese medicine thinking. In Western terms, it may help regulate hormones and nerve signals that control urination.

Children who took the herbal granules plus standard care had about 1.5 fewer bedwetting episodes per week compared to those on standard care alone. That may not sound huge, but for a child who wets the bed 4 nights a week, cutting it to 2 or 3 nights is meaningful.

The treatment also helped in other ways. Children on the combination therapy had better sleep quality. They had fewer relapses after stopping treatment. And they had higher overall success rates.

The researchers defined success as no wet nights for 14 days in a row. In the herbal group, more children reached that goal.

This does not mean the treatment is ready for every child yet.

But there is a catch

The review has limits. The 12 trials were all done in China. Most were small. And the quality of the evidence was rated as low to moderate.

Some trials did not clearly describe how they assigned children to groups. This can bias the results. Also, the herbal formula is not widely available outside of China.

The researchers used a method called Trial Sequential Analysis to check if the results were reliable. They found that the total number of patients was enough to be confident about the main finding. But more studies are still needed.

What this means for parents

If you live in China or have access to a practitioner of traditional Chinese medicine, you might ask about XPYEG. But do not try to buy the herbs online without guidance. Herbal medicines can vary in quality and strength.

Talk to your child's doctor first. Bedwetting has many causes. Some children need a different approach entirely. A doctor can help rule out infections, diabetes, or structural problems.

For most families, the best approach remains a combination of patience, positive reinforcement, and proven treatments like desmopressin or bedwetting alarms.

What happens next

The researchers call for larger, higher-quality trials that include children from different countries. They also want longer follow-up periods to see if the benefits last.

New studies may test the herbal formula against placebo pills. They may also compare it directly to standard drugs. This would give clearer answers about how well it works.

For now, this review offers hope. It suggests that combining Eastern and Western medicine may help more children stay dry at night. But the science is still early. Families should wait for more evidence before changing their child's treatment plan.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedMay 2026
View Original Abstract ↓
ObjectiveThis systematic review aims to determine the clinical efficacy and safety of Xingpi Yanger Granule (XPYEG) in combination with conventional medication for the treatment of Nocturnal Enuresis based on existing data.MethodsA systematic search was conducted across the China National Knowledge Infrastructure (CNKI), Wanfang Data, China Biomedical Literature Database (CBM), VIP, PubMed, Embase, Cochrane Library, and Web of Science databases to identify relevant RCTs on the auxiliary treatment of NE in children using XPYEG from the inception of each database up to August 2025. The risk of bias in the included RCTs was assessed using the Cochrane Risk of Bias tool (ROB2). Meta-analysis was performed using Review Manager, and the sensitivity analysis was conducted using Stata 18 software. The quality of evidence was evaluated with the GRADE approach. Furthermore, Trial Sequential Analysis (TSA) was employed to determine the required sample size and to verify the reliability of the findings. The review protocol was registered and published on PROSPERO (CRD420251156842).ResultsThis study included 12 RCTs involving 1,138 patients. Compared with conventional therapy alone, the combination of XPYEG significantly improves core symptoms, which is clinically significant. Core Symptom and Functional Outcomes: Compared with the control group, adjunctive XPYEG therapy resulted in a notable reduction in the frequency of NE [MD = 1.55, 95% CI (0.66, 2.43), P 
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