非药物干预对维持性血液透析患者疲乏影响的网状Meta分析

doi:10.3761/j.issn.1672-9234.2023.04.015

摘要/Abstract

摘要：

目的采用网状Meta分析评价不同非药物干预方法对维持性血液透析患者疲乏的影响。方法检索PubMed、Embase、Web of Science、Cochrane、中国知网、维普、万方、生物医学文献服务系统和CINAHL数据库，收集2022年2月前发表的有关非药物干预维持性血液透析患者疲乏症状的文献。由2名研究者独立筛选文献、提取资料并用Cochrane质量评价手册对纳入的文献进行质量评价，采用Stata 15.1软件进行网状Meta分析。结果共纳入27项研究，包括2 315例患者，涉及13种非药物干预方法。网状Meta分析结果显示：针刺疗法、芳香疗法、肌肉放松训练、穴位按摩、常规有氧运动缓解维持性血液透析患者疲乏的效果均优于常规干预（P<0.05）；此外，针刺疗法相比其他12种干预措施，缓解疲乏疗效更优（P<0.05）；排名前3位的非药物干预方法为针刺疗法、芳香疗法、肌肉放松训练。结论针刺疗法、芳香疗法、肌肉放松训练、穴位按摩、常规有氧运动在缓解维持性血液透析患者疲乏中的效果优于常规干预，其中针刺疗法对维持性血液透析患者疲乏干预效果最佳。但受原始文献质量或数量等限制，还需高质量、多中心、大样本的随机对照试验进行验证。

关键词: 血液透析滤过, 病人, 疲劳, 循证护理学, 非药物干预

Abstract:

Objective To evaluate the effect of difference non-pharmacological interventions on fatigue of patients with maintenance hemodialysis by network meta-analysis. Methods The PubMed，Embase，Web of Science，Cochrane，CNKI，VIP，Wanfang data，SinoMed and CINAHL were electronically searched to collect articles on non-pharmacological interventions for fatigue management in patients with maintenance hemodialysis before February 2022. Two researchers screened the articles，evaluated the quality of the included studies，as well as extracted and analyzed the data independently. Results A total of 27 articles and 13 kinds of non-pharmacological interventions were included，with a total of 2，315 patients. The results of network meta-analysis showed that the effects of acupuncture，aromatherapy，muscle relaxation training，acupressure massage，aerobic exercise were better than those of routine care（P<0.05）. Furthermore，compared with other 12 measures，acupuncture showed significantly stronger effects on fatigue（P<0.05）. The top three interventions were acupuncture，aromatherapy，and muscle relaxation training. Conclusions Acupuncture，aromatherapy，muscle relaxation training，acupoint massage，and routine aerobic exercise are more effective than routine interventions in relieving fatigue in patients with maintenance hemodialysis. Acupuncture has the best effect on fatigue；however，the conclusion needs to be further verified by high-quality RCTs with multi-centers and large sample size.

Key words: Hemodiafiltration, Patients, Fatigue, Evidence-Based Nursing, Non-pharmacological interventions

卢贤英, 侯朝铭, 高静, 柏丁兮, 刘锐芮, 陈婷婷. 非药物干预对维持性血液透析患者疲乏影响的网状Meta分析[J]. 中华护理教育, 2023, 20(4): 467-473.

LU Xianying, HOU Zhaoming, GAO Jing, BAI Dingxi, LIU Ruirui, CHEN Tingting. The effect of non-pharmacological interventions on fatigue of patients with maintenance hemodialysis：a network meta-analysis[J]. Chinese Journal of Nursing Education, 2023, 20(4): 467-473.

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