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穴位按压对血液透析患者瘙痒严重程度及实验室指标的影响:一项随机临床试验

The Effect of Acupressure on the Severity of Pruritus and Laboratory Parameters in Patients Undergoing Hemodialysis: A Randomized Clinical Trial.

作者信息

Karjalian Fatemeh, Momennasab Marzieh, Yoosefinejad Amin K, Jahromi Shahrokh E

机构信息

Student Research Committee, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

J Acupunct Meridian Stud. 2020 Aug;13(4):117-123. doi: 10.1016/j.jams.2020.05.002. Epub 2020 Jun 1.

Abstract

BACKGROUND

Uremic pruritus is a common boring complaint in patients suffering from chronic renal failure. Owing to cost and the side-effects of medications, complementary therapies are more attractive for pruritus treatment.

OBJECTIVES

The aim of this study is to determine the effect of acupressure on the severity of pruritus and some laboratory parameters in patients undergoing hemodialysis.

MATERIALS AND METHODS

The present clinical trial was conducted on 90 patients undergoing hemodialysis who were allocated in intervention, sham control, and negative control groups (30 in each group). Pressure was applied on SP6, SP10, ST36, and LI11 points in the intervention group and on ineffective points for the sham control group. The negative control group received routine care. The severity of pruritus was measured using the numeric rating scale before, two weeks, and five weeks after intervention. The laboratory parameters were measured before and after the intervention.

RESULTS

There was a significant reduction in the severity of pruritus over the course of the study in the intervention and sham control groups (p = 0.001). In addition, significant differences were observed at the end of the intervention in terms of serum phosphorus (p = 0.045) and parathyroid hormone (p = 0.004) levels between groups.

CONCLUSION

Acupressure can improve the severity of pruritus dramatically in hemodialysis patients. It can also reduce serum phosphorus and parathyroid hormone levels, which affect pruritus, significantly. Therefore, this simple and inexpensive intervention may be recommended for reducing uremic pruritus among patients undergoing hemodialysis.

摘要

背景

尿毒症瘙痒是慢性肾衰竭患者常见的令人厌烦的症状。由于药物成本和副作用,辅助疗法在瘙痒治疗中更具吸引力。

目的

本研究旨在确定穴位按压对血液透析患者瘙痒严重程度和一些实验室参数的影响。

材料与方法

本临床试验对90例血液透析患者进行,这些患者被分为干预组、假对照组和阴性对照组(每组30例)。干预组对三阴交、血海、足三里和曲池穴施加压力,假对照组对无效穴位施加压力。阴性对照组接受常规护理。在干预前、干预后两周和五周使用数字评分量表测量瘙痒严重程度。在干预前后测量实验室参数。

结果

在研究过程中,干预组和假对照组的瘙痒严重程度均显著降低(p = 0.001)。此外,干预结束时,各组之间在血清磷(p = 0.045)和甲状旁腺激素(p = 0.004)水平方面观察到显著差异。

结论

穴位按压可显著改善血液透析患者的瘙痒严重程度。它还可以显著降低影响瘙痒的血清磷和甲状旁腺激素水平。因此,对于减轻血液透析患者的尿毒症瘙痒,可能推荐这种简单且廉价的干预措施。

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