摘要
Objective This review aimed to systematically summarize and critically evaluate the clinical evidence for or against the effectiveness of acupuncture as a symptomatic therapy for uremic pruritus (UP) in end-stage renal disease (ESRD) patients. Materials and method: We searched 16 electronic databases from their inceptions to November 2009. All prospective clinical studies of needle acupuncture for uremic pruritus in hemodialysis patients with end-stage renal disease were included regardless of their design. Risk of bias of the included studies were assessed using the Cochrane criteria. Results Of 464 initially located articles, 458 studies were excluded. Three randomized controlled trials (RCTs), one non-randomized controlled trial (CCT) and two uncontrolled observational studies were included. In three RCTs, acupuncture was compared to sham-acupuncture (n=1), oral antihistamine plus topical ointment (n=1) and oral calcitriol (n=1). In one CCT, electroacupuncture (EA) was compared to superfi cial electrical stimulation. In two observational studies, EA (n=1) or manual acupuncture (n=1) were employed. Four of 6 included studies mentioned mild or no occurrence of adverse events. All of included trials reported benef icial effects of acupuncture. However, most of the studies showed high risk of bias, which leave their reports unconvincing. Conclusion The current evidence is insuffi cient to show that acupuncture is an effective treatment for uremic pruritus in patients with end-stage renal disease due to suboptimal quality and lack of methodological rigor of included studies. Future trials should overcome the limitations of the currently available evidence.
Objective This review aimed to systematically summarize and critically evaluate the clinical evidence for or against the effectiveness of acupuncture as a symptomatic therapy for uremic pruritus （UP） in end-stage renal disease （ESRD） patients. Materials and method： We searched 16 electronic databases from their inceptions to November 2009. All prospective clinical studies of needle acupuncture for uremic pruritus in hemodialysis patients with end-stage renal disease were included regardless of their design. Risk of bias of the included studies were assessed using the Cochrane criteria. Results Of 464 initially located articles, 458 studies were excluded. Three randomized controlled trials （RCTs）, one non-randomized controlled trial （CCT） and two uncontrolled observational studies were included. In three RCTs, acupuncture was compared to sham-acupuncture （n=1）, oral antihistamine plus topical ointment （n=1） and oral calcitriol （n=1）. In one CCT, electroacupuncture （EA） was compared to superfi cial electrical stimulation. In two observational studies, EA （n=1） or manual acupuncture （n=1） were employed. Four of 6 included studies mentioned mild or no occurrence of adverse events. All of included trials reported benef icial effects of acupuncture. However, most of the studies showed high risk of bias, which leave their reports unconvincing. Conclusion The current evidence is insufficient to show that acupuncture is an effective treatment for uremic pruritus in patients with end-stage renal disease due to suboptimal quality and lack of methodological rigor of included studies. Future trials should overcome the limitations of the currently available evidence.
