非药物干预改善维持性血液透析病人睡眠质量的网状Meta分析

Non-drug intervention improves sleep quality in maintenance hemodialysis patients:a network Meta-analysis

目的:通过网状Meta分析探讨非药物干预对提高维持性血液透析病人睡眠质量的效果。方法:系统检索PubMed、EMbase、Web of Science、the Cochrane Library、中国知网、万方数据库、维普数据库以及中国生物医学文献数据库等。检索时限为建库至2023年10月20日。采用Stata 14.0软件进行网状Meta分析。结果:共纳入23篇文献,涉及2078例病人,涵盖13种不同类型的非药物干预方法。Meta分析结果显示,耳穴压豆联合穴位按摩、耳穴贴压、耳穴埋豆联合中药枕、八段锦、心理疗法、认知行为干预、康复训练等对改善维持性血液透析病人睡眠质量的效果优于常规护理干预,差异均有统计学意义(P<0.05);其中,耳穴压豆联合穴位按摩相比其他12种干预措施,改善维持性血液透析病人睡眠质量疗效更优(P<0.05)。结论:耳穴压豆联合穴位按摩是改善维持性血液透析病人睡眠质量的最佳非药物干预措施,但还需大量高质量的随机对照试验进行验证。

Objective:To investigate the effect of non-drug intervention on sleep quality in patients with maintenance hemodialysis through network Meta-analysis.Methods:PubMed,EMbase,Web of Science,the Cochrane Library,CNKI,WanFang Database,VIP and CBM were searched systematically.The search period was up to October 20,2023.Stata 14.0 software was used to perform network Meta-analysis.Results:A total of 23 articles were included,involving 2078 patients,covering 13 different types of non-drug therapy.The Meta-analysis results showed that ear acupressure combined with acupoint massage,ear acupressure,ear bean embedding combined with traditional Chinese medicine pillow,eight section brocade,psychotherapy,cognitive behavioral intervention,rehabilitation exercise,etc.had better effects on improving the sleep quality of maintenance hemodialysis patients than conventional nursing interventions,and the differences were statistically significant(P<0.05).Among them,the combination of ear acupressure and acupoint massage has a better therapeutic effect on improving the sleep quality of maintenance hemodialysis patients compared to the other 12 intervention measures(P<0.05).Conclusion:Ear acupressure combined with acupoint massage is the best non-drug intervention measure to improve sleep quality in maintenance hemodialysis patients,but it still requires a large number of high-quality randomized controlled trials for verification.