Meta-analysis of ear acupoint therapy to treat sleep disorders in hemodialysis patients

Background:To evaluate the therapeutic effect of auricular therapy on sleep disorders in hemodialysis patients using meta-analysis methods,and to provide evidence-based support for clinical practice.Methods:PubMed,Embase,Cochrane Library,Chinese Biomedical Literature Database,China Journal Full-text Database,Chinese Science and Technology Journal Full-text Database,and Wanfang Resource Database were searched up to February 2023.Randomized controlled trials of auricular therapy for sleep disorders in hemodialysis patients were collected and included in the study.Meta-analysis was performed using RevMan 5.3 software.Results:587 patients from 7 randomized controlled trial studies were included.The auricular therapy group had better sleep conditions than the conventional care group,as evaluated by the Pittsburgh Sleep Quality Index,in terms of total Pittsburgh Sleep Quality Index score(mean difference(MD)=–5.11,95%confidence interval(CI)(–5.25,–4.96),P<0.00001),subjective sleep quality(MD=–0.64,95%CI(–0.72,–0.56),P<0.00001),falling asleep time(MD=–0.37,95%CI(–0.49,–0.26),P<0.00001),sleep time(MD=–0.38,95%CI(0.44,–0.32),P<0.00001),sleep efficiency(MD=–0.15,95%CI(–0.23,–0.07),P<0.0001),sleep disturbances(MD=–0.18,95%CI(–0.28,–0.09),P=0.0002),daytime dysfunction(MD=–0.89,95%CI(–1.18,–0.6),P<0.00001),and hypnotic medication(MD=–0.22,95%CI(–0.4,–0.03),P=0.02).Conclusion:Auricular therapy is an effective method for improving sleep quality in hemodialysis patients,providing evidence-based support for clinical practice.

Effects of Chinese Medicine on Symptoms,Syndrome Evolution,and Lung Inflammation Absorption in COVID-19 Convalescent Patients during 84-Day Follow-Up after Hospital Discharge:A Prospective Cohort and Nested Case-Control Study

Objective:To observe the changes of symptoms,Chinese medicine(CM)syndrome,and lung inflammation absorption during convalescence in patients with coronavirus disease 2019(COVID-19)who had not totally recovered after hospital discharge and whether CM could promote the improvement process.Methods:This study was designed as a prospective cohort and nested case-control study.A total of 96 eligible patients with COVID-19 in convalescence were enrolled from Beijing Youan Hospital and Beijing Huimin Hospital and followed up from the hospital discharged day.Patients were divided into the CM(64 cases)and the control groups(32 cases)based on the treatment with or without CM and followed up at 14,28,56,and 84 days after discharge.In the CM group,patients received the 28-day CM treatment according to two types of CM syndrome.Improvements in clinical symptoms,CM syndrome,and absorption of lung inflammation were observed.Results:All the 96 patients completed the 84-day follow-up from January 21 to March 28,2020.By the 84th day of follow-up,respiratory symptoms were less than 5%.There was no significant difference in the improvement rates of symptoms,including fatigue,sputum,cough,dry throat,thirst,and upset,between the two groups(P>0.05).Totally 82 patients(85.42%)showed complete lung inflammation absorption at the 84-day follow-up.On day 14,the CM group had a significantly higher absorption rate than the control group(P<0.05)and the relative risk of absorption for CM vs.control group was 3.029(95%confidence interval:1.026-8.940).The proportions of CM syndrome types changed with time prolonging:the proportion of the pathogen residue syndrome gradually decreased,and the proportion of both qi and yin deficiency syndrome gradually increased.Conclusions:Patients with COVID-19 in convalescence had symptoms and lung inflammation after hospital discharge and recovered with time prolonging.CM could improve lung inflammation for early recovery.The types of CM syndrome can be transformed with time prolonging.