目的 评价非药物干预对血液透析(hemodialysis,HD)患者不宁腿综合征(restless legs syndrome,RLS)症状的影响。 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,检索时限从建库至2023年5月,收集不同非药物干预对HD患者RLS影响的随机对照研究。由2名研究者独立筛选文献、提取资料并进行文献质量评价,运用Stata 17.0软件进行网状Meta分析。 结果 共纳入21项研究,总样本量为1183例。网状Meta分析结果显示:冷透析液为改善HD患者RLS症状的最优选择。冷透析液与中药足浴联合穴位按摩(SMD=-13.23,95% CI: -25.15~-1.32,P =0.004)、穴位敷贴(SMD=-18.20,95% CI:-30.06~-6.34,P<0.001)、透析中运动训练(SMD= -12.47,95% CI:-21.68~-3.27,P=0.008)、耳穴贴压治疗(SMD=-17.07,95% CI:-29.30~-4.84, P=0.025)、足部反射疗法(SMD=-11.84,95% CI:-22.02~-1.66,P<0.001)、红外光治疗(SMD=-18.16,95% CI:-30.07~-6.25,P<0.001)、督灸疗法(SMD=18.91,95% CI:7.06~30.77,P=0.012)、穴位按摩(SMD=17.91,95% CI:4.65~31.16,P=0.029)比较差异有统计学意义。 结论 冷透析液可以改善HD患者RLS症状,可根据患者的耐受性制定相关干预措施。
Objective To comprehensively evaluate the effect of non-drug intervention on the symptoms of restless legs syndrome (RLS) in hemodialysis patients, and to provide references for selecting the best intervention measures. Methods Randomized controlled studies on the effects of different non-drug interventions on RLS in hemodialysis patients were searched by computer in PubMed, Embase, Web of Science, Cochrane, CNKI, VIP, Wanfang and Biomedical Literature Service System from the establishment of the database to May 2023. Two researchers independently screened the literature, extracted data, and evaluated literature quality. Stata 17.0 software was used to perform mesh meta-analysis. Results A total of 21 studies were included, with a total sample size of 1,183 cases. The results of mesh meta-analysis showed that cold dialysate was the best choice for improving RLS symptoms in hemodialysis patients. Cold dialysate combined with foot bath using traditional Chinese medicine and acupressure (SMD=-13.23~95% CI: -25.15~-1.32), acupressure application (SMD=-18.20~95% CI: -30.06~-6.34), exercise training during dialysis (SMD=-12.47~95% CI: -21.68~-3.27), auricular-point compression therapy (SMD=-17.07~95% CI:
-29.30~-4.84), foot reflexology (SMD=-11.84~95% CI: -22.02~-1.66), infrared light therapy (SMD = -18.16~95% CI: -30.07~-6.25), acupuncture therapy (SMD=18.91, 95% CI: 7.06, 30.77), and acupressure (SMD=17.91, 95% CI: 4.65~31.16) also had the statistical differences (P<0.017). Conclusion Among the non-drug interventions, cold dialysate can improve RLS symptoms in hemodialysis patients, and the intervention of RLS can be managed according to patient tolerance.