非药物干预措施改善血液透析病人不宁腿综合征的网状Meta分析  

Non⁃pharmacological interventions for improving restless legs syndrome in hemodialysis patients:a network Meta⁃analysis

作　　者：常钟文 赵倩 何亚鹏 徐惠泽 赵剑 朱东阁 韩明华 CHANG Zhongwen;ZHAO Qian;HE Yapeng;XU Huize;ZHAO Jian;ZHU Dongge;HAN Minghua(Nursing College of Shanxi Medical University,Shanxi 030001 China;Shanxi Provincial People's Hospital)

机构地区：[1]山西医科大学护理学院,山西030001 [2]山西省人民医院

出　　处：《护理研究》2025年第8期1293-1303,共11页Chinese Nursing Research

基　　金：中国研究型医学院学会护理分会2022年临床护理研究课题,编号:Y2022FH-HLFH06-09;中华医学会杂志社2022-2023年护理学科研究课题,编号:CMAPH-NRD2022034。

摘　　要：目的:通过网状Meta分析评价不同非药物干预措施改善血液透析病人不宁腿综合征的效果,为临床护理提供依据。方法:计算机检索PubMed、CINAHL、the Cochrane Library、EMbase、Web of Science、中国知网、万方数据库、维普中文期刊全文数据库、中国生物医学文献服务系统中相关的随机对照试验,检索时限为建库至2023年11月30日。使用Cochrane手册对纳入文献进行质量评价,使用StataSE 15.0软件进行网状Meta分析,通过累积排序概率曲线下面积(SUCRA)对干预措施进行排序。绘制漏斗图进行发表偏倚检验。结果:共纳入33篇文献,涉及2065例病人,包括22种非药物干预措施。网状Meta分析结果显示,低温透析、薰衣草精油按摩、甘油按摩、甜橙精油按摩、穴位敷贴、中药足浴配合针刺、反射疗法、中药足浴加穴位按摩、脚踏车运动、中药足浴在改善透析病人不宁腿症状方面均优于对照组,SUCRA值分别为99.6%、92.2%、75.4%、72.1%、67.9%、67.4%、65.6%、57.2%、47.7%、41.9%;伸展运动在改善睡眠方面效果最为显著,其次为反射疗法和有氧运动,SUCRA值分别为84.0%、80.7%、79.4%。结论:非药物干预措施对血液透析病人不宁腿综合征的改善具有明显效果,低温透析为改善血液透析病人不宁腿症状的最佳干预措施,伸展运动是改善睡眠状况最佳的干预措施,未来可在临床工作中依据循证证据进行非药物干预。Objective:To evaluate the effect of different non-pharmacological interventions on restless legs syndrome in hemodialysis patients by network meta-analysis,and to provide evidence for clinical nursing.Methods:The relevant randomized controlled trials in PubMed,CINAHL,the Cochrane Library,EMbase,Web of Science,CNKI,WanFang database,VIP,and CBM databases were searched by computer.The retrieval time was from database establishment to November 30,2023.The quality of the included literatures was evaluated using the Cochrane handbook.A network Meta-analysis was performed using StataSE 15.0 software to rank interventions by cumulative ranking of areas under the probability curve.Funnel plot was drawn for publication bias test.Results:A total of 33 articles were included,involving 2065 patients,including 22 non-pharmacological interventions.Network Meta-analysis results showed,cool dialysate,lavender essential oil massage,glycerin massage,sweet orange essential oil massage,acupoint application,Chinese medicine foot bath combined with acupuncture,reflexology,Chinese medicine foot bath and point massage,bicycle exercise and Chinese medicine foot bath were superior to the control group in improving the symptoms of restless legs in dialysis patients,SUCRA values were 99.6%,92.2%,75.4%,72.1%,67.9%,67.4%,65.6%,57.2%,47.7%,and 41.9%,respectively.Stretching exercises were the most effective in improving sleep,followed by reflexology and aerobic exercise,SUCRA values were 84.0%,80.7%and 79.4%,respectively.Conclusion:Non-pharmacological intervention has obvious effect on the improvement of restless legs syndrome in hemodialysis patients.Low temperature dialysis is the best intervention measure to improve restless leg symptoms in hemodialysis patients.And stretching exercise is the best intervention measure to improve sleep conditions.In the future,evidence-based non-pharmacological interventions could be used in clinical practice.

关 键 词：非药物干预 血液透析 不宁腿综合征 网状Meta分析 循证护理 

分 类 号：R473.5[医药卫生—护理学]