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Non-invasive Acupoint Therapy Found Effective in Alleviating Uremic Pruritus in Dialysis Patients

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Patients undergoing dialysis often face severe discomfort due to uremic pruritus, a condition that significantly impairs their quality of life. Recent studies have explored non-invasive acupoint therapy as a potential solution to this issue, offering a promising alternative to traditional treatment methods. This innovative approach not only provides relief but also enhances the accessibility of effective healthcare for these patients.

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Review of Non-invasive Acupoint Therapy

A comprehensive review of domestic and international research was conducted to assess the effectiveness of non-invasive acupoint therapy in mitigating uremic pruritus among dialysis patients. The study aimed to enable clinical practitioners to adopt evidence-based non-invasive acupoint therapy in their practices, thereby improving patient outcomes. This review focused on studies published up to September 2023, utilizing databases such as PubMed, Cochrane Library, Embase, and others.

Research Methodology and Findings

The analysis adhered to the PRISMA guidelines for systematic reviews and meta-analyses. A total of 112 articles were initially reviewed, with nine studies involving 597 participants selected for the meta-analysis. The results demonstrated a significant reduction in uremic pruritus severity through non-invasive acupoint therapy, with a synthetic effect size of -1.30 and a 95% confidence interval between -1.67 and -0.93. Given the high heterogeneity (I² = 76%), a subgroup analysis was conducted, revealing that combining acupoint massage with traditional Chinese medicine fumigation and washing yielded better outcomes.

The study further identified that non-invasive acupoint therapy is not only effective but also easy to implement, cost-efficient, and associated with minimal side effects. These attributes make it an accessible treatment option for patients, which could potentially reduce hospitalization rates and enhance overall patient well-being.

Valuable Inferences for Clinical Practice

The findings from this study suggest several practical implications for clinical practice:

  • Combining acupoint massage with traditional Chinese medicine techniques can enhance treatment efficacy.
  • Specific acupoints, such as ST-6, SP-10, and LI-11, are particularly effective in reducing uremic pruritus.
  • Non-invasive methods like far-infrared irradiation and transcutaneous acupoint electrical stimulation further improve patient outcomes.

The review underscores the potential of non-invasive acupoint therapy as a complementary treatment for uremic pruritus in dialysis patients. Its ease of implementation and affordability make it a viable option for widespread clinical adoption. By incorporating these techniques, healthcare providers can offer more comprehensive care to improve the quality of life for dialysis patients.

Original Article:

Hu Li Za Zhi. 2023 Aug;70(4):69-80. doi: 10.6224/JN.202408_71(4).09.

ABSTRACT

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BACKGROUND: Uremic pruritus, one of the most painful symptoms experienced by patients receiving dialysis, seriously affects patient quality of life and health, causes physical and mental damage, and increases hospitalization and mortality rates. Multi-modal therapies with evidence-based healthcare are needed to provide patients receiving dialysis with more convenient and feasible medical resources.

PURPOSE: Relevant domestic and international research on the effectiveness and methods of non-invasive acupoint therapy in improving uremic pruritus in dialysis patients was reviewed. Discussing related knowledge can facilitate the evidence-based use of non-invasive acupoint therapy in clinical practice by clinical medical personnel.

METHODS: Based on the PRISMA (preferred reporting items for systematic reviews and meta-analyses) systematic literature review and integrated analysis method, a keyword search of related articles published before September 2023 was conducted in the following databases: PubMed, Cochrane Library, Embase, Web of Science, Airiti Library, Taiwan Master and Doctoral Dissertation System, Chinese Journal Full-text Database and Wanfang Data Knowledge Service Platform. In 2019, the second version of the Risk of Bias Tool for Randomized Controlled Trials was used to evaluate research quality, after which RevMan 5.4 and Stata 14.0 suite software were used for meta-analysis.

RESULTS: Nine of the 112 articles selected, including 10 sets of data and 597 participants, were included in the meta-analysis. The results indicate non-invasive acupoint therapy significantly reduces the degree of uremic pruritus (synthetic effect size = -1.30, 95% confidence interval [-1.67, -0.93], p < .00001). Because the heterogeneity test I² = 76%, showed a high degree of heterogeneity, a subgroup analysis was performed, showing that acupoint massage combined with traditional Chinese medicine fumigation and washing, a general simple itching assessment scale, and the Chinese region achieved better effect sizes.

CONCLUSIONS / IMPLICATIONS FOR PRACTICE: Non-invasive acupoint therapy is easy to implement, inexpensive, non-invasive, and associated with few side effects. The authors hope these findings may increase the awareness and understanding of patients with dialysis regarding the practical operation techniques of itching acupoints. According to the results of this systematic review and meta-analysis, massage of the lung and endocrine acupoints at ST-6, SP-10, and LI-11 as well as the relevant points on the ear may be most effective in achieving urinary itching relief. Also, acupoint massage combined with traditional Chinese medicine fumigation, ST-6 far-infrared irradiation, or LI11 transcutaneous acupoint electrical stimulation can further relieve uremic pruritus in this patient population. Based on the results, acupoint massage combined with traditional Chinese medicine fumigation and washing is a complementary method of treatment for uremic pruritus that may be recommended to patients in the future.

PMID:39084894 | DOI:10.6224/JN.202408_71(4).09


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