Efficacy of auricular acupressure in maintenance haemodialysis patients: A systematic review and meta-analysis.

Abstract

OBJECTIVES\nTo systematically evaluate the efficacy of auricular acupressure on sleep disorders, depression, pruritus, xerostomia and daily net weight gain (%) in maintenance haemodialysispatients.\n\n\nBACKGROUND\nAuricular acupressure has been used for various complications in maintenance haemodialysispatients patients, such as sleep disorders, depression, pruritus and xerostomia, but the efficacy has not yet been unified.\n\n\nDESIGN\nSystematic review and meta-analysis.\n\n\nMETHODS\nRandomised controlled trials comparing Auricular acupressure intervention with non-AA intervention in maintenance haemodialysispatients patients were included. We searched English databases (PubMed, Cochrane Library, Embase, Web of Science) and Chinese databases (CNKI, WanFang, CBM and VIP database) from the inception to 27\xa0November 2020. The risk of bias was assessed by the Cochrane risk of bias tool. The RevMan 5.3\xa0software was used to perform the meta-analysis. A descriptive analysis was conducted if the data were high of heterogeneity or could not be meta-analysed. The PRISMA statement was used to report systematic review and meta-analysis.\n\n\nRESULTS\nA total of 12 RCTs with 805\xa0MHD patients were included. Meta-analysis showed that auricular acupressure had a significant difference for improving sleep disorders (MD\xa0=\xa0-1.97 points, 95% CI: -2.62 to -1.32, p\xa0<\xa0.0001), pruritus (MD\xa0=\xa0-1.55 points, 95% CI: -2.01 to -1.08, p\xa0<\xa0.0001), and daily net weight gain (%) (MD\xa0=\xa0-0.29, 95% CI: -0.37 to -0.21, p\xa0<\xa0.0001). The efficacy of depression and xerostomia were analysed descriptively due to insufficient data.\n\n\nCONCLUSIONS\nThe meta-analysis results indicated that auricular acupressure had a positive efficacy in maintenance haemodialysispatients patients to improve sleep disorders, pruritus and daily net weight gain (%). But the results should be treated conservatively on account of the low quality of included studies. Future researchers need to conduct more high-quality, large sample, multi-centre randomised controlled studies to provide a solid basis to demonstrate of the efficacy of auricular acupressure in maintenance haemodialysispatients patients.\n\n\nRELEVANCE TO CLINICAL PRACTICE\nAuricular acupressure has the advantages of low cost, non-invasive and easy to be accepted by patients. This review suggested that auricular acupressure could be considered a non-pharmacological intervention for maintenance haemodialysispatients patients. Medical staff could teach maintenance haemodialysispatients patients auricular acupressure to help them self-manage some complications at home.