Acupressure for sleep disorders, fatigue, depression and pruritus in hemodialysis patients: A systematic review and meta-analysis

Abstract

Abstract Background To evaluate the efficacy and safety of acupressure in treating sleep disorders, fatigue, depression and pruritus in hemodialysis patients and to provide evidence for clinical treatment. Methods The China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, Chinese Biomedical Literature Database, PubMed, Web of Science, EMBASE and Cochrane Library databases were searched to screen randomized controlled trials of acupressure for sleep disorders, fatigue, depression and pruritus in hemodialysis patients. The search time frame was all from the establishment of the database to November 2022. RevMan 5.3 software was used for Meta-analysis. Results A total of 14 papers involving 1150 patients were included. Meta-analysis results showed that acupressure was superior to the control group in improving sleep disorders [MD=-4.06, 95% CI (-4.59, -3.54), Z=15.17 (p<0.00001)], fatigue [MD=-1.39, 95% CI (-1.57, -1.21), Z=14.87 (p<0.00001) 1.57, -1.21), Z=14.87 (p<0.00001)], depression [MD=-7.24, 95% CI (-9.88, -4.59), Z=5.35 (p<0.00001)] and pruritus [MD=-2.94, 95% CI (-5.04, -0.85), Z=2.75 (p=0.006)]. No severe adverse event was reported during the acupressure intervention. Conclusions Current evidence suggests that acupressure is effective and safe in treating sleep disorders, fatigue, depression, and pruritus in hemodialysis patients. However, the number of included clinical studies is small and the strength of evidence is insufficient, more high-quality, large-sample, multicenter randomized clinical trials are still needed for further validation.