經皮電刺激對於增加血液透析患者唾液流量之成效

本研究目的在探討經皮電刺激對於增加血液透析患者唾液流量之效果，並進一步檢視減輕其口乾程度及降低二次透析間體重增加之成效。研究採用單盲、重複測量之類實驗研究設計，於南部某醫院之血液透析室收案，共計80人。並依照受試者每星期一、三、五或二、四、六之透析時間隨機分配為實驗組與對照組。實驗組於頰車穴(ST 6)及翳風穴(TE17)給予250µs、50Hz及強度設定為4級之經皮電刺激共持續20分鐘，每週3次，共持續3星期。而對照組則於相同的穴位，給予50µs、2Hz及強度設定為1級之低流量電刺激。兩組均於介入措施前、中、後及介入措施完成後1星期記錄唾液流量、口乾程度及2次透析間體重增加之情形。收集的資料以mixed-design, two-way ANOVA來檢測實驗組及對照組介入措施施行前後之唾液流量、口渴程度及2次透析間體重增加之差異。研究結果發現，250µs、50Hz之經皮電刺激能有效增加血液透析患者的唾液流量(P<.001)，同時減輕其口乾程度(P<.001)，但兩次透析間體重增加情形則未有改變。此結果可作為臨床提供血液透析患者增加唾液流量、改善口乾程度之有效措施。

關鍵字

唾液流量；經皮電刺激；血液透析

並列摘要

Aim. This paper reports a study to evaluate the impact of a TENS program for hemodialysis (HD) on patients’ dry mouth, salivary flow rates and interdialytic weight gain (IWG). Background. Low salivary flow rates and dry mouth are common among hemodialysis patients. Intervention programs are needed to address this problem. Method. A single blinded with repeated measures study design was used. A total of 80 subjects were enrolled in the study and randomly assigned to a treatment group and a control group. Patients in the treatment group received a 250µs; 50Hz TENS program at acupoints ST 6 and TE17 three times a week for 3 weeks, and Patients in the control group received a 50µs; 2Hz TENS program at same acupoints three times a week for 3 weeks. Weekly Salivary flow rate, dry mouth intensity and IWG were measured at baseline, during, after treatment completion and following one week after treatment completion for both groups. Results. There were significant increases in salivary flow rates (P<.001) and decreased dry mouth intensity (P<.001) in HD patients receiving the 250µs; 50Hz TENS program. However, significant improvement in thirst intensity scores was observed in the control TENS program. There were no differences in IWG for both groups. Conclusion. This study provides preliminary evidence that TENS may be effective in improving salivary flow rates and dry mouth intensity. Further studies are needed is evaluate whether this method can offer a long term effective non-pharmacological therapy for dry mouth-disturbed hemodialysis patients.