穴位按壓應用在血液透析病人合併不寧腿症候群之文獻回顧

在台灣，血液透析（HD）病人有不寧腿症候群（RLS）的盛行率是12.6%∼25.3%。RLS會造成HD病人身心困擾。藥物治療雖然可以改善其症狀嚴重度，但常會出現副作用、症狀反彈或疾病增強。非藥物治療，如氣動壓縮、近紅外光治療、震動治療、運動訓練、按摩、針刺等方式，對緩解RLS症狀嚴重度有其效果，但皆有其限制。對於長期HD併有RLS的病人而言，因為合併使用多種藥物，以及免疫功能和凝血功能皆下降，因此，選擇非侵入性、方便又有效的治療方法，是很重要的。本篇以文獻回顧探討穴位按壓應用在HD病人有RLS症狀嚴重度之成效，由CINAHL、MELINE、PubMed及Airiti Library華藝線上圖書館等電子資料庫搜尋至2022年1月發表之所有研究，關鍵字包括不寧腿症候群（restless legs syndrome）、血液透析（Hemodialysis）、針刺（acupuncture）、穴位按壓（acupressure）。最後3篇隨機實驗控制設計的研究納入本文。結果顯示穴位按壓是一種非侵入性治療、經濟有效、沒有合併症，而且容易學習、不需要有醫囑，護理人員或病人（家屬）可以執行的措施。期望透過本文可做為臨床護理人員與血液透析病人提供緩解RLS症狀方案的參考。

關鍵字

血液透析；不寧腿症候群；穴位按壓

並列摘要

The prevalence of restless legs syndrome (RLS) in hemodialysis (HD) patients was 12.6% -25.3% in Taiwan. RLS can affect the physical and mental distress of HD patients. Although drug therapy can improve the severity of symptoms in RLS, side effects, rebound, or augmentation are common with drug use. Non-drug treatments, such as pneumatic compression, near-infrared light, vibration therapy, exercise training, massage, acupuncture etc., are effective in relieving the severity of RLS symptoms, but all have their limitations. For long-term HD patients with RLS, the selection of non-invasive, convenient and effective treatment methods is an important issue because the patients use a variety of drugs, and the immune function and coagulation function decline. The purpose of this literature review was to elucidate the effects acupressure in hemodialysis patients with restless legs syndrome. Search to January 2022, in the database including CINAHL、MELINE、PubMed and Airiti Library, by the keyword search restless legs syndrome, hemodialysis, acupuncture and acupressure, total three randomized controlled studies were in the review. The results showed acupressure is a non-invasive treatment, cost-effective, free of complication, and easy to learn, does not require medical advice, and can be performed by nurse or patients (family members). Therefore, we expect to provide clinical nurses and hemodialysis patients methods for improve the severity of symptoms in RLS.

並列關鍵字

hemodialysis ； restless legs syndrome (RLS) ； acupressure

參考文獻

陳麗麗、林君黛(2015)•穴位按壓與實證護理•護理雜誌，62(6)，27-34。[Chen, L. L. & Lin, J. D. (2015). Acupressure and evidence-based nursing. The Journal Of Nursing, 62(6), 27-34.] https://doi.org/10.6224/jn.62.6.27。

Aliasgharpour, M., Abbasi, Z., Pedram Razi, S., & Kazemnezhad, A. (2016). The effect of stretching exercises on severity of restless legs syndrome in patients on hemodialysis. Asian Journal Of Sports Medicine, 7(2), e31001-e31001. https://doi.org/10.5812/asjsm.31001。

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Giannaki, C. D., Hadjigavriel, M., Lazarou, A., Michael, A., Damianou, L., Atmatzidis, E., Stefanidis, I., Hadjigeorgiou, G. M., Sakkas, G. K., & Pantzaris, M. (2017). Restless legs syndrome is contributing to fatigue and low quality of life levels in hemodialysis patients. World Journal Of Nephrology, 6(5), 236-242. https://doi.org/10.5527/wjn.v6.i5.236。

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