背景:口渴是许多患者的常见症状,尤其是慢性心力衰竭(CHF)和/或接受血液透析(HD)的患者。由于药物治疗不可行,需要采用非药物治疗策略来减轻口渴和口渴相关负担.
目的:确定旨在减少CHF和/或HD患者口渴的非药物干预措施,为了描述干预组件,并评估这些干预措施的有效性。
方法:2024年2月,我们通过PubMed在MEDLINE中完成了系统搜索,Livivo,CINAHL,Cochrane图书馆和WebofScience。两名审稿人独立筛选标题,摘要,和全文,进行关键评估和数据提取。我们使用JoannaBriggs研究所的检查表和Cochrane偏差风险工具检查了偏差风险,并使用固定效应模型计算了足够同质研究的荟萃分析。
结果:我们纳入了15项干预研究,这些研究应用了包括口香糖在内的非药物干预措施(n=8),低钠饮食(n=2),指压(n=1),冷冻草莓(n=1),流体时间表(n=1),冰块和漱口水(n=1),和心理干预(n=1)。样本量在11至88名参与者之间变化。11项干预研究显示了减少口渴作为干预效果。使用视觉模拟量表(IV:-2,32[-10.37,5.73];p=0.57)或透析口渴清单(IV:-0.26[-1.83,1.30];p=0.74),口香糖的荟萃分析对口渴没有显着影响。研究质量中等到较低。
结论:结果表明,各种非药物干预措施可能有助于减少CHF或HD患者的口渴,但重要的不确定性仍然存在。
BACKGROUND: Thirst is a frequent and burdening symptom in many patients, especially in patients with chronic heart failure (CHF) and/or receiving hemodialysis (HD). As drug therapies are not feasible, non-pharmacological strategies are needed to reduce thirst and thirst-related burden.
OBJECTIVE: To identify non-pharmacological interventions aiming to reduce thirst in patients with CHF and/ or HD, to describe intervention components, and to evaluate the effectiveness of these interventions.
METHODS: In February 2024, we completed a systematic search in MEDLINE via PubMed, Livivo, CINAHL, Cochrane Library and Web of Science. Two reviewers independently screened titles, abstracts, and full texts, performed critical appraisal and data extraction. We checked risk of bias with the checklists of the Joanna Briggs Institute and the Cochrane Risk of Bias tool and calculated meta-analyses for sufficiently homogeneous studies using fixed-effects models.
RESULTS: We included 15 intervention studies applying non-pharmacological interventions including chewing gum (n = 8), low-sodium diet (n = 2), acupressure (n = 1), frozen strawberries (n = 1), fluid timetables (n = 1), ice cubes and mouthwash (n = 1), and a psychological intervention (n = 1). Sample sizes varied between 11 and 88 participants. Eleven intervention studies showed a reduction of thirst as intervention effect. Meta-analyses for chewing gum showed no significant effect on thirst using a visual analogue scale (IV: -2,32 [-10.37,5.73]; p = 0.57) or the dialysis thirst inventory (IV: -0.26 [- 1.83, 1.30]; p = 0.74). Quality of studies was moderate to low.
CONCLUSIONS: Results indicate that various non-pharmacological interventions could be helpful to reduce thirst in patients with CHF or HD, but important uncertainty remains.