| ObjectiveFatigue is one of the common complications of maintenance hemodialysis patients,which seriously affects the quality of life of hemodialysis patients and is also an independent predictor of cardiovascular events and all-cause death events in this population.However,it does not address the issue.In recent years,scholars have made some researches on fatigue of maintenance hemodialysis patients,but there is still a lack of unified understanding on the pathogenesis and treatment of dialysis fatigue.In this study,the fatigue in Guangdong Provincial Hospital of Traditional Chinese Medicine were understood through the revised Piper Fatigue Scale,and then the effects of acupoint massage therapy on fatigue symptoms and sleep disorders of hemodialysis patients were explored,also the effect of characteristic therapy technology of traditional Chinese medicine on symptom management of maintenance hemodialysis patients was brought into play.MethodsFirstly,a cross-sectional study was conducted to understand the fatigue of hemodialysis maintenance hemodialysis patients in Guangdong Provincial Hospital of Traditional Chinese Medicine through the revised Piper Fatigue Scale,and basic clinical information and data such as primary disease,age,gender,dialysis age,related complications(including anemia,hypercalcemia,secondary hyperparathyroidism,sleep disorder)and other basic clinical information were collected.Secondly,60 maintenance hemodialysis patients who met the inclusion criteria and exclusion criteria were randomly divided into control group and observation group according to simple randomization method.All participants agreed to point massage therapy.The control group did not receive acupoint massage.After dialysis,they were rested in bed for 15 minutes and recovered by themselves.The observation group selected bilateral Zusanli,Sanyinjiao,Taixi,Yongquan,Neiguan(upper limb opposite to internal fistula)acupuncture points according to the pathogenesis of fatigue and clinical experience,and massaged 100 times per acupuncture point.According to the location of point by body,the patient' s self-complaint of soreness,numbness,swelling and other manifestations indicate that the point selection is in place,and the pressure degree is suitable for the patient's tolerance.The simple fatigue scale(BFI)was used to evaluate the fatigue level 15minutes before the completion of each dialysis and the treatment was carried out.After the treatment,the patients stayed in bed for 15 min and was re-evaluated when leaving the dialysis room.The treatment lasted for 4 weeks.The Pittsburgh Sleep Quality Score(Pittsburgh Sleep Quality Index,PSQI)was evaluated before and at the end of the intervention.After the data are imported into SPSS19.0 database,the imported data are checked to ensure that the data are correct.After the inspection,SPSS19.0 statistical software was used for statistical analysis.ResultsThe cross-sectional survey results of this study was to survey total teacher road institute of guangdong hospital of hemodialysis center 180 maintenance hemodialysis patients,a total of 137 patients with dialysis correlation between fatigue,accounting for 76.1%.Among them,the occurrence of fatigue after dialysis patients 123 cases,accounting for 89.8%of all patients with fatigue,in the crowd,31 patients with mild fatigue,accounted for 22.6%;101 patients with moderate fatigue,accounting for 73.7%;5 patients with severe fatigue,accounting for 3.7%.Influencing factors show that dialysis related fatigue is related to marital status,and the risk of fatigue in unmarried patients is 0.236 times that of married patients.The intervention group and control group in patients with social demographic information such as:gender,education level,marital status,the primary disease,payment method,working condition,dialysis fixed number of year;Degree of fatigue,such as:RPFS rating scale of each dimension(behavior dimension,emotional dimension,sensory dimension,cognitive dimension)score,RPFS total score;Sleep the PSQI score,two groups of baseline comparison(P>0.05,no statistically significant differences between the two groups.The observation group and control group before and after the intervention revision Piper fatigue rating scale of comparison.(1)the observation group before and after the intervention RPFS rating scale of each dimension score,score and 12 times before and after treatment of BFI each score comparison,P values are less than 0.05,the difference was statistically significant.(2)The scores of each dimension,total score and PSQI of RPFS scoring scale in the control group were compared before and after the intervention.Among them,the differences of the scores of each dimension and RPFS total score in RPFS scoring scale were statistically significant.Non-parametric tests were used for each BFI score before and after 12 treatments.The results showed that the P value of each BFI score before and after the 1st to 5th,7th to 10th and 12th treatments was less than 0.05,and the difference was statistically significant.Compared with PSQI score,BFI score before and after the 6th and 11th treatment,the P value is greater than 0.05,and the difference is not statistically significant.(3)Before and after the intervention,the observation group and the control group were compared in each dimension score,RPFS total score and BFI average score,among which the behavior dimension,emotional dimension,sensory dimension,cognitive dimension,RPFS total score and BFI average score were compared between the two groups,P value was less than 0.05,the difference between the two groups was statistically significant.The observation group and control group before and after the intervention of Pittsburgh sleep quality score(PSQI).(1)the observation group of PSQI score comparison before and after the intervention,t=10.657,P<0.05,differences between the two groups have statistical significance.(2)in the control group before and after the intervention PSQI score comparison,t=1.790,P=0.084,there was no statistically significant difference in both groups.(3)comparison between the two groups,P<0.05,differences between the two groups have statistical significance.The comparison of two groups of laboratory indexes before and after the intervention.Observation group and control group before and after the intervention of KT/V,blood urea nitrogen,serum creatinine,blood hemoglobin,serum calcium,serum phosphorus,parathyroid hormone,albumin,serum potassium,P values were greater than 0.05,there was no statistically significant difference.Comparison between observation group and control group before and after the intervention group,P values were greater than 0.05,the difference between the two groups has no statistical significance.ConclusionThe incidence of fatigue symptoms of hemodialysis patients is more than 70%.Acupoint massage can improve the mild and moderate fatigue symptoms of maintenance hemodialysis patients,especially the behavioral dimension,emotional dimension and cognitive dimension.Meanwhile,acupoint massage can alleviate the sleep disorders of patients. |
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