简介:ObjectiveThisreviewaimedtosystematicallysummarizeandcriticallyevaluatetheclinicalevidencefororagainsttheeffectivenessofacupunctureasasymptomatictherapyforuremicpruritus(UP)inend-stagerenaldisease(ESRD)patients.Materialsandmethod:Wesearched16electronicdatabasesfromtheirinceptionstoNovember2009.Allprospectiveclinicalstudiesofneedleacupunctureforuremicpruritusinhemodialysispatientswithend-stagerenaldiseasewereincludedregardlessoftheirdesign.RiskofbiasoftheincludedstudieswereassessedusingtheCochranecriteria.ResultsOf464initiallylocatedarticles,458studieswereexcluded.Threerandomizedcontrolledtrials(RCTs),onenon-randomizedcontrolledtrial(CCT)andtwouncontrolledobservationalstudieswereincluded.InthreeRCTs,acupuncturewascomparedtosham-acupuncture(n=1),oralantihistamineplustopicalointment(n=1)andoralcalcitriol(n=1).InoneCCT,electroacupuncture(EA)wascomparedtosuperficialelectricalstimulation.Intwoobservationalstudies,EA(n=1)ormanualacupuncture(n=1)wereemployed.Fourof6includedstudiesmentionedmildornooccurrenceofadverseevents.Allofincludedtrialsreportedbeneficialeffectsofacupuncture.However,mostofthestudiesshowedhighriskofbias,whichleavetheirreportsunconvincing.ConclusionThecurrentevidenceisinsufficienttoshowthatacupunctureisaneffectivetreatmentforuremicpruritusinpatientswithend-stagerenaldiseaseduetosuboptimalqualityandlackofmethodologicalrigorofincludedstudies.Futuretrialsshouldovercomethelimitationsofthecurrentlyavailableevidence.