心衰竭患者接受限鈉飲食對減輕體液滯留症狀和提升生活品質的效果

The Effect of Sodium-Restricted Diet on Alleviating Fluid Retention Symptoms and Improving Quality of Life among Heart Failure Patients

心衰竭是全球性的健康問題，臨床醫護人員為了穩定患者的心臟功能，減輕體液滯留症狀對生活品質的衝擊，經常建議患者限鈉飲食，故瞭解目前實證文獻對於心衰竭限鈉飲食減輕體液滯留症狀與提升生活品質的情況，有利提供臨床照護指引參考。本文採用實證步驟，搜尋2019年1月到2024年至今（8月）期間的中、英文資料庫，最後獲得4篇文獻（2篇為系統性文獻回顧，2篇為臨床隨機試驗），以Joanna Briggs Institute（JBI）評析工具進行評析。
雖然這些文章，傾向於限鈉飲食未能減輕體液滯留症狀（體重, N terminal fragment of type B natriuretic peptide），且對生活品質的效果未有一致性的結果，研究結果的不一致，有可能來自於研究品質的干擾。現有部分文獻顯示，限鈉飲食對減輕心衰竭患者的體液滯留症狀和改善生活品質有些效果，若想要改變傳統的介入措施，需要謹慎面對，應依賴更多的實證研究來驗證。
基於對相關文獻的評析，目前在此領域進行研究時面臨的主要挑戰，包括樣本流失、限鈉飲食遵從性、鈉攝取量的精確測量以及干擾因素的控制等。此外患者的鈉排泄差異也可能影響研究結果的解釋。未來的研究應進一步探討這些問題，以產生更多的實證資料，從而為臨床照護提供更有力的支持。

Heart failure was a global health issue, and clinical healthcare providers often recommended sodium-restricted diets to stabilize patients' cardiac function and alleviate the impact of fluid retention symptoms on quality of life. Understanding the existing evidence regarding the effects of sodium restriction on alleviating fluid retention symptoms and improving quality of life in heart failure patients provided valuable guidance for clinical care. This paper employed an evidence-based approach, searching Chinese and English databases for literature published from January 2019 to August 2024. A total of four studies were identified (two systematic reviews and two randomized controlled trials) and were appraised using the Joanna Briggs Institute (JBI) appraisal tool.
Although these articles tended to suggest that sodium-restricted diets did not alleviate symptoms of fluid retention (such as body weight and N terminal fragment of type B natriuretic peptide), and the effects on quality of life were inconclusive, this paper suggested that the inconsistency in research results may have been influenced by the quality of the studies. Some existing literature indicated that sodium-restricted diets could have alleviated fluid retention symptoms and improved quality of life among heart failure patients. Nevertheless, this paper argued that any attempt to change traditional intervention should have been approached cautiously and relied on more robust evidence-based research for validation.
Based on the analysis of relevant literature, the primary challenges faced in research in this field included sample attrition, adherence to sodium-restricted diets, accurate measurement of sodium intake, and controlling for confounding factors. Additionally, variations in patients' sodium excretion may have also affected the interpretation of research results. Future studies should have further investigated these issues to generate more robust empirical data, thereby providing stronger support for clinical care.