认知行为疗法对植入型心脏复律除颤器患者生活质量影响的Meta分析

摘要

Objective To quantitatively summarize the effect of anxiety,depression,physical and mental health in ICD (Implantable Cardioverter Defibrillator) patients who accept cognitive behavioral therapy (CBT),and evaluate its significance.Methods We performed a meta-analysis of randomized,placebo controlled trials with database search of the Medline,Embase,PubMed,Cochrane Central Register of Controlled Trials (CENTRAL),China biological medical literature database,China journal full text database on ICD(Implantable Cardioverter Defibrillator),cognitive behavioral therapy(CBT).Results 4 articles were included.The result shows that CBT were superior to usual care for improve anxiety of WMD-0.60 (95％ CI-1.12 to -0.08,P =0.02),but there was no significant differences between patients with CBT and usual care on their depression of WMD-0.18 (95 ％ CI-0.39 to 0.02,P =0.08),mental health of WMD-0.22 (95 ％ CI-0.68 to 0.25,P =0.36),and physical health of WMD-0.10 (95 ％ CI-0.80 to 0.60,P =0.78).Conclusion CBT can improve anxiety,but compared with the conventional cardiac care group,did not see obvious improvement in depressive symptoms and physical and mental health.%目的 系统评价认知行为疗法(CBT)对植入型心脏复律除颤器(ICD)患者焦虑、抑郁及身心健康的影响,评价其有效性.方法 计算机检索Medline、EMBASE、PubMed、Cochrane Central Register of Controlled Trials (CENTRAL)、中国生物医学文献数据库、中国期刊全文数据库、万方数据库中关于CBT对ICD患者干预治疗的随机对照试验(试验组进行认知行为疗法,对照组进行常规心脏护理治疗),同时筛检纳入的参考文献.对文献质量进行严格评价和资料提取,对符合质量标准的RCT进行Meta分析.结果 共纳入4篇文献504例患者,分析结果显示,与对照组相比,试验组患者焦虑评分的WMD为-0.60(95％CI-1.12～-0.08,P=0.02),抑郁评分的WMD为-0.18(95％ CI-0.39 ～0.02,P=0.08),心理健康评分的WMD为-0.22(95％ CI-0.68,0.25,P=0.36),身体健康评分的WMD为-0.10(95％ CI-0.80～0.60,P=0.78).结论 CBT可以改善ICD患者焦虑症状,但是与常规心脏护理相比,患者的抑郁症状及身心健康状况未见明显改善.