正念减压法对创伤后应激障碍患者干预效果的meta分析

摘要

Objective:To systematically examine the efficacy of mindfulness-based stress reduction (MBSR) for post-traumatic stress disorder (PTSD).Methods:A systematic literature search was performed in multiple databases,including Cochrane Library,Pubmed,MEDLINE,Embase,Web of Science,CBM,CNKI,WanFang Database.Paper inclusion criteria were confined to intervention trials of MBSR conducted in patients with PTSD.Revman5.3 and Stata12.0 was used to get pooled results.Results:A total of 8 studies were included,4 randomized controlled trials (including 255 patients with PTSD) and 4 self-controlled studies (including 152 patients with PTSD).Comparing to control groups,MBSR groups resulted in statistically significant improvements on symp toms of PTSD [SMD =-0.53,95 ％ CI(-0.87--0.19),P ＜ 0.05].The symptoms of PTSD after the intervention was improved [SMD =-1.95,95％ CI(-2.84--1.07),P ＜0.01].There was no statistically significant difference between the data of follow-up and post-intervention [SMD =-0.26,95％ CI(-0.77-0.26),P ＞0.05].Contusion:It suggests that the mindfulness-based stress reduction (MBSR) may be effective in reducing symptoms of post-traumatic stress disorder and have stable short-term effects.%目的:系统评价正念减压(MBSR)对创伤后应激障碍(PTSD)患者的干预效果.方法:计算机检索Cochrane Library、Pubmed、MEDLINE、Embase、Web of Science、中国生物医学文献服务系统(CBM)、中国学术期刊全文数据库(CNKI)、万方数据库中MBSR对PTSD患者干预效果的相关研究,包括随机对照研究和自身前后对照研究,由2名研究者对纳入研究的质量进行评价和资料提取,采用Rev-Man5.3和Stata12.0软件进行统计学分析.结果:最终纳入文献8篇,其中随机对照研究4篇(纳入患者255人),自身前后对照研究4篇(纳入患者152人).Meta分析结果显示,较常规干预措施,MBSR对患者PTSD症状有明显改善作用[SMD=-0.53,95％CI(-0.87～-0.19),P＜0.05];自身前后干预效果评价表明,干预后患者PTSD症状较干预前明显改善[SMD=-1.95,95％ CI(-2.84 ～-1.07),P＜0.01].患者干预后与随访过程中PTSD症状无明显变化[SMD=-0.26,95％ CI(-0.77 ～0.26),P＞0.05].结论:正念减压能有效改善患者创伤后应激障碍,且干预效果比较稳定.