正念疗法对冠心病病人干预效果的Meta分析

摘要

Objective:To systematically evaluate the intervention effect of mindfulness therapy on patients with coronary heart disease. Methods:By Meta analysis method and PubMed,Cochrane,Web of Science,EBSCO,Embase,CNKI,Wan Fang and other Chinese English database,clinical randomized controlled trials on mindfulness therapy in patients with coronary heart disease were collected, the quality of the literatures was evaluated and the data were extracted,and the data were analyzed by RevMan5.3 software.Results:A total of 9 randomized controlled trials (RCT)were included for a total of 809 patients.The results of Meta analysis showed that compared with the conventional nursing measures,mindfulness therapy could alleviate the anxiety mood of patients[MD=-5.87, 95%CI(-9.62,-2.12),P=0.002]and depressive mood[MD=-1.93,95%CI(-3.62,-0.23),P=0.03]and reduce the per-ceived stress of patients[MD=-7.63,95%CI(-14.52,-0.74),P =0.03].In lowering blood pressure,subgroup analysis showed that compared with control group,mindfulness therapy could reduce systolic blood pressure[MD=-10.24,95%CI(-12.88,-7.59), P<0.000 01],while diastolic blood pressure had no significant difference compared with control group(P>0.05).Conclusions:Mind-fulness therapy could improve patients'anxiety and depression mood,relieve perceived pressure of patients with coronary heart disease and stabilize blood pressure and reduce systolic blood pressure,but had no significant effect on diastolic blood pressure.%[目的]系统评价正念疗法对冠心病病人干预效果的影响.[方法]采用 Meta 分析方法,通过 PubMed、Cochrane 图书馆、Web of Science、EBSCO、Embase、CNKI、万方等多个中英文数据库,收集正念疗法对冠心病病人相关研究的临床随机对照试验,进行文献质量评价并从中提取数据,采用 RevMan5.3软件进行数据分析.[结果]共纳入9篇随机对照试验(RCT)研究,合计809例病人.Meta分析结果显示,与常规护理措施相比,正念疗法能够缓解病人焦虑情绪[MD=-5.87,95%CI(-9.62,-2.12),P=0.002]和抑郁情绪[MD=-1.93,95%CI(-3.62,-0.23),P=0.03],减轻病人的知觉压力[MD=-7.63,95%CI(-14.52,-0.74),P=0.03].在降低血压方面,亚组分析的结果显示,与对照组比较,正念疗法能够降低收缩压[MD=-10.24,95%CI(-12.88,-7.59),P<0.00001],而舒张压与对照组比较,差异无统计学意义(P>0.05).[结论]正念疗法能够改善病人焦虑、抑郁情绪,减轻冠心病病人的知觉压力,同时能够稳定血压水平,降低收缩压,但对舒张压无明显改善作用.