摘要
目的采用Meta分析的方法探讨心理干预对我国糖尿病患者焦虑抑郁症状及血糖控制的影响。方法计算机检索万方、维普、CNKI及中国生物医学等中文数据库,全面收集有关心理干预对糖尿病患者焦虑抑郁症状及血糖控制影响的临床对照试验,汇总数据采用RevMan5.1.6和Stata12.0进行分析,两组之间差异采用SMD或OR及其95%c,描述。结果根据纳入和排除标准最终纳入25个临床对照试验,包括2417例糖尿病患者,其中心理干预组1239例,对照组1178例。Meta分析结果表明:治疗前,心理干预组与对照组患者抑郁自评量表(SDS)评分和焦虑自评量表(SAS)评分差异均无统计学意义(P〉0.05);治疗后,两组之间SDS评分[SMD=-1.32,95%CI(-1.74,-0.90),P〈0.00001]和SAS评分[SMD=-1.06,95%CI(-1.62,-0.50),P=0.0002]差异均有统计学意义。此外,治疗后两组之间空腹血糖[sMD=-1.18,95%CI(-1.56,-0.81),P〈0.00001]、餐后2h血糖[SMD=-0.62,95%CI(-0.74,-0.50),P〈0.00001]及糖化血红蛋白水平[sMD=-1.35,95%c,(-2.02,-O.68),P〈0.0001]差异亦有统计学意义,而治疗前差异无统计学意义(P〉0.05)。结论现有证据表明,心理干预可有效地改善糖尿病患者的抑郁和焦虑症状,并可较好地控制血糖水平,显著降低空腹血糖、餐后2小时血糖及糖化血红蛋白水平。由于纳入研究质量及数量有限,本研究结论尚需大样本高质量临床研究进行证实。
Objective To investigate the effect of psychological intervention on depression symptoms and blood glucose level of patients with diabetes mellitus using meta - analysis. Methods Wan Fang, CNKI, VIP and CBM databases were searched for clinical controlled trials on effect of psychological intervention on depression symptoms and blood glucose level of pa- tients with diabetes mellitus. Data were analyzed with RevMan 5.1.6 and Stata 12. 0 softwares. Results were described as stand- ardized mean difference or odds ratio with 95% confidence intervals. Results A total of 25 clinical controlled trials involving 2 417 diabetes mellitus patients ( 1 239 in intervention group and 1 178 in control group) were included in this systematic review. Meta - analysis showed that significant difference of self - rating depression scale and self - rating anxiety scale scores between the two groups appeared after the intervention (P 〈 0. 05). Fasting plasma glucose, postprandial glucose, and HbAlo also became significantly different between the two groups after the intervention ( P 〈 0. 05 ) . Conclusion The present data suggest that psy- chological intervention may improve depression symptoms and have good blood glucose control for patients with diabetes mellitus. Further well - designed randomized controlled trials with large sample size are needed to confirm current conclusions.
出处
《中国全科医学》
CAS
CSCD
北大核心
2013年第4期436-439,共4页
Chinese General Practice
关键词
心理干预
糖尿病
焦虑
抑郁
临床对照研究
META分析
Psychological intervention
Diabetes mellitus
Anxiety
Depression
Clinical controlled trials
Meta - analysis