生物反馈治疗对失眠症患者主客观睡眠质量疗效的Meta分析

Efficacy of biofeedback treatment on subjective and objective sleep quality of patients with insomnia：a meta -analysis

目的：综合评价生物反馈治疗对失眠症患者主客观睡眠质量的干预疗效。方法计算机检索MEDLINE、EMbase、Cochrane Library、万方数据库、维普中文期刊数据库（VIP）、中国生物医学文献数据库（CBM ）、中国期刊网（CNKI），检索年限为1980-2014年。纳入的研究符合：（1）随机对照研究；（2）研究对象为失眠症患者；（3）干预措施为生物反馈治疗；（4）效应指标：主观睡眠质量采用匹兹堡睡眠质量指数量表（PSQI）评估，客观睡眠质量采用多导睡眠图（PSG）评估。Meta分析使用 Review Manager 5．0软件完成。结果共纳入7项随机对照研究，以PSQI评分为效应指标的Meta分析显示MD值为－3．32（95％ CI ：－6．05，－0．59），实验组和对照组之间差异有统计学意义（Z ＝2．38，P ＜0.05）。实验组总睡眠时间、睡眠效率、REM 睡眠期时间高于对照组，差异有统计学意义（Z值分别为4.49、3．77、7．37，P均＜0．01），觉醒次数和睡眠潜伏期低于对照组，差异有统计学意义（Z值分别为4.48、3．61，P均＜0．01），REM潜伏期与对照组相比差异无统计学意义（Z＝1．23，P＝0．22）。敏感性分析显示高质量研究和低质量研究结果均与基础分析结果一致。结论生物反馈治疗对失眠症患者主客观睡眠质量都有明显的改善作用。

Objective To evaluate biofeedback therapy effect on subjective and objective sleep quality of patients with insomnia .Methods We searched all literatures from 1980 to 2014 using MED‐LINE ,EMbase , Cochrane Library , Wan Fang databases , VIP database , China Biology Medicine （CBM） ,China National Knowledge Infrastructure（CNKI） .The literatures meet the following requirements ：（1）Randomized controlled studies ;（2）Research subjects ：patients with insomnia;（3）Intervention measures ：biofeedback therapy ;（4）Effect index ：Using Pittsburgh sleep quality index （PSQI） for subjective sleep quality evaluation and polysomnography （PSG） for objective sleep quality evaluation .Using Review Manager 5 .0 software to complete a meta-analysis .Results Seven randomized controlled trials were selected .The result of meta-analysis showed that the MD value of PSQI score was -3 .32 （95%CI ：-6 .05 ,-0 .59） ,there was significant difference between the experimental group and the control group （Z= 2 .38 ,P 〈 0 .05） .Total sleep time、sleep efficiency、REM sleep time of experimental group were higher than that in control group ,the difference had statistically significance （Z = 4 .49 ,3 .77 , 7.37 ,P 〈 0 .01） ,the number of awake and the time of sleep latency were lower than that in control group ,the difference had statistically significance （Z= 4 .48 ,3 .61 ,P〈 0 .01） ,the time of REM latency had no statistically significance （Z= 1 .23 ,P= 0 .22）compared with control group .The results of high quality research and low quality research were consistent with the basic analysis .Conclusions Biofeed‐back therapy can remarkably improve subjective and objective sleep quality of patients with insomnia .