正念减压法对创伤后应激障碍患者干预效果的meta分析

A meta-analysis of mindfulness-based stress reduction for improving symptoms of post-traumatic stress disorder

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RevMan5.3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。

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 symptoms 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]. Conclusion： 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.