认知行为疗法对改善糖尿病患者抑郁及血糖的Meta分析

Effectiveness of cognitive behavioral therapy on depression and glycemic control in patients with diabetes mellitus:a Meta-analysis

目的评价认知行为疗法改善糖尿病患者抑郁症状及血糖控制的效果。方法计算机检索中英文数据库有关认知行为疗法治疗糖尿病患者抑郁症状及血糖控制的随机对照试验,按照纳入和排除标准进行文献质量评价后,采用RevMan5.3软件进行数据分析。结果最终纳入11项研究,共计1 279例患者,Meta分析结果显示:认知行为疗法可改善糖尿病患者的抑郁症状,缓解患者的相关情绪困扰,减轻患者的焦虑情绪(均P<0.01)。然而,认知行为疗法在糖尿病患者的血糖控制,提高其自我效能、心理健康和生活质量方面无明显效果(均P>0.05)。结论认知行为疗法能够改善糖尿病患者的抑郁症状、缓解相关情绪困扰和焦虑情绪;但对于改善糖尿病患者的血糖控制,提高其自我效能、心理健康和生活质量方面无明显作用。

Objective To evaluate the efficacy of cognitive behavior therapy（CBT）on depressive symptoms and glycemic control in patients with diabetes mellitus.Methods Randomized clinical trials（RCTs）regarding the effect of CBT on depression and glycemic control in patients with diabetes mellitus were retrieved in electronic databases.RevMan5.3 software was used to analyze the data after assessing the quality of included studies according to the inclusion and exclusion criteria.Results Eleven studies involving 1 279 patients were included.The results of Meta-analysis supported the effectiveness of CBT on alleviating depressive symptoms,emotional distress and anxiety（P〈0.01 for all）.However,CBT had no significant effect on improving glycemic control,self-efficacy,mental health and quality of life（P〉0.05 for all）.Conclusion CBT could relieve depressive symptoms,emotional distress and anxiety of diabetic patients,however,its effects on improving glycemic control,self-efficacy,mental health and quality of life are not obvious.