正念减压疗法对慢性疼痛患者干预效果的Meta分析

The intervention effectiveness of Mindfulness-Based Stress Reduction for patients with chronic pain: a Meta-analysis

目的 :评价正念减压疗法对慢性疼痛患者的干预效果。方法 :系统检索Pub Med、Cochrane Library、Medline complete、CINAHL、中国生物医学文献数据库、中国知网、万方及维普数据库中正念减压疗法对慢性疼痛患者干预效果的随机对照实验,对符合质量标准的随机对照实验采用Rev Man 5.3软件进行Meta分析。结果 :共纳入9篇文献,960例患者。Meta分析结果显示,正念减压疗法组与对照组干预后及干预后6个月的疼痛强度[SMD=-0.27,95%CI(-0.39,-0.14),P<0.01][SMD=-0.35,95%CI(-0.52,-0.18),P<0.01]、干预后焦虑水平[SMD=-0.46,95%CI(-0.69,-0.22),P<0.01]及干预后生活质量[SMD=0.29,95%CI(0.12,0.47),P<0.01]的改善差异有统计学意义,但对于抑郁情绪及干预后6个月焦虑水平的疗效两组差异并不显著。结论 :正念减压疗法能有效缓解患者疼痛症状、短期内减轻焦虑情绪及改善生活质量,但对于改善抑郁情绪及长期效果仍需开展更多研究予以验证。

Objective： To evaluate the intervention effectiveness of Mindfulness-Based Stress Reduction （MBSR） for patients with chronic pain. Methods： We performed a systematic search in PubMed, Cochrane Library, Medline complete, CINAHL, CBMdisc （China Biology Medicine disc）, CNKI （China National Knowledge Infrastructure）, Wan Fang Data, and VIP （China Science and Technology Journal Database） to collect Randomized Controlled Trails （RCTs） about the effectiveness of MBSR for patients with chronic pain. Meta-analysis was conducted using RevMan 5.3 software for eligible RCTs. Results： Totally 9 studies were retrieved and 960 patients were included. The Meta-analysis results showed that the improvement of pain intensity after intervention [SMD=-0.27, 95%CI（-0.39, -0.14）, P〈0.01] and after 6-month intervention [SMD=-0.35, 95%CI （-0.52, -0.18）, P〈0.01], anxiety level [SMD=-0.46, 95%CI （-0.69, -0.22）, P〈0.01] and quality of life [SMD=0.29, 95%CI （0.12, 0.47）, P〈0.01] after intervention had statistical significance. But the difference of depression and anxiety after 6-month intervention between the two groups were not statistically significant. Conclusion： The present evidences show that the MBSR can improve the pain intensity, anxiety level and quality of life for patients with chronic pain during a short period, but the effectiveness of depression and long-term effects still needs further studies to verify.