认知行为干预对炎症性肠病患者焦虑、抑郁及生活质量影响的Meta分析

Effects of cognitive-behavioral intervention on anxiety, depression and life quality in inflammatory bowel disease patients： a Meta analysis

目的探讨认知行为疗法对炎症性肠病患者焦虑、抑郁及生活质量的影响。方法对Cochrane Library、Pubmed、EMbase、CNKI、中国生物医学文献数据库（CBM）、万方数据资源系统进行检索，收集炎症性肠病认知行为干预的RCT研究，应用RevMan5．3软件进行统计分析。结果共纳入12项随机对照研究。结果显示，认知行为疗法能够提高患者生活质量[WMD=7．78，95％CI（3．30，12．27），P=0．0007]，在短期内（≤3个月）能够改善炎症性肠病患者的焦虑[SMD=-0．47，95％CI（-0．78，-0．16），P=0．01]、抑郁[SMD=-1．48，95％CI（-3．13，-1．83），P〈0．0001]，但长期（〉3个月）干预对焦虑和抑郁改善无统计学意义（P〉0．05）。结论本系统评价中，认知行为干预能够提高炎症性肠病患者的生活质量，短期内能够改善炎症性肠病患者的焦虑、抑郁，而长期效应尚不明确。

Objective To explore the effects of cognitive behavior therapy on anxiety, depression and life quality in inflammatory bowel disease （IBD）. Methods The Cochrane Library, Pubmed, EMbase, CNKI, China biological medicine （CBM）, WanFang were searched and the randomised controlled trials （RCTs） related to cognitive-behavioral intervention for IBD data was collected. The RevMan 5.3 was used in statistical analysis. Results A total of 12 RCTs were enrolled in the study. Results showed that cognitive behavior therapy could improve patients＇ life quality [ WMD=7.78, 95%CI（3.30, 12.27）, P=0.000 7 ], relieve anxiety [ SMD=-0.47, 95%CI（-0.78, -0.16）, P=0.01] and depression [ SMD=-2.48, 95%CI（-3.13, -1.83）, P 〈 0.000 1 ] of patients with IBD in the short term （less than or equal to three months）. However, there was no significant difference in improvement of anxiety and depression in the long-term （more than three months） （P〉0.05）. Conclusions In this systematic review, cognitive-behavioral intervention can improve life quality of patients with IBD and can relieve anxiety and depression of patients with IBD in the short term but with no effects in the long term.