正念减压疗法在乳腺癌患者中应用效果的Meta分析

Meta-analysis of the effect of mindfulness-based stress reduction therapy in breast cancer patients

目的评价正念减压疗法在乳腺癌患者中的应用效果。方法检索Cochrane Library、PubMed、EMbase、中国生物医学文献数据库、中国知网全文数据库、维普数据库和万方数据库等,收集符合纳入标准的随机对照研究,采用Rev Man 5.3软件进行统计分析。结果最终纳入10项随机对照试验,共1 517例患者。Meta分析显示,正念减压疗法较常规护理缓解了患者的焦虑[SMD=-0.24,95%CI(-0.36,-0.12),P<0.01]、抑郁[SMD=-0.37,95%CI(-0.49,-0.24),P<0.01]及疲乏[SMD=-0.80,95%CI(-1.45,-0.14),P=0.02],提高了生活质量[SMD=0.99,95%CI(0.06,1.92),P=0.04]。然而正念减压疗法在改善患者压力、复发恐惧感及睡眠方面无明显作用(P>0.05)。结论正念减压疗法缓解乳腺癌患者的焦虑及抑郁情绪,改善疲乏症状,提高患者的生活质量;而在压力、复发恐惧感及睡眠等方面的结果并不理想,尚需进行深入研究及验证。

Objective To evaluate the effect of mindfulness-based stress reduction （MBSR）therapy in breast cancer patients. Methods To retrieve the Cochrane Library,PubMed,EMbase,China Biology Medicine disc,VIP,CNKI and Wangfang Database,collect randomized controlled trials （RCTs） that meet inclusion criteria,using RevMan 5.3 software for statistical analysis. Results A total of 10 RCTs involving 1 517 patients were included.Meta-analysis showed that MBSR significantly induce anxiety[SMD=-0.24,95%CI（-0.36,-0.12）, P 〈0.01],depression[SMD=-0.37,95%CI（-0.49,-0.24）, P 〈0.01] and fatigue[SMD=-0.80,95%CI （-1.45,-0.14）, P =0.02],and improve quality of life [SMD=0.99,95%CI （0.06,1.92）, P =0.04] compared with conventional nursing.However,MBSR had no significant effect on improving patient stress,recurrence fear and sleep （ P 〉0.05）. Conclusion MBSR relieves anxiety,depression and fatigue,enhances quality of life in breast cancer patients,but results in stress, recurrence fear and sleep are not ideal.In-depth research and verification is required.