心理干预对国内脑卒中后抑郁预防效果的Meta分析

Effectiveness of psychological intervention on prevention of post-stroke depression in Chinese: A Meta analysis

目的通过Meta分析评价心理干预对国内脑卒中患者发生抑郁的预防效果。方法检索PubMed、Cochrane Library、中国生物医学数据库(CBM)、中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方科技期刊全文数据库的随机对照试验,检索时间从2001年1月至2018年6月。按照纳入和排除标准筛选文献并进行质量评价,从中提取数据。采用RevMan5.3软件进行Meta分析。结果共纳入12篇随机对照试验,合计1351例患者。Meta分析结果显示:心理干预组相对于对照组,不仅能够降低抑郁的评分和发生率,还能够缓解患者的焦虑情绪。对抑郁的预防效果根据不同的干预周期进行亚组分析,干预周期为1个月、6周、6个月,干预组均优于对照组;根据不同的心理干预方法进行亚组分析,采用支持性心理疗法和认知行为疗法联合与采用一般心理干预方法的结果均优于对照组。结论心理干预对国内脑卒中患者抑郁的发生有一定的预防作用,但仍需要更多的大样本RCT研究来进一步证明心理干预的最佳周期、频率和方法,建议对于卒中患者及早进行心理干预等非药物预防。

Objective To evaluate the preventive effect of psychological intervention on depression in stroke patients in China by Meta-analysis. Methods The randomized controlled trials were collected in PubMed,the Cochrane Library,CBM,CNKI,VIP and Wanfang Database,retrieval time limit from January 2000 to June 2018.According to the inclusion and exclusion criteria,the literature was screened and the quality was evaluated to extract the data.Meta-analysis was carried out with RevMan5.3 software. Results A total of 1351 patients were enrolled in 12 randomized controlled trials.The results of Meta-analysis showed that the psychological intervention group could not only reduce the score and incidence of depression,but also alleviate the anxiety of the patients compared with the control group.According to different intervention cycles,1 month,6 weeks and 6 months cycle conducted better preventive effects than control group;According to the subgroup analysis of different psychological intervention methods,the results of the combination of supportive psychotherapy and cognitive behavioral therapy and general psychological intervention were more effective than those of the control group. Conclusion Psychological intervention has certain effect on prevention of post-stroke depression in Chinese.It is suggested that non-drug prevention such as psychological intervention should be carried out as early as possible for stroke patients.