中医情志护理对脑卒中患者焦虑、抑郁情绪干预效果的Meta分析

Intervention effect of TCM emotional nursing on the anxiety and depression of patients with stroke:a Meta-analysis

目的系统评价中医情志护理对脑卒中患者焦虑、抑郁情绪的干预效果,为临床应用提供证据支持。方法计算机检索中英文数据库CNKI、CBM、万方医学网、PubMed、Embase、Web of Science、Cochrane library关于中医情志护理干预脑卒中患者焦虑、抑郁情绪的随机对照试验,各库检索时间均为建库至2020年5月10日。通过对文献进行筛选、资料提取及质量评价后,利用RevMan 5.3进行Meta分析。结果最终纳入13篇文献,包括1210例脑卒中患者,其中干预组605例,对照组605例。Meta分析结果显示,干预结束时,中医情志护理干预组抑郁水平低于对照组,差异有统计学意义:抑郁自评量表(SDS)评分(MD=-7.89,95%CI:-13.14^-2.64,P<0.01),汉密尔顿抑郁量表(HAMD)评分(MD=-4.70,95%CI:-8.48^-0.92,P<0.05);而焦虑评分方面,中医情志护理干预组焦虑自评量表(SAS)评分低于对照组(MD=-6.65,95%CI:-9.24^-4.06,P<0.01),差异有统计学意义,中医情志护理干预组汉密尔顿焦虑量表(HAMA)评分低于对照组(MD=-2.06,95%CI:-4.14~0.02,P=0.05),差异无统计学意义。结论中医情志护理可能有助于降低脑卒中患者抑郁水平,但对脑卒中患者焦虑水平的改善效果尚不明确。

Objective To systematically review the intervention effect of TCM(Traditional Chinese Medicine)emotional nursing on the anxiety and depression of stroke patients,so as to provide a basis for clinical application.Methods Chinese and English databases including CNKI,CBM,Wanfang,PubMed,Embase,Web of Science and Cochrane library were searched via computer for randomized controlled trials on intervention effect of TCM emotional nursing on the anxiety and depression of stroke patients from the database establishment date to May 10th,2020.After screening literature,extracting data and evaluating the quality of literature,Meta-analysiswascarriedoutusingRevMan 5.3software.Results Finally,1210strokepatientsin 13randomizedcontrolled trials were enrolled,including 605 individuals in intervention group and 605 individuals in control group.Meta-analysis showed that the post-intervention Self-rating Depression Scale(SDS)(MD=-7.89,95%CI:-13.14^-2.64,P<0.01)and Hamilton Depression Scale(HAMD)(MD=-4.70,95%CI:-8.48^-0.92,P<0.05)scores of intervention group were lower than those of control group,with significant difference.The post-intervention Self-rating Anxiety Scale(SAS)score(MD=-6.65,95%CI:-9.24^-4.06,P<0.01)was lower in intervention group than in control group,with statistic difference.Hamilton Anxiety Scale(HAMA)score(MD=-2.06,95%CI:-4.14~0.02,P=0.05)of intervention group was lower than that of control group,while the difference was not statistic.Conclusion TCM emotional nursing may alleviate the depression status of stroke patients,but its long term effect on anxiety symptoms of stroke patients remains unclear and requires further studies.