非药物性干预对化疗期病人睡眠质量影响的网状Meta分析

Effect of non⁃drug intervention on sleep quality in patients during chemotherapy:a network Meta⁃analysis

[目的]系统评价非药物性干预对化疗期病人睡眠质量的影响。[方法]计算机检索the Cochrane Library、PubMed、Web of Science、EMbase、中国期刊全文数据库、万方医学数据库、中国生物医学文献数据库、维普数据库中关于非药物性干预方法对化疗期病人睡眠质量影响的随机对照试验,检索时限均为建库至2019年1月31日。由2名研究者独立进行文献筛选、提取数据,采用R 3.5.0软件GeMET程序包、ADDIS 1.16.5及Stata 13.0软件进行网状Meta分析。[结果]共纳入20项随机对照试验,共计2601例病人。网状Meta分析结果显示,除运动疗法外,正念疗法、放松训练、音乐疗法、书写表达、认知行为疗法的应用对化疗期病人睡眠质量的干预效果与常规护理相比,差异均有统计学意义(P<0.05)。直观评估排序概率图下面积排序结果显示:6种非药物性干预方法中,书写表达有效提升化疗期病人睡眠质量的可能性最大,放松训练次之,运动疗法最小。[结论]现有证据表明:书写表达可能是改善化疗期病人睡眠质量的最优非药物性干预方法,但其适用性还应进一步验证。

Objective:To systematically evaluate the effect of non-drug intervention on sleep quality in patients during chemotherapy.Methods:Randomized controlled trials about the effect of non-drug intervention on sleep quality in patients during chemotherapy were retrieved from the Cochrane Library,PubMed,Web of Science,Embase,China national knowledge infrastructure,Wanfang medical database,China biology medicine disc,VIP database for Chinese technical periodical.The retrieval time was from inception to January 31,2019.Literature screening and data extraction were carried out independently by two researchers.GeMET package of R 3.5.0 software,ADDIS 1.16.5 and Stata 13.0 software were used for network Meta⁃analysis.Results:A total of 20 randomized controlled trials were included,involving 2601 patients.Network Meta⁃analysis showed that excluding exercise therapy,the application of mindfulness therapy,relaxation training,music therapy,written expression,and cognitive behavior therapy all had statistically significant differences from routine nursing in effect on sleep quality in patients during chemotherapy(P<0.05).Ranked results of area under the visual assessment ranking probability graph showed that among the six non⁃drug intervention methods,written expression had the greatest possibility for improving sleep quality of patients during chemotherapy,followed by relaxation training,and exercise therapy had least possibility.Conclusions:Current evidence showed that writing expression may be the best non⁃drug intervention method to improve sleep quality in patients during chemotherapy,but its applicability should be further verified.