认知行为疗法对心血管疾病病人失眠疗效影响的Meta分析

Effect of cognitive behavioral therapy on insomnia in patients with cardiovascular disease:a Meta-analysis

目的:系统评价认知行为疗法(CBT)对心血管疾病病人失眠的疗效。方法:计算机检索PubMed、EMbase、Web of Science、the Cochrane Library、中国知网(CNKI)、维普数据(VIP)、万方数据库(WanFang Database)以及中国生物医学文献数据库(CBM)从各数据库建库至2021年7月发表的CBT治疗心血管疾病病人失眠的随机对照试验(RCT)。由2位研究员独立筛选文献、提取资料并对纳入研究进行质量评价。采用RevMan 5.3软件进行Meta分析。结果:最终纳入10项研究,涉及823例研究对象,其中干预组416例,对照组407例。Meta分析结果显示,与对照组相比,干预组降低心血管疾病合并失眠病人的失眠严重程度指数(ISI)[MD=-3.09,95%CI(-4.04,-2.14),P<0.00001]和匹兹堡睡眠质量指数(PSQI)[MD=-2.92,95%CI(-3.72,-2.12),P<0.00001]更有效果,差异均具有统计学意义。结论:现有证据表明,通过CBT干预可以改善心血管疾病合并失眠病人的睡眠状况。此结论需进一步在更多高质量研究中予以验证。

Objective:To systematically evaluate the effect of cognitive behavioral therapy(CBT)on insomnia in patients with cardiovascular disease.Methods:Randomized controlled trials(RCTs)of CBT for insomnia in patients with cardiovascular disease were retrieved from PubMed,EMbase,Web of Science,the Cochrane Library,CNKI,VIP,WanFang Database and CBM.The retrieval time was from the establishment of each database to the publication in July 2021.Two researchers independently screened literatures,extracted data and evaluated the quality of the included studies.RevMan 5.3 software was used for Meta-analysis.Results:A total of 10 studies were included,involving 823 subjects,416 in the intervention group and 407 in the control group.Meta-analysis results showed that compared with the control group,the insomnia severity Index(ISI)[MD=-3.09,95%CI(-4.04,-2.14),P<0.00001]and Pittsburgh Sleep Quality Index(PSQI)[MD=-2.92,95%CI(-3.72,-2.12),P<0.00001]in patients with cardiovascular disease complicated with insomnia were effectively reduced in the intervention group,and the differences were statistically significant.Conclusion:Existing evidence indicates that CBT can improve sleep in patients with cardiovascular disease and insomnia.This conclusion needs to be validated in more high-quality studies.