多囊卵巢综合征患者焦虑、抑郁筛查及管理的最佳证据总结

Best evidence for screening and management of anxiety and depression in patients with polycystic ovary syndrome

目的检索并总结多囊卵巢综合征(PCOS)患者焦虑、抑郁筛查及管理的相关证据。方法按照“6S”金字塔模型,利用计算机检索Up To Date、BMJ Best Practice、JBI循证卫生保健中心数据库、美国国家指南库(NGC)、国际指南网(GIN)、英国国家临床优化研究所(NICE)、苏格兰院际指南网(SIGN)、加拿大安大略注册护士协会网(RNAO)、美国妇产科医师学会网(ACOG)、英国皇家妇产科医师学会网(RCOG)、医脉通、物理治疗证据数据库(PEDro)、PubMed、Web of Science、Cochrane Library、Embase、护理文献累积索引数据库(CINAHL)、中国生物医学文献数据库、中国知网、万方数据库中关于PCOS患者焦虑、抑郁筛查及管理的临床决策、指南、专家共识、证据总结、系统评价及随机对照试验,检索时间自建库至2022年4月30日。根据纳入标准遴选文献,由2名研究者对纳入文献进行质量评价及证据提取。结果本研究共纳入22篇文献,包括指南5篇,专家共识2篇,立场声明1篇,系统评价4篇,随机对照试验10篇。从初步筛查、综合评估、药物治疗及注意事项、生活方式干预、中医治疗、心理及社会支持、信息支持7个方面总结了26条最佳证据,包括A级推荐(强烈推荐)级别20条和B级推荐6条。结论PCOS患者焦虑、抑郁筛查及管理的最佳证据可指导临床医护人员以科学的方法规范、精准地管理患者的焦虑、抑郁情绪,进而提高其生活质量水平。

Objective:To search and summarize the relevant evidence for screening and management of anxiety and depression in patients with polycystic ovary syndrome(PCOS),and to provide practical basis for clinical practice.Methods:According to the“6S”pyramid model,the related of clinical decision-making,guidance,expert consensus,evidence summary,systematic reviews and randomized controlled trial on screening and management of anxiety and depression in PCOS patients were searched by computer from Up To Date,BMJ Best Practice,JBI Evidence-based Health Care Center Database,National Guidelines Library(NGC),International Guidelines Network(GIN),National Institute for Clinical Excellence(NICE),Scottish Inter Academy Guidelines Network(SIGN),Ontario Registered Nurses Association Network(RNAO),American College of Obstetricians and Gynecologists(ACOG),Royal College of Obstetricians and Gynecologists(RCOG),Yimaitong Physical Therapy Evidence Database(PEDro),PubMed,Web of Science,Cochrane Library,Embase,Nursing Literature Cumulative Index Database(CINAHL),China Biomedical Literature Database,CNKI,Wanfang Database from the database established to April 30,2022.Two researchers evaluated the quality of the included literature and extracted evidence.Results:Twenty-two references were included in this study,including 5 guides,2 expert consensus,1 position statement,4 systematic reviews,and 10 randomized controlled trials.Twenty-six best evidences were summarized from seven aspects of preliminary screening,comprehensive evaluation,drug treatment and precautions,lifestyle intervention,traditional Chinese medicine treatment,psychological and social support,and information support,including 20 A-level recommendations(highly recommended)and 6 B-level recommendations.Conclusions:The best evidence for screening and management of anxiety and depression in PCOS patients can guide clinical doctors and nurses to manage anxiety and depression of patients in a scientific,standardized and accurate way,thereby improving their quality of life.