双心模式治疗冠心病合并失眠的Meta分析

A Meta-analysis of psychocardiology mode in the treatment of coronary heart disease complicated with insomnia

目的应用Meta分析探讨双心模式治疗冠心病合并失眠的疗效。方法在中国知网、维普数据库、万方数据库、中国生物医学文献数据库、PubMed、Embase、the Cochrane Library检索获得符合本研究纳入、排除标准的中、英文公开发表文献,时间限定为建库至2022年4月,应用RevMan 5.4.1软件进行Meta分析,从失眠和冠心病方面的指标评价双心模式治疗冠心病合并失眠的效果。结果纳入的随机对照试验共21个,涉及2272例患者,其中12篇文献质量相对较高。Meta分析结果显示:在失眠方面,干预组(双心模式治疗)匹兹堡睡眠质量指数(PSQI)评分[MD=-3.55,95%CI(-4.17,-2.93),P<0.05]低于对照组;干预组睡眠质量优良率[OR=4.38,95%CI(2.86,6.72),P<0.05]和失眠疗效有效率[OR=3.70,95%CI(1.70,8.05),P<0.05]均高于对照组;在冠心病方面,干预组心绞痛发作频率[MD=-3.47,95%CI(-4.18,-2.76),P<0.05]和心绞痛持续时间[MD=-3.07,95%CI(-3.86,-2.27),P<0.05]均少/短于对照组;干预组心肌肌钙蛋白I水平[MD=-0.13,95%CI(-0.18,-0.09),P<0.05]和心血管不良件事件发生率[OR=0.18,95%CI(0.10,0.33),P<0.05]均低于对照组。结论接受双心模式治疗的冠心病合并失眠患者在失眠和冠心病方面的改善程度均优于接受常规冠心病治疗的患者。

Objective To investigate the efficacy of psychocardiology mode in the treatment of coronary heart disease complicated with insomnia using Meta-analysis.Method Published articles in Chinese and English meeting the inclusion and exclusion criteria of this study were retrieved from CNKI,VIP Database,Wanfang Database,China Biomedical Literature Database,PubMed,Embase,and the Cochrane Library from the database establishment to April 2022,and the RevMan 5.4.1 software was used for a Meta-analysis which aimed to evaluate the efficacy of psychocardiology mode in the treatment of coronary heart disease complicated with insomnia according to indexes of both insomnia and coronary heart disease.Results A total of 21 randomized controlled trials involving 2272 patients were included,of which 12 articles were of relatively high quality.The Meta-analysis results showed that in terms of insomnia,the intervention group(psychocardiology mode treatment)had a lower Pittsburgh Sleep Quality Index(PSQI)score(MD=-3.55,95%CI[-4.17,-2.93],P<0.05),a higher excellent and good rate of sleep quality(OR=4.38,95%CI[2.86,6.72],P<0.05),and a higher effective rate in treating insomnia(OR=3.70,95%CI[1.70,8.05],P<0.05)than the control group;in terms of coronary heart disease,the intervention group had lower frequency of angina pectoris attack(MD=-3.47,95%CI[-4.18,-2.76],P<0.05),shorter angina pectoris duration(MD=-3.07,95%CI[-3.86,-2.27],P<0.05),and decreased cardiac troponin I level(MD=-0.13,95%CI[-0.18,-0.09],P<0.05)and incidence of cardiovascular adverse events(OR=0.18,95%CI[0.10,0.33],P<0.05)than the control group.Conclusion Patients with coronary heart disease and insomnia who have received psychocardiology mode therapy have better improvements in both insomnia and coronary heart disease than those who have received conventional coronary heart disease treatment.