虚拟现实暴露疗法对创伤后应激障碍的疗效:系统评价和Meta分析

Efficacy of Virtual Reality Exposure Therapy for Post-traumatic Stress Disorder:a Systematic Review and Meta-analysis

目的:对虚拟现实暴露疗法(virtual reality exposure therapy,VRET)治疗创伤后应激障碍(posttraumatic stress disorder,PTSD)的有效性进行系统回顾和Meta分析。方法:计算机检索PubMed、Science Direct、Embase和Medline数据库从1995年至2022年2月21日的相关文献,搜索VRET治疗PTSD的临床随机对照试验,由2位研究者独立对文献进行资料提取和质量评价后,使用RevMan 5.4和Stata16软件进行Meta分析。结果:发现VRET治疗PTSD疗效的研究12项(478例),大多数VRET研究的质量较低,结果参差不齐。Meta分析显示,与对照组相比,VRET治疗组患者PTSD症状明显缓解[SMD=-0.45,95%CI(-0.84,-0.06)]。之后进行2次亚组分析,以分析其异质性来源。结论:VRET可以有效缓解PTSD症状。VRET治疗方法优于等待对照组,与其他治疗方法效果相当。结合多模态运动辅助VRET技术作为改良后的治疗方法应得到关注,并需要更多的被试来验证其治疗PTSD的效果。

Objective:To conduct a systematic review and Meta-analysis of the effectiveness of virtual reality exposure therapy(VRET)in the treatment of posttraumatic stress disorder(PTSD).Methods:Computerized searches of PubMed,Science Direct,Embase and Medline databases were conducted for relevant literature from 1995 to February 21,2022.Clinical randomized controlled trials of VRET for the treatment of PTSD were searched.Two researchers independently extracted data and evaluated the quality of the literature.Meta-analysis was performed using RevMan 5.4 and Stata16 software.Results:Twelve studies(478 cases)on the efficacy of VRET for PTSD were found.Most VRET studies were of a low quality and had heterogeneous results.Me-taanalysis showed that compared with the control group,patients in the VRET treatment group had significantly reduced symptoms of PTSD[SMD=-0.45,95%CI(-0.84,-0.06)].Two subgroup analyses were then conduct-ed to analyze the sources of heterogeneity.Conclusion:VRET can effectively alleviate PTSD symptoms.VRET treatment is superior to waitlist control groups and is equivalent to other treatments.Multi-modular Mo-tion-Assisted VRET technology as an improved treatment method deserves attention,and more participants are needed to verify its effectiveness in treating PTSD.