认知行为疗法对肺癌患者焦虑、抑郁及生活质量干预效果的meta分析

Effects of cognitive behavioral therapy on anxiety,depression,and quality of life in patients with lung cancer:a meta-analysis

目的探讨认知行为疗法(cognitive behavioral therapy,CBT)对肺癌患者焦虑、抑郁及生活质量的干预效果。方法检索Web of Science、PubMed、Embase、CINAHL、MEDLINE、中国知网、万方、维普数据库,检索时限为建库至2023年4月1日。按照纳入、排除标准筛选CBT干预肺癌患者的相关文献,并进行文献质量评价,使用RevMan 5.4软件进行meta分析。结果纳入9篇文献,共800例肺癌患者。CBT可以改善肺癌患者的焦虑[标准化均数差(SMD)=-0.80;95%CI-0.97~-0.63;P<0.00001]及抑郁(SMD=-1.25;95%CI-1.99~-0.52;P=0.0008),提高生活质量(SMD=0.89;95%CI 0.62~1.16;P<0.00001)。结论现有证据表明,CBT可以改善肺癌患者的焦虑、抑郁,提高生活质量,但现有研究存在发表偏倚、异质性高、质量较低等问题,还需要开展多中心、大样本、同质化的高质量研究,进一步探讨CBT对肺癌患者焦虑、抑郁及生活质量的干预效果。

Objective To investigate the effects of cognitive behavioral therapy(CBT)on anxiety,depression,and quality of life in patients with lung cancer.Methods The databases such as Web of Science,PubMed,Embase,CINAHL,MEDLINE,CNKI,Wanfang,and VIP were searched until April 1,2023.Literatures related to CBT intervention in lung cancer patients were screened according to the inclusion and exclusion criteria,the literature quality was evaluated,and meta-analysis was performed using RevMan 5.4 software.Results A total of 9 studies were included,involving 800 patients with lung cancer.CBT improved the anxiety[SMD=-0.80,95%CI(-0.97,-0.63),P<0.00001],depression[SMD=-1.25,95%CI(-1.99,-0.52),P=0.0008],and quality of life[SMD=0.89,95%CI(0.62,1.16),P<0.00001]in lung cancer patients.Conclusions Existing evidences show that CBT can improve the anxiety,depression,and quality of life in lung cancer patients,but existing studies have problems of publication bias,high heterogeneity,and low quality.It is necessary to conduct high-quality,multi-center,and large-sample homogenization studies to further explore the intervention effects of CBT on anxiety,depression,and quality of life in lung cancer patients.