Krasnik Catherine, Montori Victor M, Guyatt Gordon H, Heels-Ansdell Diane, Busse Jason W
Department of Medical Science, Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada.
Am J Obstet Gynecol. 2005 Sep;193(3 Pt 1):658-61. doi: 10.1016/j.ajog.2005.01.055.
This systematic review summarizes the evidence from randomized clinical trials of bright light therapy for treatment of premenstrual dysphoric disorder.
The authors performed a systematic review and meta-analysis of randomized clinical trials. They searched MEDLINE, AMED, CINAHL, Digital Dissertations, EMBASE, and the Cochrane Central Register of Controlled Trials. The main outcome measure was the change in depressive symptom scores as measured by the Hamilton Depression Rating Scale and the Beck Depression Inventory.
Four crossover trials studying a total of 55 participants met inclusion criteria. Three trials showed similar results; one fully unblinded trial showed a much larger effect. The pooled effect size from the random-effects model of the 3 higher quality trials was -0.20 (95% CI -0.48 to 0.07).
The small size of trials and correspondingly wide confidence limits, and methodologic limitations of the trials, leaves the impact of bright light therapy for relief of premenstrual depressive symptoms uncertain. The current evidence justifies neither enthusiastic dissemination nor confident rejection of this therapeutic modality.
本系统评价总结了关于亮光疗法治疗经前烦躁障碍的随机临床试验证据。
作者对随机临床试验进行了系统评价和荟萃分析。他们检索了MEDLINE、AMED、CINAHL、学位论文数据库、EMBASE以及Cochrane对照试验中央注册库。主要结局指标是通过汉密尔顿抑郁量表和贝克抑郁量表测量的抑郁症状评分变化。
四项交叉试验共纳入55名参与者，符合纳入标准。三项试验结果相似；一项完全非盲法试验显示效果大得多。三项高质量试验的随机效应模型合并效应量为-0.20（95%CI -0.48至0.07）。
试验规模小且相应的置信区间宽，以及试验的方法学局限性，使得亮光疗法缓解经前抑郁症状的效果尚不确定。目前的证据既不支持积极推广也不支持坚决拒绝这种治疗方式。
