Roberts Leanne, Ahmed Irshad, Hall Steve, Davison Andrew
Hertford College, Catte Street, Oxford, UK, OX1 3BW.
Cochrane Database Syst Rev. 2009 Apr 15;2009(2):CD000368. doi: 10.1002/14651858.CD000368.pub3.
Prayer is amongst the oldest and most widespread interventions used with the intention of alleviating illness and promoting good health. Given the significance of this response to illness for a large proportion of the world's population, there has been considerable interest in recent years in measuring the efficacy of intercessory prayer for the alleviation of ill health in a scientifically rigorous fashion. The question of whether this may contribute towards proving or disproving the existence of God is a philosophical question lying outside the scope of this review of the effects of prayer. This revised version of the review has been prepared in response to feedback and to reflect new methods in the conduct and presentation of Cochrane reviews.
To review the effects of intercessory prayer as an additional intervention for people with health problems already receiving routine health care.
We systematically searched ten relevant databases including MEDLINE and EMBASE (June 2007).
We included any randomised trial comparing personal, focused, committed and organised intercessory prayer with those interceding holding some belief that they are praying to God or a god versus any other intervention. This prayer could be offered on behalf of anyone with health problems.
We extracted data independently and analysed it on an intention to treat basis, where possible. We calculated, for binary data, the fixed-effect relative risk (RR), their 95% confidence intervals (CI), and the number needed to treat or harm (NNT or NNH).
Ten studies are included in this updated review (7646 patients). For the comparison of intercessory prayer plus standard care versus standard care alone, overall there was no clear effect of intercessory prayer on death, with the effect not reaching statistical significance and data being heterogeneous (6 RCTs, n=6784, random-effects RR 0.77 CI 0.51 to 1.16, I(2) 83%). For general clinical state there was also no significant difference between groups (5 RCTs, n=2705, RR intermediate or bad outcome 0.98 CI 0.86 to 1.11). Four studies found no effect for re-admission to Coronary Care Unit (4 RCTs, n=2644, RR 1.00 CI 0.77 to 1.30).Two other trials found intercessory prayer had no effect on re-hospitalisation (2 RCTs, n=1155, RR 0.93 CI 0.71 to 1.22).
AUTHORS' CONCLUSIONS: These findings are equivocal and, although some of the results of individual studies suggest a positive effect of intercessory prayer,the majority do not and the evidence does not support a recommendation either in favour or against the use of intercessory prayer. We are not convinced that further trials of this intervention should be undertaken and would prefer to see any resources available for such a trial used to investigate other questions in health care.
祈祷是最古老且应用最广泛的干预措施之一,旨在减轻病痛、促进健康。鉴于世界上很大一部分人口对这种应对疾病的方式极为重视,近年来人们对以科学严谨的方式衡量代祷减轻健康问题的功效产生了浓厚兴趣。祈祷是否有助于证明或证伪上帝的存在,这是一个哲学问题,不在本祈祷效果综述的讨论范围内。本综述的修订版是根据反馈意见编写的,以反映Cochrane综述在开展和呈现方面的新方法。
评估代祷作为对已接受常规医疗保健的健康问题患者的额外干预措施的效果。
我们系统检索了包括MEDLINE和EMBASE在内的10个相关数据库(2007年6月)。
我们纳入了任何将个人、针对性、虔诚且有组织的代祷与那些相信自己在向上帝或神灵祈祷的代祷者进行比较的随机试验,与任何其他干预措施相对照。这种祈祷可以代表任何有健康问题的人进行。
我们独立提取数据,并尽可能基于意向性分析进行分析。对于二元数据,我们计算了固定效应相对风险(RR)、其95%置信区间(CI)以及治疗所需人数或伤害所需人数(NNT或NNH)。
本更新综述纳入了10项研究(7646名患者)。对于代祷加标准护理与单独标准护理的比较,总体而言代祷对死亡没有明显影响,效果未达到统计学显著性且数据存在异质性(6项随机对照试验,n = 6784,随机效应RR 0.77,CI 0.51至1.16,I² 83%)。对于一般临床状态,两组之间也没有显著差异(5项随机对照试验,n = 2705,RR中度或不良结局0.98,CI 0.86至1.11)。4项研究发现代祷对再次入住冠心病监护病房没有影响(4项随机对照试验,n = 2644,RR 1.00,CI 0.77至1.30)。另外两项试验发现代祷对再次住院没有影响(2项随机对照试验,n = 1155,RR 0.93,CI 0.71至1.22)。
这些结果并不明确,尽管个别研究的一些结果表明代祷有积极作用,但大多数研究并非如此,且证据不支持赞成或反对使用代祷的建议。我们不相信应该进行这种干预措施的进一步试验,更希望看到可用于此类试验的任何资源用于研究医疗保健中的其他问题。