Liverpool Reviews and Implementation Group, University of Liverpool, Brownlow Hill, Liverpool, UK.
J Hypertens. 2010 Apr;28(4):644-52. doi: 10.1097/HJH.0b013e3283370e20.
To assess the evidence for the long-term effectiveness of biofeedback for the treatment of essential hypertension in adults.
A systematic review following accepted international guidelines was conducted. Randomized controlled trials that compared biofeedback procedures with antihypertensive medication, placebo (sham biofeedback treatment), no intervention or other behavioural treatments were included. The outcome measure was change in blood pressure.
The inclusion criteria were fulfilled by 36 trials. Twenty-one trials employed biofeedback treatment with no adjunctive therapy, whereas 15 others used biofeedback treatment alongside another treatment. The majority of trials were small with no posttreatment follow-up or follow-up of less than 6 months. Qualitative heterogeneity of the included studies (e.g. poor quality of the trials, differences in interventions and inconsistencies in the measurement of outcomes) meant that it was inappropriate to pool data in the form of a meta-analysis. A narrative summary of the data based on trial authors' conclusions is presented. No studies reported long-term (>12 months) follow-up of patients. Data were grouped first by treatment type and then by comparator. Trial results were variable and conflicting, demonstrating no clear benefits of biofeedback in relation to moderation of hypertension.
Although there may be other reported life benefits to its use, we found no convincing evidence that consistently demonstrates the effectiveness of the use of any particular biofeedback treatment in the control of essential hypertension when compared with pharmacotherapy, placebo, no intervention or other behavioural therapies. Any future research needs to be conducted using accepted quality standards and given current guidelines for the treatment of hypertension is likely to be considered only as an adjunct to pharmacological treatment.
评估生物反馈治疗成人原发性高血压的长期疗效的证据。
按照国际公认的指南进行了系统评价。纳入了将生物反馈程序与降压药物、安慰剂（假生物反馈治疗）、无干预或其他行为治疗进行比较的随机对照试验。结局测量为血压变化。
有 36 项试验符合纳入标准。21 项试验采用了无附加治疗的生物反馈治疗，而其他 15 项试验则将生物反馈治疗与另一种治疗联合使用。大多数试验规模较小，没有治疗后随访或随访时间少于 6 个月。纳入研究的定性异质性（例如试验质量差、干预措施的差异以及结局测量的不一致性）意味着不适合以荟萃分析的形式汇总数据。根据试验作者的结论，对数据进行了叙述性总结。没有研究报告对患者进行长期（>12 个月）随访。数据首先按治疗类型分组，然后按比较器分组。试验结果各不相同且相互矛盾，表明生物反馈在控制高血压方面没有明显的益处。
尽管生物反馈可能还有其他被报道的生活益处，但我们没有发现令人信服的证据表明，与药物治疗、安慰剂、无干预或其他行为治疗相比，使用任何特定的生物反馈治疗方法在控制原发性高血压方面始终有效。任何未来的研究都需要使用公认的质量标准进行，并考虑到当前的高血压治疗指南，可能仅将其视为药物治疗的辅助手段。
