以患者为中心的认知行为疗法对心血管代谢综合征患者进行生活方式干预的效果：一项随机对照试验。
Effects of lifestyle intervention using patient-centered cognitive behavioral therapy among patients with cardio-metabolic syndrome: a randomized, controlled trial.
作者信息
Zhang Ying, Mei Songli, Yang Rui, Chen Ling, Gao Hang, Li Li
机构信息
Department of Children and Adolescent Health Care, School of Public Health, Jilin University, #1163 Xinmin Street, Changchun, 130021, People's Republic of China.
Department of Education, The First Affiliated Hospital, Jinzhou Medical University, Jinzhou, China.
出版信息
BMC Cardiovasc Disord. 2016 Nov 18;16(1):227. doi: 10.1186/s12872-016-0398-9.
BACKGROUND
Cardio-metabolic syndrome (CMS) is a highly prevalent condition. There is an urgent need to identify effective and integrated multi-disciplinary approaches that can reduce risk factors for CMS.
METHODS
Sixty-two patients with a history of CMS were randomized 1:1 into two groups: a standard information -only group (control), or a self-regulated lifestyle waist circumference (patient-centered cognitive behavioral therapy) intervention group. A pretest and posttest, controlled, experimental design was used. Outcomes were measured at the baseline (week 0) and at the end of intervention (week 12). Comparisons were drawn between groups and over time.
RESULTS
The mean (standard deviation) age of the subjects was 48.6 (5.8) years ranging from 32 to 63, and 56.9% of the participants were female. Both groups showed no significant differences in Demographic variables and the metabolic syndrome indicators at baseline. While the control group only showed modest improvement after 12 weeks, compared to baseline, the intervention group demonstrated significant improvement from baseline. This study controlled for patients' demographics and baseline characteristics when assessing the effects of intervention. After adjusting for age, education and baseline level, the experimental group and the control group were statistically significant different in the following post-treatment outcomes: WC (F = 35.96, P < 0.001), TG (F = 18.93, P < 0.001), RSBP (F = 33.89, P < 0.001) and SF-36(F = 157.93, P < 0.001). The results showed patients' age and education were not strong predictors of patients' outcome (including WC, TG, RSBP and SF-36).
CONCLUSIONS
Lifestyle intervention on patient-centered cognitive behavioral therapy can improve the physical and mental health conditions among individuals reporting a history of cardio-metabolic syndrome, and possibly provided preliminary benefits for the treatment of CMS.
TRIAL REGISTRATION
Chinese Clinical Trial Register #, ChiCTR15006148 .
背景
心血管代谢综合征（CMS）是一种高度流行的病症。迫切需要确定有效的综合多学科方法，以降低CMS的风险因素。
方法
62例有CMS病史的患者按1:1随机分为两组：仅提供标准信息的组（对照组），或自我调节生活方式腰围（以患者为中心的认知行为疗法）干预组。采用前测和后测、对照、实验设计。在基线（第0周）和干预结束时（第12周）测量结果。对组间和随时间变化进行比较。
结果
受试者的平均（标准差）年龄为48.6（5.8）岁，范围为32至63岁，56.9%的参与者为女性。两组在基线时的人口统计学变量和代谢综合征指标无显著差异。虽然对照组在12周后仅显示出适度改善，但与基线相比，干预组显示出从基线开始的显著改善。本研究在评估干预效果时对患者的人口统计学和基线特征进行了控制。在调整年龄、教育程度和基线水平后，实验组和对照组在以下治疗后结果上有统计学显著差异：腰围（F = 35.96，P < 0.001）、甘油三酯（F = 18.93，P < 0.001）、静息收缩压（F = 33.89，P < 0.001）和SF-36（F = 157.93，P < 0.001）。结果表明，患者的年龄和教育程度不是患者预后（包括腰围、甘油三酯、静息收缩压和SF-36）的强预测因素。
结论
以患者为中心的认知行为疗法的生活方式干预可以改善有心血管代谢综合征病史个体的身心健康状况，并可能为CMS的治疗提供初步益处。
试验注册
中国临床试验注册中心编号，ChiCTR15006148 。
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