School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama.
School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama.
J Card Fail. 2018 Mar;24(3):186-201. doi: 10.1016/j.cardfail.2017.09.008. Epub 2017 Sep 20.
The effects of mind-body interventions (MBIs) (eg, Tai Chi, yoga, meditation) for individuals with heart failure (HF) have not been systematically evaluated.
We performed a systematic review of randomized controlled trials (RCTs) examining the effects of MBIs in HF. We extracted participant characteristics, MBI procedure, outcomes assessed, and main results of English-language RCTs before October 2016. We identified 24 RCTs (n = 1314 participants) of 9 MBI types: Tai Chi (n = 7), yoga (n = 4), relaxation (n = 4), meditation (n = 2), acupuncture (n = 2), biofeedback (n = 2), stress management (n = 1), Pilates (n = 1), and reflexology (n = 1). Most (n = 22, 95.8%) reported small-to-moderate improvements in quality of life (14/14 studies), exercise capacity (8/9 studies), depression (5/5 studies), anxiety and fatigue (4/4 studies), blood pressure (3/5 studies), heart rate (5/6 studies), heart rate variability (7/9 studies), and B-type natriuretic peptide (3/4 studies). Studies ranged from 4 minutes to 26 weeks and group sizes ranged from 8 to 65 patients per study arm.
Although wide variability exists in the types and delivery, RCTs of MBIs have demonstrated small-to-moderate positive effects on HF patients' objective and subjective outcomes. Future research should examine the mechanisms by which different MBIs exert their effects.
针对心力衰竭(HF)患者的身心干预(MBI)(如太极、瑜伽、冥想)的效果尚未得到系统评估。
我们对 2016 年 10 月前发表的评估 MBI 对 HF 影响的随机对照试验(RCT)进行了系统评价。我们提取了参与者特征、MBI 程序、评估的结果以及英语 RCT 的主要结果。共纳入 24 项 RCT(n=1314 名参与者),涉及 9 种 MBI 类型:太极(n=7)、瑜伽(n=4)、放松(n=4)、冥想(n=2)、针灸(n=2)、生物反馈(n=2)、应激管理(n=1)、普拉提(n=1)和反射疗法(n=1)。大多数(n=22,95.8%)报告生活质量(14/14 项研究)、运动能力(8/9 项研究)、抑郁(5/5 项研究)、焦虑和疲劳(4/4 项研究)、血压(3/5 项研究)、心率(5/6 项研究)、心率变异性(7/9 项研究)和 B 型利钠肽(3/4 项研究)有小到中度改善。研究持续时间从 4 分钟到 26 周,每组人数从 8 到 65 名患者不等。
尽管 MBI 的类型和实施存在很大差异,但 MBI 的 RCT 已经证明对 HF 患者的客观和主观结果有小到中度的积极影响。未来的研究应探讨不同 MBI 发挥作用的机制。