Unit for Psychooncology and Health Psychology, Department of Psychology and Behavioral Sciences, Aarhus University, Denmark.
Biobehavioral Oncology Program, Hillman Cancer Center; Departments of: Psychiatry, Psychology, Behavioral & Community Health Sciences, and Health & Community Systems, University of Pittsburgh, Pittsburgh, PA, USA.
Brain Behav Immun. 2018 Nov;74:68-78. doi: 10.1016/j.bbi.2018.04.005. Epub 2018 Apr 7.
The purpose of the present investigation was to systematically review randomized controlled trials examining the effects of psychological interventions on inflammatory biomarkers in adult populations and to quantitatively analyze those effects by meta-analysis. Two researchers independently searched key electronic databases, selected eligible publications, extracted data, and evaluated methodological quality. Nineteen randomized controlled trials examining a total of 1510 participants were included. The overall combined effect size from pre to post psychological intervention on pro-inflammatory biomarker levels was statistically significant, showing an attenuating effect, although of a small magnitude (s' g = 0.15, p = .008, CI [0.04-0.26]). However, this effect was not maintained into the follow-up period (g < -0.01, p = .964, CI [-0.19-0.18]). Looking at the individual biomarkers assessed across studies, only C-reactive protein (CRP) was found to significantly decrease following psychological intervention. A number of moderation analyses were conducted, none of which reached statistical significance. However, the numerically largest - and significant - within-group effect size was obtained for the group of studies that had preselected participants based on elevated psychological distress (g = 0.29, p = .047). In conclusion, psychological interventions appear efficacious in reducing pro-inflammatory biomarker levels. Future studies are recommended to carefully select individuals based on inflammatory (e.g., the presence of low-grade inflammation) and/or psychological (e.g., psychological distress) criteria.
本研究旨在系统回顾考察心理干预对成年人群炎症生物标志物影响的随机对照试验，并通过荟萃分析定量分析这些影响。两名研究人员独立搜索了主要电子数据库，选择了合格的出版物，提取了数据，并评估了方法学质量。共纳入了 19 项共涉及 1510 名参与者的随机对照试验。从心理干预前到后，促炎生物标志物水平的总体综合效应大小具有统计学意义，表现出一种减弱效应，尽管幅度较小（s' g=0.15，p=0.008，CI[0.04-0.26]）。然而，这种效应在随访期间并未持续（g<-0.01，p=0.964，CI[-0.19-0.18]）。纵观研究中评估的各个生物标志物，只有 C 反应蛋白（CRP）在心理干预后发现显著下降。进行了一些调节分析，但均未达到统计学意义。然而，在根据心理困扰程度预先选择参与者的研究组中，获得了组内效应大小的数值最大且显著的结果（g=0.29，p=0.047）。总之，心理干预似乎有效降低了促炎生物标志物水平。建议未来的研究根据炎症（例如低度炎症的存在）和/或心理（例如心理困扰）标准仔细选择个体。
