正念减压疗法（MBSR）对乳腺癌患者症状变量和健康相关生活质量的有效性：系统评价和荟萃分析。
Effectiveness of mindfulness-based stress reduction (MBSR) on symptom variables and health-related quality of life in breast cancer patients-a systematic review and meta-analysis.
机构信息
Department of Nursing, The Affiliated Hospital of Nanjing University, Nanjing Drum Tower Hospital, Nanjing, 210008, Jiangsu, China.
出版信息
Support Care Cancer. 2019 Mar;27(3):771-781. doi: 10.1007/s00520-018-4570-x. Epub 2018 Nov 28.
OBJECTIVE
The purpose of this systematic review and meta-analysis was to evaluate the effectiveness of mindfulness-based stress reduction (MBSR) in breast cancer patients.
METHODS
A systematic search of Cochrane Library, Cochrane Central Register of Controlled Trials, PsycINFO database, Web of science, Medline, EMBASE, CNKI, and CBM database was carried out from February to May 2018, with no language restrictions. Trials examining the effects of MBSR versus control group on symptom variables and health-related quality of life were included. Data concerning studies, patient characteristics, and outcomes were extracted. Methodological quality of each included randomized controlled trials were assessed individually by two reviewers independently using criteria recommended in the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. Meanwhile, Newcastle-Ottawa Quality Assessment Scale (NOS) was used to evaluate methodological quality of non-randomized studies.
RESULTS
In all, 14 studies involving 1505 participants were included. Due to the effect of MBSR, statistically significant results were found on physiological function (SMD = 0.28, 95% CI [0.07, 0.049], P = 0.008), cognitive function (SMD = 1.48, 95% CI [0.34, 2.61], P = 0.01), fatigue (SMD = - 0.66, 95% CI [- 1.11, - 0.20], P = 0.004), emotional wellbeing (SMD = 1.01, 95% CI [0.35, 1.67], P = 0.003), anxiety (SMD = - 0.54, 95% CI [- 1.01, - 0.07], P = 0.02), depression (SMD = - 0.61, 95% CI [- 1.11, - 0.11], P = 0.02), stress (SMD = - 0.48, 95% CI [- 0.81, - 0.15], P = 0.004), distress (SMD = - 0.56, 95% CI [- 0.85, - 0.26], P = 0.0002) and mindfulness (SMD = 0.94, 95% CI [0.10, 1.79], P = 0.03). Although the effects on pain, sleep quality, and global QoL were in the expected direction, they were not statistically significant (P > 0.05) based on insufficient evidence.
CONCLUSIONS
MBSR is worthy of being recommended to breast cancer patients as a complementary treatment or adjunctive therapy.
目的
本系统评价和荟萃分析旨在评估正念减压（MBSR）对乳腺癌患者的有效性。
方法
从 2018 年 2 月至 5 月，我们对 Cochrane 图书馆、Cochrane 对照试验中心注册库、PsycINFO 数据库、Web of science、Medline、EMBASE、CNKI 和 CBM 数据库进行了系统检索，不限制语言。纳入了比较 MBSR 与对照组对症状变量和健康相关生活质量影响的试验。提取有关研究、患者特征和结局的数据。由两名独立的审查员使用干预措施的 Cochrane 系统评价手册推荐的标准单独评估每个纳入的随机对照试验的方法学质量。同时，使用纽卡斯尔-渥太华质量评估量表（NOS）评估非随机研究的方法学质量。
结果
共纳入了 14 项涉及 1505 名参与者的研究。由于 MBSR 的影响，在生理功能（SMD = 0.28，95%CI [0.07，0.049]，P = 0.008）、认知功能（SMD = 1.48，95%CI [0.34，2.61]，P = 0.01）、疲劳（SMD = -0.66，95%CI [-1.11，-0.20]，P = 0.004）、情绪健康（SMD = 1.01，95%CI [0.35，1.67]，P = 0.003）、焦虑（SMD = -0.54，95%CI [-1.01，-0.07]，P = 0.02）、抑郁（SMD = -0.61，95%CI [-1.11，-0.11]，P = 0.02）、压力（SMD = -0.48，95%CI [-0.81，-0.15]，P = 0.004）、痛苦（SMD = -0.56，95%CI [-0.85，-0.26]，P = 0.0002）和正念（SMD = 0.94，95%CI [0.10，1.79]，P = 0.03）方面，MBSR 具有显著效果。虽然疼痛、睡眠质量和总体生活质量的影响符合预期，但由于证据不足，无统计学意义（P > 0.05）。
结论
MBSR 值得推荐给乳腺癌患者作为一种补充治疗或辅助治疗。
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