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认知行为疗法对慢性阻塞性肺疾病患者的疗效:系统评价和荟萃分析。

Effectiveness of cognitive behavioural therapy for chronic obstructive pulmonary disease patients: A systematic review and meta-analysis.

机构信息

School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin Province, 130021, PR China.

School of Nursing, Jilin University, No. 965 Xinjiang Street, Changchun, Jilin Province, 130021, PR China.

出版信息

Complement Ther Clin Pract. 2020 Feb;38:101071. doi: 10.1016/j.ctcp.2019.101071. Epub 2019 Nov 13.

Abstract

BACKGROUND

and purpose: Cognitive behavioural therapy (CBT) has gained increasing attention for the treatment of psychological disorders. This study aims to establish the effectiveness of CBT on psychological and physical outcomes in patients with chronic obstructive pulmonary disease (COPD).

METHODS

Two waves of electronic searches of the PubMed, Cochrane library, EMBASE, Web of Science and China National Knowledge Infrastructure databases were conducted. Statistical analyses were performed using Revman Manager 5.3 and Stata 12.0 software.

RESULTS

Sixteen randomized controlled trials were eligible. There were significant improvements in anxiety (SMD = -0.23; 95% CI: -0.42 to -0.04; P = 0.02), depression (SMD = -0.29, 95% CI: -0.40 to -0.19, P < 0.01), quality of life (MD = -5.21; 95% CI: -10.25 to -0.17; P = 0.04), and mean visits to emergency departments in the CBT groups. No statistically significant differences were observed in fatigue (SMD = 0.88, 95% CI: -0.58 to 2.35, P = 0.24), exercise capacity (MD = 28.75, 95% CI: -28.30 to 85.80, P = 0.32), self-efficacy (SMD = 0.15, 95% CI: -0.05 to 0.34, P = 0.14), or sleep quality (MD = 1.21, 95% CI: -0.65 to 3.06, P = 0.20).

CONCLUSION

This meta-analysis suggests that CBT can serve as a complementary therapy to improve anxiety, depression, and quality of life in COPD patients and deserves more widespread application in clinical practice.

摘要

背景和目的

认知行为疗法(CBT)在治疗心理障碍方面受到越来越多的关注。本研究旨在确定 CBT 对慢性阻塞性肺疾病(COPD)患者心理和生理结局的疗效。

方法

对 PubMed、Cochrane 图书馆、EMBASE、Web of Science 和中国国家知识基础设施数据库进行了两轮电子检索。使用 Revman Manager 5.3 和 Stata 12.0 软件进行统计分析。

结果

纳入了 16 项随机对照试验。CBT 组在焦虑(SMD=-0.23;95%CI:-0.42 至-0.04;P=0.02)、抑郁(SMD=-0.29,95%CI:-0.40 至-0.19,P<0.01)、生活质量(MD=-5.21;95%CI:-10.25 至-0.17;P=0.04)和急诊就诊次数方面有显著改善。CBT 组在疲劳(SMD=0.88;95%CI:-0.58 至 2.35;P=0.24)、运动能力(MD=28.75;95%CI:-28.30 至 85.80;P=0.32)、自我效能感(SMD=0.15;95%CI:-0.05 至 0.34;P=0.14)和睡眠质量(MD=1.21;95%CI:-0.65 至 3.06;P=0.20)方面无统计学差异。

结论

本荟萃分析表明,CBT 可作为 COPD 患者焦虑、抑郁和生活质量的补充治疗方法,值得在临床实践中更广泛应用。

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