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蓝光疗法治疗创伤性脑损伤后嗜睡、睡眠障碍、抑郁和疲劳:系统评价和网络荟萃分析。

Blue-wavelength light therapy for post-traumatic brain injury sleepiness, sleep disturbance, depression, and fatigue: A systematic review and network meta-analysis.

机构信息

Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

出版信息

PLoS One. 2021 Feb 4;16(2):e0246172. doi: 10.1371/journal.pone.0246172. eCollection 2021.

Abstract

OBJECTIVE

This review aimed to determine the efficacy of blue-wavelength light therapy (BWLT) for post-traumatic brain injury (TBI) sleepiness, sleep disturbance, depression, and fatigue.

METHODS

Pubmed, Scopus, Web of Science, Cochrane Library, Academic Search Complete, and CINAHL. Included trials were randomized controlled trials (RCTs) of BWLT in adults with a history of TBI. Outcomes of interest included sleepiness, sleep disturbance, depression, or fatigue. Two reviewers independently screened the searched items, selected the trials, extracted the data, and rating the quality of trials. We aggregated the data using a random-effect, frequentist network meta-analysis (NMA).

RESULTS

We searched the databases on July 4, 2020. This review included four RCTs of 117 patients with a history of TBI who were randomized to received BWLT, amber light therapy (ALT), or no light therapy (NLT). Moderate-quality evidence revealed that: i) BWLT was significantly superior to NLT in reducing depression (SMD = 0.81, 95% CI = 0.20 to 1.43) ii) BWLT reduced fatigue at a significantly greater extent than NLT (SMD = 1.09, 95% CI = 0.41 to 1.76) and ALT (SMD = 1.00, 95% CI = 0.14 to 1.86). Low-quality evidence suggested that BWLT reduced depression at a greater extent than ALT (SMD = 0.57, 95% CI = 0.04 to 1.10). Low-quality evidence found that the dropout rates of those receiving BWLT and ALT were not significantly different (RR = 3.72, 95% CI = 0.65 to 21.34).

CONCLUSION

Moderate-quality evidence suggests that BWLT may be useful for post-TBI depression and fatigue.

摘要

目的

本综述旨在确定蓝光疗法(BWLT)治疗创伤性脑损伤(TBI)后嗜睡、睡眠障碍、抑郁和疲劳的疗效。

方法

检索 Pubmed、Scopus、Web of Science、Cochrane 图书馆、学术搜索综合版和 CINAHL。纳入的试验为 BWLT 治疗 TBI 后成人的随机对照试验(RCT)。感兴趣的结局包括嗜睡、睡眠障碍、抑郁或疲劳。两位审查员独立筛选检索到的项目,选择试验,提取数据,并对试验质量进行评分。我们使用随机效应、频率主义网络荟萃分析(NMA)汇总数据。

结果

我们于 2020 年 7 月 4 日检索数据库。本综述纳入了四项 RCT,共 117 例 TBI 后患者被随机分为接受 BWLT、琥珀光疗法(ALT)或无光疗法(NLT)。中等质量证据表明:i)BWLT 显著优于 NLT 降低抑郁(SMD = 0.81,95%CI = 0.20 至 1.43);ii)BWLT 降低疲劳的程度显著大于 NLT(SMD = 1.09,95%CI = 0.41 至 1.76)和 ALT(SMD = 1.00,95%CI = 0.14 至 1.86)。低质量证据表明,BWLT 降低抑郁的程度显著大于 ALT(SMD = 0.57,95%CI = 0.04 至 1.10)。低质量证据表明,接受 BWLT 和 ALT 的患者的辍学率无显著差异(RR = 3.72,95%CI = 0.65 至 21.34)。

结论

中等质量证据表明,BWLT 可能对 TBI 后抑郁和疲劳有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f55/7861530/aab565832df0/pone.0246172.g001.jpg

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