National Centre Stress Management, Innovational and Educational Centre HartFocus, 1231 NC78 Loosdrecht, The Netherlands.
Department Psychiatry, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands.
Int J Environ Res Public Health. 2021 Mar 24;18(7):3329. doi: 10.3390/ijerph18073329.
Heart Rate Variability Biofeedback (HRVB) is a treatment in which patients learn self-regulation of a physiological dysregulated vagal nerve function. While the therapeutic approach of HRVB is promising for a variety of disorders, it has not yet been regularly offered in a mental health treatment setting.
To provide a systematic review about the efficacy of HRV-Biofeedback in treatment of anxiety, depression, and stress related disorders.
Systematic review in PubMed and Web of Science in 2020 with terms HRV, biofeedback, Post-Traumatic Stress Disorder (PTSD), depression, panic disorder, and anxiety disorder. Selection, critical appraisal, and description of the Random Controlled Trials (RCT) studies. Combined with recent meta-analyses.
The search resulted in a total of 881 studies. After critical appraisal, nine RCTs have been selected as well as two other relevant studies. The RCTs with control groups treatment as usual, muscle relaxation training and a "placebo"-biofeedback instrument revealed significant clinical efficacy and better results compared with control conditions, mostly significant. In the depression studies average reduction at the Beck Depression Inventory (BDI) scale was 64% (HRVB plus Treatment as Usual (TAU) versus 25% (control group with TAU) and 30% reduction (HRVB) at the PSQ scale versus 7% (control group with TAU). In the PTSD studies average reduction at the BDI-scale was 53% (HRV plus TAU) versus 24% (control group with TAU) and 22% (HRVB) versus 10% (TAU) with the PTSD Checklist (PCL). In other systematic reviews significant effects have been shown for HRV-Biofeedback in treatment of asthma, coronary artery disease, sleeping disorders, postpartum depression and stress and anxiety.
This systematic review shows significant improvement of the non-invasive HRVB training in stress related disorders like PTSD, depression, and panic disorder, in particular when combined with cognitive behavioral therapy or different TAU. Effects were visible after four weeks of training, but clinical practice in a longer daily self-treatment of eight weeks is more promising. More research to integrate HRVB in treatment of stress related disorders in psychiatry is warranted, as well as research focused on the neurophysiological mechanisms.
心率变异性生物反馈（HRVB）是一种治疗方法，患者通过该方法学会自我调节生理失调的迷走神经功能。虽然 HRVB 的治疗方法对各种疾病都有很好的疗效，但它尚未在精神健康治疗环境中得到常规应用。
系统评价 HRV-Biofeedback 在治疗焦虑、抑郁和应激相关障碍中的疗效。
2020 年在 PubMed 和 Web of Science 进行系统检索，检索词为 HRV、生物反馈、创伤后应激障碍（PTSD）、抑郁、惊恐障碍和焦虑障碍。选择、评价和描述随机对照试验（RCT）研究。结合最近的荟萃分析。
检索共得到 881 项研究。经过严格评价，共选择了 9 项 RCT 研究和另外 2 项相关研究。与对照组（常规治疗、肌肉松弛训练和“安慰剂”-生物反馈仪器）相比，有对照组的 RCT 研究显示出显著的临床疗效和更好的结果，其中大多数是显著的。在抑郁研究中，贝克抑郁量表（BDI）的平均降低率为 64%（HRVB 加常规治疗（TAU）与 25%（TAU 对照组），PSQ 量表的降低率为 30%（HRVB）与 7%（TAU 对照组）。在 PTSD 研究中，BDI 量表的平均降低率为 53%（HRV 加 TAU）与 24%（TAU 对照组），PCL 的平均降低率为 22%（HRVB）与 10%（TAU 对照组）。在其他系统评价中，HRV-Biofeedback 在治疗哮喘、冠心病、睡眠障碍、产后抑郁和压力及焦虑等应激相关障碍方面显示出显著效果。
本系统评价显示，非侵入性 HRVB 训练在应激相关障碍（如 PTSD、抑郁和惊恐障碍）方面有显著改善，尤其是与认知行为疗法或其他 TAU 相结合时。在四周的训练后即可看到效果，但八周的日常自我治疗的临床实践效果更有前景。需要更多的研究将 HRVB 整合到精神病学中的应激相关障碍的治疗中，以及关注神经生理机制的研究。
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