Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200092, China.
School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China.
Neural Plast. 2021 Nov 11;2021:6552246. doi: 10.1155/2021/6552246. eCollection 2021.
The objective of this study was to systematically review the literature on the effects of cognitive behavioral therapy (CBT) on insomnia and pain in patients with traumatic brain injury (TBI). PubMed, Embase, the Cochrane Library, Cumulative Index to Nursing and Allied Health, and Web of Science databases were searched. Outcomes, including pain, sleep quality, and adverse events, were investigated. Differences were expressed using mean differences (MDs) with 95% confidence intervals (CIs). The statistical analysis was performed using STATA 16.0. Twelve trials with 476 TBI patients were included. The included studies did not indicate a positive effect of CBT on pain. Significant improvements were shown for self-reported sleep quality, reported with the Pittsburgh Self-Reported Sleep Quality Index (MD, -2.30; 95% CI, -3.45 to -1.15; < 0.001) and Insomnia Severity Index (MD, -5.12; 95% CI, -9.69 to -0.55; = 0.028). No major adverse events related to CBT were reported. The underpowered evidence suggested that CBT is effective in the management of sleep quality and pain in TBI adults. Future studies with larger samples are recommended to determine significance. This trial is registered with PROSPERO registration number CRD42019147266.
本研究旨在系统回顾认知行为疗法（CBT）对创伤性脑损伤（TBI）患者失眠和疼痛影响的文献。检索了 PubMed、Embase、Cochrane 图书馆、护理与健康相关综合索引和 Web of Science 数据库。调查了包括疼痛、睡眠质量和不良事件在内的结局。使用 95%置信区间（CI）的均数差值（MDs）表示差异。使用 STATA 16.0 进行统计分析。纳入了 12 项涉及 476 例 TBI 患者的试验。纳入的研究并未表明 CBT 对疼痛有积极影响。匹兹堡睡眠质量指数（PSQI）（MD，-2.30；95%CI，-3.45 至-1.15；<0.001）和失眠严重指数（ISI）（MD，-5.12；95%CI，-9.69 至-0.55；=0.028）的自我报告睡眠质量显示出显著改善。未报告与 CBT 相关的重大不良事件。证据表明 CBT 对 TBI 成人的睡眠质量和疼痛管理有效，但证据强度不足。建议开展更大样本的未来研究以确定其意义。本试验已在 PROSPERO 注册，注册号为 CRD42019147266。
