认知行为疗法对心力衰竭患者的疗效：一项系统评价与荟萃分析

Efficacy of Cognitive Behavioral Therapy in Heart Failure Patients: A Systematic Review and Meta-Analysis.

作者信息

Nso Nso, Emmanuel Kelechi, Nassar Mahmoud, Rezaei Bookani Kaveh, Antwi-Amoabeng Daniel, Alshamam Mohsen, Kondaveeti Ravali, Kompella Ritika, Lakhdar Sofia, Rizzo Vincent, Sorkin Miry, Munira Most Sirajum, Radparvar Farshid

机构信息

From the Department of Medicine, Icahn School of Medicine at Mount Sinai/NYC H+H/Queens, New York, NY.

Department of Medicine, University of Pittsburgh Medical Center Pinnacle, PA.

出版信息

Cardiol Rev. 2023;31(3):139-148. doi: 10.1097/CRD.0000000000000439. Epub 2022 Jan 6.

DOI:10.1097/CRD.0000000000000439

PMID:37036192

Abstract

BACKGROUND

Heart failure (HF) is a global disorder affecting around 6.2 million Americans aged 20 years and above. Neurovegetative disorders are common among such patients, and depression is a major problem that affects 20% to 40% of them. Cognitive behavioral therapy (CBT) is a type of treatment that produces the most favorable results compared to other psychotherapies, especially among patients with depression and anxiety. We aim to summarize and synthesize evidence regarding the efficacy of CBT for patients with HF.

METHODS

We conducted this study by searching PubMed, Scopus, and Web of Science for relevant studies about CBT use in patients with HF. The outcomes were pooled as mean difference (MD) or standard MD with a 95% CI. The analysis was performed using the RevMan software.

RESULTS

Combined data from 9 randomized controlled trials (1070 patients) revealed that CBT can alleviate both depression symptoms in HF patients when measured using different scales after 3 months of follow-up (standard MD, -0.18 [95% CI, -0.33 to -0.02]; P = 0.03) and the quality of life after 3 and 6 months of follow-up (MD, 4.92 [95% CI, 1.14-8.71]; P = 0.01 and MD, 7.72 [95% CI, 0.77-14.68]; P = 0.03, respectively).

CONCLUSION

CBT is an effective type of psychotherapy for dealing with depression, mediocre quality of life, and defective physical functioning; therefore, it should be considered in HF patients' care.

摘要

背景

心力衰竭（HF）是一种全球性疾病，影响着约620万20岁及以上的美国人。神经植物功能紊乱在这类患者中很常见，抑郁症是一个主要问题，影响着20%至40%的患者。认知行为疗法（CBT）是一种治疗方法，与其他心理治疗相比，能产生最有利的结果，尤其是在抑郁症和焦虑症患者中。我们旨在总结和综合关于CBT对HF患者疗效的证据。

方法

我们通过检索PubMed、Scopus和Web of Science来进行这项研究，以查找关于CBT在HF患者中应用的相关研究。结果合并为平均差（MD）或标准化MD，并带有95%置信区间（CI）。使用RevMan软件进行分析。

结果

来自9项随机对照试验（1070名患者）的综合数据显示，随访3个月后，当使用不同量表测量时，CBT可以减轻HF患者的抑郁症状（标准化MD，-0.18 [95% CI，-0.33至-0.02]；P = 0.03），以及随访3个月和6个月后的生活质量（MD，4.92 [95% CI，1.14 - 8.71]；P = 0.01和MD，7.72 [95% CI，0.77 - 14.68]；P = 0.03）。