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瑜伽对创伤后应激障碍的疗效:随机对照试验的系统评价和荟萃分析。

Efficacy of yoga for posttraumatic stress disorder: A systematic review and meta-analysis of randomized controlled trials.

机构信息

HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran; Systematic Review and Meta‑analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran.

Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran; Social Determinants of Health Research Center, Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Psychiatry Res. 2024 Oct;340:116098. doi: 10.1016/j.psychres.2024.116098. Epub 2024 Jul 22.

Abstract

Yoga is an increasingly popular complementary intervention to reduce posttraumatic stress disorder (PTSD) symptoms and related comorbidities, but its safety and treatment efficacy are not firmly established. We conducted a systematic review and meta-analysis of existing randomized control trials (RCTs) of yoga interventions for PTSD and related secondary outcomes (e.g., depression). Initial search results found over 668 potential papers. Twenty met inclusion criteria (e.g., RCTs on adult participants with PTSD that evaluated safety or efficacy outcomes). Meta-analysis indicated that, compared to control interventions, participation in yoga interventions significantly improved self-report PTSD (standardized mean difference [SMD]: -0.51; 95 % confidence interval [CI]: -0.68, -0.35) and immediate (SMD: -0.39; 95 % CI: -0.56, -0.22) and long-term (SMD: -0.44; 95 % CI: -0.74, -0.13) depression symptoms. However, using clinician-reported assessments, yoga interventions were not associated with improved PTSD symptoms. Type of yoga differentially predicted outcomes. Sensitivity analysis showed consistent effect sizes when omitting each study from main analyses. Six studies reported whether any serious adverse events occurred. None were indicated. No publication bias was found, although individual intervention studies tended to be high in bias. Results suggest yoga is likely a safe and effective complementary intervention for reducing PTSD and depressive symptoms in individuals with PTSD. More rigorous RCTs are warranted.

摘要

瑜伽是一种越来越受欢迎的辅助干预措施,可用于减轻创伤后应激障碍(PTSD)症状和相关合并症,但它的安全性和治疗效果尚未得到明确证实。我们对现有的瑜伽干预 PTSD 及相关次要结局(如抑郁)的随机对照试验(RCT)进行了系统评价和荟萃分析。初步搜索结果发现了超过 668 篇潜在论文。有 20 篇符合纳入标准(例如,针对 PTSD 成年参与者的 RCT,评估安全性或疗效结局)。荟萃分析表明,与对照组相比,参加瑜伽干预显著改善了自我报告的 PTSD(标准化均数差 [SMD]:-0.51;95%置信区间 [CI]:-0.68,-0.35)和即时(SMD:-0.39;95%CI:-0.56,-0.22)及长期(SMD:-0.44;95%CI:-0.74,-0.13)抑郁症状。然而,使用临床医生报告的评估方法,瑜伽干预与 PTSD 症状的改善无关。瑜伽类型对结果有不同的预测作用。敏感性分析表明,当从主要分析中排除每项研究时,效应大小保持一致。有 6 项研究报告了是否发生任何严重不良事件。没有表明。虽然个别干预研究存在高偏倚的倾向,但未发现发表偏倚。结果表明,瑜伽可能是一种安全有效的辅助干预措施,可用于减轻 PTSD 患者的 PTSD 和抑郁症状。需要进行更严格的 RCT。

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