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创伤后应激障碍的超觉静坐疗法系统评价与荟萃分析

Systematic Review and Meta-Analysis of Transcendental Meditation for Post-Traumatic Stress Disorder.

作者信息

Orme-Johnson David W, Barnes Vernon A, Rees Brian, Tobin Jean

机构信息

Faculty Emeritus, Maharishi International University, Fairfield, IA 52556, USA.

Faculty Emeritus, Georgia Prevention Institute, Department of Medicine, Augusta University, Augusta, GA 30912, USA.

出版信息

Medicina (Kaunas). 2025 Apr 3;61(4):659. doi: 10.3390/medicina61040659.

Abstract

Our recent systematic review and meta-analysis of all studies on meditation as treatment for PTSD (61 studies) found a moderate effect size of Hedges's g = -0.67 for post-minus-pre change in symptom scores. Separate tests of the four meditation categories found a large effect size of g = -1.13 for the Transcendental Meditation (TM) technique that is significantly greater than for each other category. The present follow-up used a different method, calculating effects relative to internal controls, to better characterize the effects of this meditation technique. . Our study followed Prisma guidelines. Major databases, research anthologies, and bibliographies were searched for studies that used TM for treating PTSD, all military and civilian populations, and all age groups. The searches located 15 controlled trials on TM that met the inclusion criteria (longitudinal and reporting sufficient statistics to calculate effect sizes), 1248 subjects total, mean age 40.5 years (range 20.6 to 54.4 years), and 46.9% males (range 0% to 100%). Using the random effects model, the pooled effect across all studies of TM compared to other treatments was g = -1.01, 95% CI = -1.29 to -0.74, < 0.000000001. One-study removed analysis found that no study reduced the pooled effect to less than -1.0. Funnel plots indicated no risk of bias. TM was non-inferior to prolonged exposure therapy, = 0.0001, and it worked significantly faster ( = 0.04 at week six). TM produced clinically meaningful reductions in PTSD for civilian and military personnel, young and older adults, and for both men and women. We recommend phase-III multisite studies comparing TM with known first-line treatments for PTSD.

摘要

我们最近对所有关于冥想治疗创伤后应激障碍(PTSD)的研究(61项研究)进行了系统评价和荟萃分析,发现症状评分的前后变化中,Hedges's g = -0.67的中等效应量。对四种冥想类别进行的单独测试发现,超觉静坐(TM)技术的效应量很大,g = -1.13,显著大于其他每一类。本随访采用了不同的方法,计算相对于内部对照的效应,以更好地描述这种冥想技术的效果。我们的研究遵循了Prisma指南。在主要数据库、研究选集和参考文献中搜索使用TM治疗PTSD的研究,涵盖所有军事和 civilian 人群以及所有年龄组。搜索找到了15项符合纳入标准(纵向研究且报告了足够的统计数据以计算效应量)的关于TM的对照试验,共有1248名受试者,平均年龄40.5岁(范围20.6至54.4岁),男性占46.9%(范围0%至100%)。使用随机效应模型,与其他治疗相比,TM在所有研究中的合并效应为g = -1.01,95%置信区间 = -1.29至 -0.74,P < 0.000000001。逐一剔除研究的分析发现,没有一项研究能将合并效应降低到小于 -1.0。漏斗图表明无偏倚风险。TM不劣于延长暴露疗法,P = 0.0001,且起效明显更快(在第6周时P = 0.04)。TM在临床上能使 civilian 和军事人员、年轻人和老年人以及男性和女性的PTSD症状显著减轻。我们建议进行III期多中心研究,将TM与已知的PTSD一线治疗方法进行比较。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ed1/12028398/c070fa6a7e76/medicina-61-00659-g003.jpg

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