非药物干预对稳定型COPD患者心理健康的影响：一项系统综述和网络meta分析

IF 3.5 2区医学 Q2 PSYCHIATRY

Journal of Psychosomatic Research Pub Date : 2025-07-15 DOI:10.1016/j.jpsychores.2025.112324

Yujie Xue , Kaiwen Tang , Huimin Liu , Xueqin Jin

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引用次数: 0

摘要

目的通过网络meta分析，比较多种非药物干预措施对慢性阻塞性肺疾病（COPD）患者焦虑和抑郁的改善效果，确定最佳干预措施。方法检索spubmed、Embase、Cochrane Library、CINAHL、PsycINFO、Web of Science等数据库，检索与研究目标相关的随机对照试验（rct）。搜索范围从数据库建立到2025年1月。两位审稿人独立选择文献，提取数据，并评估纳入研究的偏倚风险。采用基于频率框架的随机效应模型，采用Stata 18.0软件进行网络meta分析。采用漏斗图评价发表偏倚。结果本研究共纳入41项随机对照试验，共5055名受试者，涉及7个不同的干预类别。网络荟萃分析显示，心身疗法（MBT） [SMD = -0.59, 95% CI(- 0.88, - 0.30)]、运动疗法（EX） [SMD = -0.44, 95% CI(- 0.84, - 0.05)]和生物心理社会疗法（BA） [SMD = -0.42, 95% CI(- 0.69, - 0.15)]在改善焦虑方面显著优于对照组。在抑郁缓解方面，MBT组[SMD = -0.72, 95% CI(- 1.03, - 0.40)]和EX组[SMD = -0.68, 95% CI(- 1.08, - 0.27)]显著优于对照组。排序概率表明，在减少COPD患者的抑郁和焦虑方面，身心疗法最有效，其次是运动。漏斗图提示存在发表偏倚的潜在风险。结论我们的网络荟萃分析强调了心身疗法和运动干预在改善COPD患者焦虑和抑郁方面的优越疗效。然而，鉴于证据的低确定性，需要额外的高质量试验来证实这些发现。

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Efficacy of non-pharmacological interventions on psychological well-being in stable COPD: A systematic review and network meta-analysis

Objective

This study aimed to compare the efficacy of multiple non-pharmacological interventions to improve anxiety and depression in chronic obstructive pulmonary disease (COPD) patients by network meta-analysis and to determine the optimal intervention.

Methods

PubMed, Embase, Cochrane Library, CINAHL, PsycINFO, and Web of Science databases were searched for randomized controlled trials (RCTs) related to the study objectives. The search spanned from database inception to January 2025. Two reviewers independently selected the literature, extracted data, and assessed the risk of bias in the included studies. A random-effects model based on a frequency framework was applied using Stata 18.0 software to perform network meta-analysis. Publication bias was evaluated using funnel plots.

Results

This study included 41 RCTs involving 5055 participants, and seven different intervention categories were involved. Network meta-analysis revealed that mind-body therapy (MBT) [SMD = -0.59, 95 %CI (−0.88, −0.30)], exercise (EX) [SMD = -0.44, 95 %CI (−0.84, −0.05)], and biopsychosocial approach (BA) [SMD = -0.42, 95 %CI (−0.69, −0.15)] significantly outperformed the control group in improving anxiety. For depression relief, MBT [SMD = -0.72, 95 %CI (−1.03, −0.40)] and EX [SMD = -0.68, 95 %CI (−1.08, −0.27)] significantly surpassed the control group. The ranked probabilities indicated that mind-body therapy was the most effective, followed by exercise, in reducing depression and anxiety in patients with COPD. The funnel plot suggested a potential risk of publication bias.

Conclusion

Our network meta-analysis highlights the superior efficacy of mind-body therapy and exercise interventions in improving anxiety and depression among COPD patients. However, given the low certainty of the evidence, additional high-quality trials are needed to confirm these findings.

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来源期刊

Journal of Psychosomatic Research 医学-精神病学

CiteScore

7.40

自引率

6.40%

发文量

314

审稿时长

6.2 weeks

期刊介绍： The Journal of Psychosomatic Research is a multidisciplinary research journal covering all aspects of the relationships between psychology and medicine. The scope is broad and ranges from basic human biological and psychological research to evaluations of treatment and services. Papers will normally be concerned with illness or patients rather than studies of healthy populations. Studies concerning special populations, such as the elderly and children and adolescents, are welcome. In addition to peer-reviewed original papers, the journal publishes editorials, reviews, and other papers related to the journal''s aims.