天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (10): 1099-1107.doi: 10.11958/20170706

• 循证医学 • 上一篇    下一篇

正念干预改善糖尿病患者身心症状的系统评价

曾艳丽 1，2，王国富 3，胡秀英 4△   

  1. 1 成都职业技术学院（邮编 610041）；2 四川大学灾后重建与管理学院研究生院；3 成都市第五人民医院门诊部；4 四川大学华 西医院护理部
  • 收稿日期:2017-06-19 修回日期:2017-07-08 出版日期:2017-10-15 发布日期:2017-10-13
  • 通讯作者: 胡秀英 E-mail:xiuying.hu@163.com
  • 基金资助:
    四川省应用心理学研究中心资助项目;四川省教育厅人文社科重点项目

Systematic review of mindfulness intervention in improving physical and mental symptoms in diabetic patients

ZENG Yan-li1, 2, WANG Guo-fu3, HU Xiu-ying4△   

  1. 1 Institute of Disaster Management and Reconstruction, Sichuan University, Chengdu 610041, China; 2 Chengdu Vocational and Technical College; 3 Outpatient Department, Chengdu Fifth People’s Hospital; 4 Department of Nursing, West China Hospital, Sichuan University
  • Received:2017-06-19 Revised:2017-07-08 Published:2017-10-15 Online:2017-10-13

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摘要： 目的 评价正念干预（MBI）对糖尿病患者身心症状的效果。方法 检索有关正念干预对糖尿病患者身心 症状研究的类实验研究或者随机对照试验，检索从建库开始截至 2016 年 5 月，并追溯纳入研究的参考文献。按照 纳入和排除标准筛选文献并进行质量评价，从中提取数据。采用 Review Manager 5.3 软件进行 Meta 分析。结果 共纳入 9 项研究的 474 例患者，其中 MBI 组 251 例，对照组 223 例。Meta 分析显示，MBI 组在有效缓解糖尿病患者 的抑郁、焦虑、压力及糖尿病相关困扰症状方面明显优于对照组［MD=-5.35，95%CI：-7.11～-3.59；MD=-1.91，95% CI：-3.04～-0.79；MD=-4.65，95%CI：-6.68～-2.44；MD=-6.37，95%CI：-10.84～-1.90］，差异均有统计学意义（P＜ 0.05），且负性情绪的改善具有长期效应，患者可持续获益。正念干预对于生存质量的效果，无论是短期还是长期效 应结论均不一致，有待进一步验证；对血糖控制的影响，MBI 组总体上均趋向优于对照组的趋势。结论 正念干预 对 2 型糖尿病患者减轻抑郁、焦虑、压力及糖尿病相关困扰是一种有益的非药物辅助治疗，而对于提高生存质量和 改善血糖控制的作用有待于进一步验证。

关键词: 糖尿病, Meta 分析, 正念干预, 心理干预, 系统评价

Abstract: Objective To evaluate the effect of mindfulness intervention (MBI) on physical and mental symptoms in patients with diabetes mellitus. Methods Data of the relevant MBI in the physical and psychological symptoms were reviewed in patients with diabetes. The quasi- experimental studies or randomized controlled trials were used to retrieval from May 2016, and back into the study of references. According to the inclusion and exclusion criteria, the literature was screened and the quality was evaluated to extract the data. Review Manager 5.3 software was used for Meta- analysis. Results The total of 9 studies and 474 patients were included in this study. Patients were divided into MBI group (n=251) and control group (n=223). Meta- analysis showed that mindfulness therapy was effective in relieving depression, anxiety, stress and diabetes distress symptoms in diabetic patients compared with those of controls [MD=-5.35, 95%CI:-7.11- -3.59; MD=-1.91, 95%CI:-3.04- -0.79; MD=-4.65, 95%CI:-6.68- -2.44; MD=-6.37, 95%CI:-10.84- -1.90], the differences were statistical significance (P < 0.05). The improvement of the negative emotions was sustained long- term effect, and patients can benefit from it. The effects of MBI on the quality of life, whether short-term or long-term, were inconsistent and required further verification. The effects of glycemic control were generally better in MBI group than those of the control group. Conclusion Mindfulness intervention shows beneficial non-drug adjuvant therapy in reducing depression, anxiety, stress and diabetes related distress in patients with type 2 diabetes. The effects of MBI on improving the quality of life, blood glucose control need further verification.

Key words: diabetes mellitus, Meta-analysis, mindfulness-based intervention, psychological intervention, systematic review