Meta-analysis of the efficacy of Chinese medicine care in patients with coronary heart disease and anxiety and depression
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摘要: 目的 检索近年来公开发表的中医护理干预冠心病兼焦虑抑郁患者的随机对照试验,系统评价中医护理干预冠心病兼焦虑抑郁的疗效。 方法 通过电子和手工检索,全面检索2009—2018年间公开发表的中医护理干预冠心病兼焦虑抑郁患者的临床研究文献,对文献进行筛选,制定纳入及排除标准,根据标准纳入合格的临床研究,确定总有效率、SAS评分、SDS评分、HAMD评分为结局指标。采用Review Manager 5.3软件和Stata 14.0软件对资料进行异质性检验、合并效应量、发表偏倚分析,完成Meta分析。 结果 共检索出相关文献176篇,根据纳入标准和排除标准,最终纳入11项研究,共纳入1 079例病例,其中试验组560例,对照组519例,对文献进行质量评分,结果显示文献质量一般。Meta分析结果显示,总有效率(R=1.25,95%CI:1.14~1.37,P<0.001)、SAS评分(WMD=-8.70,95%CI:-14.74~-2.66,P=0.005)、SDS评分(WMD=-9.11,95%CI:-11.36~-6.85,P<0.001)、HAMD评分(WMD=-5.41,95%CI:-6.07~-4.74,P<0.001),结果差异均有统计学意义。异质性检验结果示,总有效率和HAMD评分的每项研究均P>0.10,具有同质性;SAS评分和SDS评分每项研究均P<0.10,具有异质性。Egger检验结果显示P=0.092,表明出现发表偏倚的可能性较小。 结论 中医护理对冠心病兼焦虑抑郁患者有明显改善效果,但由于纳入文献质量一般,需要更进一步研究加以证实。Abstract: Objective To retrieve the randomized controlled trials of traditional Chinese medicine nursing intervention for patients with coronary heart disease and anxiety and depression published in recent years, and systematically evaluate the efficacy of traditional Chinese medicine nursing intervention for patients with coronary heart disease and anxiety and depression. Methods Through electronic and manual searches, we searched the published literature on clinical research of patients with coronary heart disease and anxiety and depression in TCM nursing intervention from 2009 to 2018, screened the literature, formulated inclusion and exclusion criteria, and included qualified clinical studies according to the criteria, and determined the total effective rate, SAS score, SDS score and HAMD score as outcome indicators. Review Manager 5.3 software and Stata 14.0 software were used to test the heterogeneity of the data, merge the effects, publication bias analysis, and complete meta-analysis. Results A total of 176 relevant literatures were retrieved. According to the inclusion criteria and exclusion criteria, 11 studies were finally included. A total of 1079 cases were included, including 560 cases in the experimental group and 519 cases in the control group. The quality of the literature was evaluated, and the results showed that the quality of the literature was general. Meta-analysis results showed that the levels of Total efficiency(OR=4.23, 95% CI:2.36 to 7.60, P<0.001), SAS(WMD=-8.70, 95% CI:-14.74 to-2.66, P=0.005), SDS(WMD=-9.11, 95% CI:-11.36 to-6.85, P<0.001), HAMD(WMD=-5.41, 95% CI:-6.07 to-4.74, P<0.001]. All the results were statistically significant. Heterogeneity test results showed that the total effective rate and HAMD score for each study were P>0.10, which was homogenous. SAS score and SDS score were P<0.10 for each study, which was heterogeneous. Egger test showed that P=0.092, indicating that there was less possibility of publication bias. Conclusion Chinese medicine nursing has obvious improvement effect on patients with coronary heart disease and anxiety and depression. However, due to the quality of the included literature, further improvement in quality is needed to confirm.
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Key words:
- Coronary heart disease /
- Anxiety and depression /
- Chinese medicine care /
- Meta analysis
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