目的 探讨心理干预对肝癌患者焦虑和抑郁症状的影响.方法 计算机检索万方、维普、CNKI及中国生物医学等中文数据库,全面收集有关心理干预对肝癌患者焦虑和抑郁症状影响的临床对照试验,汇总数据采用RevMan 5.1.6和Stata 12.0进行分析,两组之间差异采用标准均数差及其95％可信区间描述.结果 严格根据纳入和排除标准,最终纳入9个临床对照试验,包括716例肝癌患者,其中观察组360例,对照组356例.Meta分析结果表明:治疗前,心理干预组与对照组患者抑郁自评量表评分和焦虑自评量表评分均无明显差异(分别为标准均数差0.06,95％可信区间-0.11～0.22,P=0.54；标准均数差-0.03,95％可信区间-0.18～0.13,P=0.72)；治疗后,心理干预组患者抑郁自评量表评分和焦虑自评量表评分显著低于对照组患者,两组之间差异有统计学意义(分别为标准均数差-1.55,95％可信区间-1.75～-1.35,P＜0.000 01；标准均数差-1.90,95％可信区间-2.10～-1.71,P＜0.000 01).结论 现有证据表明,进行综合性心理干预可有效地改善肝癌患者的抑郁和焦虑症状,减轻患者负性情绪,改善患者的情感及认知功能,增强自我价值感,具有一定的有效性和可行性.由于纳入研究质量及数量有限,本研究结论尚需大样本高质量临床研究进一步证实.%Objective This study aims to investigate the influence of psychological intervention on the anxiety and depressive symptoms for patients with liver cancer by conducting a systematic review and meta-analysis. Methods WanFang, CNKI, VIP and CBM databases were searched extensively to identify relevant clinical controlled trials. Data were analyzed by RevMan 5.1.6 software. Results were described as standardized mean difference (SMD) with 95% confidence intervals (CI). Results A total of 9 clinical controlled trials involving 716 liver cancer patients were included in this systematic review, including 360 patients in psychological intervention group and 356 patients in control group. Meta-analysis showed that there was no significant difference between two groups in pre-intervention self-rating depression scale (SDS) scores (SMD 0.06, 95%CI -0.11-0.22, P=0.54) and pre-intervention self-rating anxiety scale (SAS) scores (SMD -0.03, 95%CI -0.18-0.13,P=0.72). However, post-intervention SDS scores (SMD -1.55, 95%CI -1.75 — 1.35, P<0.000 01) and post-intervention SAS scores (SMD -1.90, 95%CI -2.10—1.71, P< 0.000 01) had statistically significant differences. Conclusions The present data suggests that psychological intervention may relieve anxiety and depressive symptoms for patients with liver cancer. Further well-designed randomized controlled trials are needed to confirm or adjust current conclusions.
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