基于网络的心理干预对慢性腰背痛患者效果的Meta分析

doi:10.3761/j.issn.0254-1769.2023.19.016

摘要/Abstract

摘要：

目的通过Meta分析评价基于网络的心理干预对慢性腰背痛患者的干预效果。方法系统检索中国知网、CINAHL、PsycInfo等9个数据库和临床试验注册平台中基于网络对慢性腰背痛患者实施心理干预的相关随机对照试验。检索时限为建库至2023年1月，由2名研究者按照纳入和排除标准筛选文献并提取资料，使用Cochrane手册5.1.0版本评估文献质量。采用Revman 5.4软件进行Meta分析。结果共纳入9篇文献，包括1 158例患者。Meta分析结果显示，基于网络的心理干预可以改善运动恐惧（SMD=-1.33，95%CI[-1.53，-1.12]，P<0.001）和疼痛灾难化（SMD= -2.16，95%CI[-2.57，-1.74]，P<0.001）的发生，减轻患者疼痛程度（SMD=-1.35，95%CI[-2.42，-0.28]，P=0.010）、提高患者自我效能（SMD=0.28，95%CI[0.09，0.47]，P=0.004），改善患者残疾障碍（MD=-1.66，95%CI[-2.20，-1.13]，P<0.001），提升患者生活质量（SMD=0.74，95%CI[0.37，1.12]，P<0.001）。结论基于网络的心理干预对慢性腰背痛患者的疼痛灾难化、运动恐惧、自我效能及生活质量等方面有效，减轻疼痛方面仍需要进一步研究。

关键词: 网络, 慢性腰背痛, 心理干预, 预后, 生活质量, Meta分析, 循证护理学

Abstract:

Objective To evaluate the effect of web-based psychological intervention on the patients with chronic low back pain through meta-analysis. Methods Randomized controlled trials of web-based psychological intervention for patients with chronic low back pain were systematically searched from 9 databases and clinical trial registration platforms including CNKI，CINAHL，Psyclnfo，etc. The search time was limited to January 2023. The literature was screened and extracted by 2 researchers according to the inclusion criteria，and the quality of the literature was assessed using Cochrane Manual 5.1.0. Revman 5.4 software was used for meta-analysis. Results A total of 9 articles，including 1158 patients，were included. Meta-analysis showed that web-based psychological intervention can improve motor fear （SMD=-1.33，95%CI[-1.53 to -1.12]，P<0.001） and pain catastrophe（SMD=-2.16，95%CI[-2.57 to -1.74]，P<0.001），effectively reduce the degree of pain（SMD=-1.35，95%CI[-2.42 to -0.28]，P=0.010），improve self-efficacy（SMD=0.28，95%CI[0.09 to 0.47]，P=0.004），improve disability disorders（MD=-1.66，95%CI[-2.20 to-1.13]，P<0.001），and improve patients’ quality of life（SMD=0.74，95%CI[0.37 to 1.12]，P<0.001） Conclusion Web-based psychological intervention has significant effects on pain catastrophe，motor phobia，self-efficacy and quality of life in patients with chronic low back pain，but it has no significant effect on pain reduction，and further research is needed.

Key words: Internet, Chronic Low Back Pain, Psychological Interventions, Prognosis, Quality of Life, Meta-Analysis, Evidence-Based Nursing

罗浩月, 李秋芳, 赵燕利, 廉莎莉, 韩双嵘, 杨佳音. 基于网络的心理干预对慢性腰背痛患者效果的Meta分析[J]. 中华护理杂志, 2023, 58(19): 2409-2415.

LUO Haoyue, LI Qiufang, ZHAO Yanli, LIAN Shali, HAN Shuangrong, YANG Jiayin. A meta-analysis of the effect of web-based psychological intervention in patients with chronic low back pain[J]. Chinese Journal of Nursing, 2023, 58(19): 2409-2415.

图/表 5

图1 PubMed检索策略图

Figure 1 PubMed search strategy diagram

图2 文献筛选流程图

Figure 2 Flow chart of literature screening

表1 纳入文献基本特征（n=9）

Table 1 Basic characteristics of included literature （n=9）

表2 文献质量评价结果（n=9）

Table 2 Literature quality evaluation results （n=9）

图3 基于网络的不同心理干预方法对慢性腰背痛患者疼痛的影响

Figure 3 Effects of different web-based pain psychological interventions on pain in patients with CLBP

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