不同非药物干预方式对产后抑郁症患者影响的网状Meta分析

doi:10.3761/j.issn.0254-1769.2024.02.015

摘要/Abstract

摘要：

目的评估不同非药物干预方式对产后抑郁症患者的干预效果，为护理实践提供非药物干预的循证。方法系统检索中国知网、中国生物医学文献数据库、万方数据库、维普数据库、PubMed、Embase、Cochrane Library等数据库中关于非药物干预方式对产后抑郁症患者影响的随机对照试验，同时进行溯源。检索时限为建库至2022年7月。使用Stata 17.0和Review Manager 5.3软件进行网状Meta分析。结果最终纳入43项研究，包括14种非药物干预方式，共4 451例产后抑郁症产妇。网状Meta分析结果显示，与常规护理组相比，运动疗法[SMD=-5.41，95%CI（-6.94，-3.89），P<0.001]、认知行为疗法[SMD=-4.72，95%CI（-6.13，-3.31），P<0.001]、综合心理疗法[SMD=-4.64，95%CI（-8.53，-0.75），P<0.001]、针灸疗法[SMD=-4.52，95%CI（-8.01，-1.03），P<0.001]对产后抑郁症具有较好的改善效果。累积排序概率图下面积显示，运动疗法是改善产后抑郁症的最佳非药物干预方式。结论运动疗法改善产后抑郁症的效果最佳，建议临床护理优先考虑，但仍需大量高质量随机对照试验进行验证。

关键词: 非药物干预, 产妇, 产后抑郁症, 网状Meta分析, 产科护理, 循证护理学

Abstract:

Objective To evaluate the effects of different non-pharmacological interventions on postpartum depression，and to provide the evidence for the formulation of relevant intervention programs. Methods Databases，including China National Knowledge Infrastructure（CNKI），China Biomedical Literature Database，Wanfang Database，VIP database，PubMed，EMBase，the Cochrane Library，were systematically searched for randomized controlled trials （RCT） on the effects of non-pharmacological interventions on postpartum depression. The search time limit was from the establishment of the database to July 2022. Network meta-analysis was performed using Stata17.0 and Review Manager 5.3 software. Results A total of 43 studies were included，including 14 non-pharmaceutical interventions，involving 4451 parturients. The results of network meta-analysis showed that compared with the usual care group，exercise therapy[SMD=-5.41，95%CI（-6.94，-3.89），P<0.001]，cognitive behavioral therapy[SMD=-4.72， 95%CI（-6.13，-3.31），P<0.001]，acupuncture and moxibustion[SMD=-4.52，95%CI（-8.01，-1.03），P<0.001] and the comprehensive psychotherapy[SMD=-4.64，95%CI（-8.53，-0.75），P<0.001] had better improvement effects on postpartum depression. The results of the area under the cumulative rank probability map showed that exercise was the best non-pharmacological intervention to improve postpartum depression. Conclusion Exercise has the best effect on improving postpartum depression，and it is recommended that clinical nursing care should be prioritized. However，a large number of high-quality RCTs are still needed for verification.

Key words: Non-Pharmacological Intervention, Puerpera, Postpartum Depression, Network Meta-Analysis, Obstetric Nursing, Evidence-Based Nursing

季谋芳, 李若冰, 胡廷进, 陈静怡. 不同非药物干预方式对产后抑郁症患者影响的网状Meta分析[J]. 中华护理杂志, 2024, 59(2): 228-235.

JI Moufang, LI Ruobing, HU Tingjin, CHEN Jingyi. Effects of different non-pharmacological interventions on postpartum depression in pregnant women：a network Meta-analysis[J]. Chinese Journal of Nursing, 2024, 59(2): 228-235.

图/表 4

表1 纳入文献的基本特征（n=43）

Table 1 Basic information of included literature（n=43）

图1 非药物干预对产后抑郁症患者影响效果的网状证据结构图

Figure 1 Network evidence structure for the effect of non-pharmacological interventions on postpartum depression

图2 非药物干预对产后抑郁症患者影响效果的联赛表

Figure 2 League table of the effect of non-pharmaceutical intervention on postpartum depression

表2 网状Meta分析排序概率

Table 2 Ranking of SUCRA probability values in network meta-analysis

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