认知行为治疗对失眠的疗效:系统回顾和针对联合治疗的元分析  

The Effect of Cognitive Behavioral Therapy on Insomnia:A Systematic Review and Meta-analysis of Combined Therapy

作　　者：吴昭含 高隽[1] WU Zhao-han;GAO Jun(Department of Psychology,School of Social Development and Public Policy,Fudan University,Shanghai 200433,China)

机构地区：[1]复旦大学社会发展与公共政策学院心理学系,上海200433

出　　处：《中国临床心理学杂志》2020年第5期1066-1071,974,共7页Chinese Journal of Clinical Psychology

摘　　要：目的:用系统回顾和元分析方法评价国内认知行为治疗对失眠的疗效。方法:在中国知网等数据库检索发表于2006年1月-2017年9月的文章,最终88篇涉及失眠认知行为治疗的疗效研究进入系统回顾,10篇CBT-I(Cognitive Behavioral Therapy for Insomnia)+西药联合治疗的RCT(Randomized Controlled Trials)研究纳入元分析。结果:系统回顾提示,单独CBT-I、CBT-I联合西药及CBT-I联合中医药是常用治疗方案。单纯CBT-I能显著改善失眠各项指标,CBT-I的具体治疗方案组合及实施方式则对疗效影响不大,而联合治疗的疗效表现出优于单一治疗形式的趋势。元分析显示,CBT-I+西药的联合治疗疗效优于西药[g=-3.50,95%CI(-4.70,-2.31),P<0.001]。结论:无论是单独CBT-I或联合其他药物治疗均能有效缓解原发性失眠,且CBT+西药的联合治疗疗效优于西药治疗;但疗效研究总体质量有待提高。Objective:To evaluate the efficacy of Chinese cognitive behavioral therapy on insomnia by systematic review and meta-analysis.Methods:In the database of CNKI and other databases published in January 2006-September2017,the final 88 studies on the efficacy of insomnia cognitive behavioral therapy entered a systematic review,and 10 RCT studies of CBT-I+Western medicine combined therapy were included in meta-analysis.Results:The systematic review suggested that CBT-I,CBT-I combined with Western medicine and CBT-I combined with traditional Chinese medicine were common treatment options.CBT-I alone can significantly improve the result of insomnia.The specific treatment combination and implementation of CBT-I had little effect on the curative effect,and the curative effect of combined therapy was better than single treatment form.Meta-analysis showed that the combined treatment of CBT-I+western medicine was superior to western medicine[g=-3.50,95%CI(-4.70,-2.31),P<0.001].Conclusion:Both CBT-I alone or in combination with other medicine can effectively alleviate primary insomnia,and the combined treatment of CBT-I+western medicine is better than western medicine alone;however,the overall quality of research needs to be improved.

关 键 词：失眠 认知行为治疗 联合治疗 元分析 

分 类 号：R395.5[哲学宗教—心理学]