酒精使用障碍心理治疗效果的网状Meta分析  

A Network Meta-Analysis of the Effects of Psychological Treatment for Alcohol Use Disorder

作　　者：赵垠锋 陈继卿 刘山业 滕飞[1] 郝羽 杨娟[1,2] ZHAO Yin-feng;CHEN Ji-qing;LIU Shan-ye;TENG Fei;HAO Yu;YANG Juan(International School of Public Health and One Health,Hainan Medical University,Haikou 570100,China;Affiliated Maternal and Child Health Care Center/Affiliated Children’s Hospital,Hainan Medical University,Haikou 570100,China)

机构地区：[1]海南医学院公共卫生与全健康国际学院,海口570100 [2]海南医学院附属妇幼保健院/附属儿童医院,海口570100

出　　处：《中国临床心理学杂志》2023年第2期496-500,485,共6页Chinese Journal of Clinical Psychology

基　　金：国家自然科学基金青年项目“正念训练干预酒精使用障碍渔民反应抑制功能的神经机制研究”(项目号:81901392);海南医学院研究生创新科研课题“正念训练对渔民酒精使用的影响”(项目号:HYYS2020-12)。

摘　　要：目的:应用网状Meta分析方法比较药物治疗与不同心理治疗联合药物疗法在酒精使用障碍(AUD)中的临床疗效,并对不同方法降低复饮率、复饮天数及改善患者焦虑抑郁的效果进行排序。方法:计算机检索并筛选中国知网、PubMed等数据库中关于心理治疗AUD的随机对照试验(RCT)。借助软件Gemtc和Stata进行网状Meta分析。结果:共纳入14个RCT,总计1117例AUD患者:试验组558例,对照组559例。分析结果提示,降低复饮行为的效果排序:厌恶疗法>家庭干预>认知行为疗法>综合心理护理干预>正念干预>森田疗法>简短心理干预>单纯药物治疗。降低复饮天数的效果排序:认知行为疗法>简短心理干预>单纯药物治疗>正念干预。降低焦虑效果的排序:正念干预>综合心理护理干预>单纯药物治疗>厌恶疗法。降低抑郁效果的排序:综合心理护理干预>正念干预>厌恶疗法>单纯药物治疗。结论:与单纯药物治疗AUD相比,结合心理治疗后均有更好的效果,且不同的心理治疗方法有着不同的优势。Objective:To compare the clinical efficacy of pharmacotherapy with each psychotherapy combined with pharmacotherapy in alcohol use disorder(AUD)by applying the network meta-analysis method,and to rank the effectiveness of different methods in reducing the rate of relapse,the number of days of relapse and improving patients’anxiety and depression.Methods:Computer searches and screening of randomized controlled trials(RCTs)on psychological treatment of AUD in databases such as CNKI and PubMed were conducted to extract information after screening the included literature.Network meta-analysis was performed with the help of software Gemtc and Stata.Results:A total of 14 RCTs with a total of 1117 AUD patients were included:558 in the trial group and 559 in the control group.The results of the network meta-analysis suggested the following ranking of effectiveness in reducing relapse to drinking behaviour:aversion therapy>family psychological intervention>cognitive behavioural therapy>integrated psychological care intervention>mindfulness therapy>morita therapy>brief psychological intervention>medication alone.The effect of reducing the number of days of relapse was ranked as follows:cognitive behavioural therapy>brief psychological intervention>medication alone>mindfulness therapy.The order of effectiveness in reducing anxiety was as follows:mindfulness therapy>comprehensive psychological care intervention>medication alone>aversion therapy.The order of effectiveness in reducing depression was as follows:integrated psychological care intervention>mindfulness therapy>aversive therapy>medication alone.Conclusion:Compared to pharmacological treatment alone,all had better outcomes when combined with psychological treatment,and different psychological treatments had different advantages.

关 键 词：心理治疗 酒精使用障碍 网状Meta分析 

分 类 号：R395.5[哲学宗教—心理学]