非药物干预对体外受精-胚胎移植患者负性情绪及妊娠结局影响的网状Meta分析  

Effect of non-drug intervention on negative emotions and pregnancy outcome in patients with IVF-ET:a network Meta-analysis

作　　者：杨卓群 刘琳[2] 王笑艳 刘慧慧[1] 朱晶晶 胡俊平[1,2] YANG Zhuo-qun;LIU Lin;WANG Xiao-yan;LIU Hui-hui;ZHU Jing-jing;HU Jun-ping(School of Nursing,Lanzhou University,Lanzhou 730000;The Reproductive Medicine Center,the First Hospital of Lanzhou University,Lanzhou 730000)

机构地区：[1]兰州大学护理学院,兰州730000 [2]兰州大学第一医院生殖医学中心,兰州730000

出　　处：《生殖医学杂志》2023年第10期1522-1533,共12页Journal of Reproductive Medicine

基　　金：兰州市人才创新创业项目(2022-RC-47);兰州大学医学科研创新能力提升项目(lzuyxcx-2022-191)。

摘　　要：目的系统评价非药物干预对体外受精-胚胎移植(IVF-ET)患者负性情绪及妊娠结局的影响,为选择最佳干预方法提供参考。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、CINAHL、中国知网、中国生物医学文献数据库、维普数据库、万方数据库,检索时间为建库至2022年11月,搜集非药物干预对IVF-ET患者负性情绪及妊娠结局影响的随机对照试验。2名研究者对文献筛选、数据提取并进行方法学质量评价后,采用RevMan5.4.1软件和Stata17.0软件分别对不同结局指标进行直接Meta分析和网状Meta分析。结果共纳入45项研究,涉及8种非药物干预方法,总样本量为5641例。Meta分析结果显示:与常规护理相比,认知行为疗法、正念疗法、耳穴贴压、聚焦解决模式、曼陀罗彩绘疗法、音乐疗法可降低IVF-ET患者焦虑水平(P<0.05);认知行为疗法、正念疗法、曼陀罗彩绘疗法、音乐疗法可降低IVF-ET患者抑郁水平(P<0.05);认知行为疗法、耳穴贴压、音乐疗法、经皮穴位电刺激可提高IVF-ET患者临床妊娠率(P<0.05)。SUCRA概率排序结果显示:正念疗法改善IVF-ET患者负性情绪的效果最佳,认知行为疗法提高IVF-ET患者临床妊娠率的效果最佳。结论在改善IVF-ET患者负性情绪方面,正念疗法是最佳的非药物干预方法;在提高IVF-ET患者临床妊娠率方面,认知行为疗法最具有优势。仍需开展更多随机对照试验进一步验证上述结论。Objective:To systematically evaluate the efficacy of non-drug interventions on negative emotions and pregnancy outcome in patients undergoing IVF-ET,and to provide a reference for selecting the best interventions.Methods:PubMed,Embase,Cochrane Library,Web of Science,CINAHL,CNKI,CBM,VIP and Wanfang Database were searched from the establishment of the database to November 2022.The randomized controlled trials involved the effects of non-drug interventions on negative emotions and pregnancy outcomes in patients with IVF-ET were retrieved.After literature screening,data extraction,and methodological quality evaluation were conducted by two researchers,and direct meta-analysis and network meta-analysis of different outcome indicators were performed by RevMan 5.4.1 and Stata 17.0 software.Results:A total of 45 studies involving 8 non-drug interventions were included,with a total sample size of 5641 patients.The results of meta-analysis showed that compared with routine nursing therapy,the cognitive behavioral therapy,mindfulness therapy,auricular point sticking,focused solution model,mandala painting therapy and music therapy could reduce anxiety in patients with IVF-ET(P<0.05).Cognitive behavioral therapy,mindfulness therapy,mandala painting therapy and music therapy could reduce depression in patients with IVF-ET(P<0.05).Cognitive behavioral therapy,auricular point sticking,music therapy,and transcutaneous electrical acupoint stimulation could improve the clinical pregnancy rate of patients with IVF-ET(P<0.05).SUCRA probability ranking results showed that mindfulness therapy had the best effect on improving negative emotions in patients with IVF-ET,and cognitive behavioral therapy had the best effect on improving the clinical pregnancy rate in patients with IVF-ET.Conclusions:Mindfulness therapy is the best non-drug intervention for improving negative emotions in patients with IVF-ET.Cognitive behavioral therapy has the greatest advantage in improving the clinical pregnancy rate in patients with IVF-ET.However,more r

关 键 词：非药物干预 体外受精-胚胎移植 负性情绪 妊娠结局 网状Meta分析 

分 类 号：R473.71[医药卫生—护理学]