認知行為療法對乳腺癌患者失眠治療效果的系統評價_《中國循證醫學雜志》

作者：

 田浪 ¹ , 曹曉翼 ²

1. 四川省腫瘤醫院（成都 610041）；2. 四川大學華西醫院護理部/華西臨床醫學院護理系（成都 610041）;

關鍵詞：

認知行為治療乳腺癌失眠系統評價 Meta分析隨機對照試驗

DOI：

10.7507/1672-2531.20130014

視頻：

導出 下載 收藏 掃碼 引用

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　系統評價認知行為療法對乳腺癌患者失眠的療效。
方法　計算機檢索CENTRAL（2011.4）、Cochrane Library（2005～2011.11）、MEDLINE（1948～2011.11）、EMbase（1966.1～2011.11）、CINAHL（Cumulative Index to Nursing and Allied Health Literature，1982～2011.11）、CBM（1978～2011）和CNKI（1979～2011）中所有關于認知行為療法治療乳腺癌患者失眠的隨機對照試驗（RCT），根據納入和排除標準篩選文獻、提取資料和對納入研究進行方法學質量評價后，采用RevMan 5.0軟件進行Meta分析。
結果　共納入5個RCT。Meta分析結果顯示：干預組患者接受認知行為治療后經睡眠日記主觀評價的睡眠效率高于對照組，睡眠潛伏期低于對照組；而兩組患者經睡眠活動記錄儀客觀記錄的睡眠效率、總睡眠時間、睡眠潛伏期和入睡后清醒時間的差異無統計學意義。
結論　認知行為治療有助于改善乳腺癌患者主觀評價的睡眠效率、睡眠潛伏期，但目前證據不能證明認知行為治療對乳腺癌患者客觀記錄的睡眠參數的治療效果。今后研究需加大樣本含量、盡量采用盲法（如評價者盲）、明確分配隱藏方案、選用統一的睡眠活動記錄儀進行測評，以提供更高級別的臨床證據。

引用本文： 田浪,曹曉翼. 認知行為療法對乳腺癌患者失眠治療效果的系統評價. 中國循證醫學雜志, 2013, 13(1): 70-77. doi: 10.7507/1672-2531.20130014 復制

1.	Savard J, Morin CM. Insomnia in the context of cancer: A review of a neglected problem. J Clin Oncol, 2001, 19(3): 895-908.
2.	Davidson JR, MacLean AW, Brundage MD, et al. Sleep disturbance in cancer patients. Soc Sci Med, 2002, 54(9): 1309-1321.
3.	Savard J, Simard S, Blanchet J, et al. Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep, 2001, 24(5): 583-589.
4.	Berger AM, Mitchell SA. Modifying cancer related fatigue by optimizing sleep quality. J Natl Compr Canc Netw, 2008, 6(1): 3-13.
5.	Simon GE, VonKorff M. Prevalence, burden, and treatment of insomnia in primary care. Am J Psychiatr, 1997, 154(10): 1417-1423.
6.	Roscoe JA, Kaufman ME, Matteson-Rusby SE, et al. Cancer-related fatigue and sleep disorders. Oncologist, 2007, 12(1): 35-42.
7.	Currie SR, Wilson KG, Pontefract AJ, et al. Cognitive-behavioral treatment of insomnia secondary to chronic pain. J Consult Clin Psychol, 2000, 68(3): 407-416.
8.	Lichstein KL, Wilson NM, Johnson CT. Psychological treatment of secondary insomnia. Psychol Aging, 2000, 15(2): 232-240.
9.	Rochester, MN. International Classification of Sleep Disorders (ICSD): Diagnostic and Coding Manual. American Sleep Disorders Association, 1997.
10.	American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4ed). APA, Washington, DC, 1994.
11.	Bootzin RR, Epstein D. Stimulus control. In Lichstein KL, Morin CM (Eds.), Treatment of late-life insomnia. Thousand Oaks, CA: Sage. 2000: 167-184.
12.	Bootzin RR, Epstein D, Engle-Fnedman M, et al. Sleep disturbances. In Carstensen LL, Edelstein BA, Dombrand L (Eds.), The practical handbook of clinical gerontology. Thousand Oaks. CA: Sage. 1996: 398-420.
13.	Epstein DR, Bootzin RR. Insomnia. Nursing Clinics of North America, 2002, 37: 611-613.
14.	Epstein DR, Dirksen SR. Randomized trial of a cognitive-behavioral intervention for insomnia in breast cancer survivors. Oncol Nurs Forum, 2007, 34(5): 51-59.
15.	Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated March 2011]. The Cochrane Collaboration, 2008. Available from: www. cochrane-handbook. org.
16.	Savard J, Simard S, Ivers H, et al. Randomized study on the efficacy of cognitive-behavioral therapy for insomnia secondary to breast cancer, part I: Sleep and psychological effects. J Clin Oncol, 2005, 23(25): 6083-6096.
17.	Berger AM, Kuhn BR, Farr LA, et al. Behavioral therapy intervention trial to improve sleep quality and cancer-related fatigue. Psycho Oncol, 2009, 18(6): 634-646.
18.	Berger AM, Kuhn BR, Farr LA, et al. One-year outcomes of a behavioral therapy intervention trial on sleep quality and cancer-related fatigue. J Clin Oncol, 2009, 27(35): 6033-6040.
19.	莫錦萍, 鄭婉婷, 林弟. 認知行為療法對乳腺癌術后化療患者睡眠質量的影響. 中國現代護理雜志, 2010, 16(36) :4380-4383.
20.	Espie CA, Fleming L, Cassidy J, et al. Randomized controlled clinical effectiveness trial of cognitive behavior therapy compared with treatment as usual for persistent insomnia in patients with cancer. J Clin Oncol, 2008, 26(28): 4651-4658.
21.	Currie SR, Clark S, Hodgins DC, et al. Randomized controlled trial of brief cognitive-behavioural interventions for insomnia in recovering alcoholics. Addiction, 2004, 99(9): 1121-1132.
22.	Lichstein KL, Stone KC, Donaldson J, et al. Actigraphy validation with insomnia. Sleep, 2005, 29(2): 232-239.
23.	Litlner M, Kushida CA, Anderson WM, et al. Practice parameters for the role of actigraphy in the study of sleep and circadian rhythms: An update for 2002. Sleep, 2003, 26(3): 337-341.
24.	Buysse DJ, Ancoli-Israel S, Edinger JD, et al. Recommendations for a standard research assessment of insomnia. Sleep, 2006, 29(9): 1155-1173.

1. Savard J, Morin CM. Insomnia in the context of cancer: A review of a neglected problem. J Clin Oncol, 2001, 19(3): 895-908.
2. Davidson JR, MacLean AW, Brundage MD, et al. Sleep disturbance in cancer patients. Soc Sci Med, 2002, 54(9): 1309-1321.
3. Savard J, Simard S, Blanchet J, et al. Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep, 2001, 24(5): 583-589.
4. Berger AM, Mitchell SA. Modifying cancer related fatigue by optimizing sleep quality. J Natl Compr Canc Netw, 2008, 6(1): 3-13.
5. Simon GE, VonKorff M. Prevalence, burden, and treatment of insomnia in primary care. Am J Psychiatr, 1997, 154(10): 1417-1423.
6. Roscoe JA, Kaufman ME, Matteson-Rusby SE, et al. Cancer-related fatigue and sleep disorders. Oncologist, 2007, 12(1): 35-42.
7. Currie SR, Wilson KG, Pontefract AJ, et al. Cognitive-behavioral treatment of insomnia secondary to chronic pain. J Consult Clin Psychol, 2000, 68(3): 407-416.
8. Lichstein KL, Wilson NM, Johnson CT. Psychological treatment of secondary insomnia. Psychol Aging, 2000, 15(2): 232-240.
9. Rochester, MN. International Classification of Sleep Disorders (ICSD): Diagnostic and Coding Manual. American Sleep Disorders Association, 1997.
10. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (4ed). APA, Washington, DC, 1994.
11. Bootzin RR, Epstein D. Stimulus control. In Lichstein KL, Morin CM (Eds.), Treatment of late-life insomnia. Thousand Oaks, CA: Sage. 2000: 167-184.
12. Bootzin RR, Epstein D, Engle-Fnedman M, et al. Sleep disturbances. In Carstensen LL, Edelstein BA, Dombrand L (Eds.), The practical handbook of clinical gerontology. Thousand Oaks. CA: Sage. 1996: 398-420.
13. Epstein DR, Bootzin RR. Insomnia. Nursing Clinics of North America, 2002, 37: 611-613.
14. Epstein DR, Dirksen SR. Randomized trial of a cognitive-behavioral intervention for insomnia in breast cancer survivors. Oncol Nurs Forum, 2007, 34(5): 51-59.
15. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 [updated March 2011]. The Cochrane Collaboration, 2008. Available from: www. cochrane-handbook. org.
16. Savard J, Simard S, Ivers H, et al. Randomized study on the efficacy of cognitive-behavioral therapy for insomnia secondary to breast cancer, part I: Sleep and psychological effects. J Clin Oncol, 2005, 23(25): 6083-6096.
17. Berger AM, Kuhn BR, Farr LA, et al. Behavioral therapy intervention trial to improve sleep quality and cancer-related fatigue. Psycho Oncol, 2009, 18(6): 634-646.
18. Berger AM, Kuhn BR, Farr LA, et al. One-year outcomes of a behavioral therapy intervention trial on sleep quality and cancer-related fatigue. J Clin Oncol, 2009, 27(35): 6033-6040.
19. 莫錦萍, 鄭婉婷, 林弟. 認知行為療法對乳腺癌術后化療患者睡眠質量的影響. 中國現代護理雜志, 2010, 16(36) :4380-4383.
20. Espie CA, Fleming L, Cassidy J, et al. Randomized controlled clinical effectiveness trial of cognitive behavior therapy compared with treatment as usual for persistent insomnia in patients with cancer. J Clin Oncol, 2008, 26(28): 4651-4658.
21. Currie SR, Clark S, Hodgins DC, et al. Randomized controlled trial of brief cognitive-behavioural interventions for insomnia in recovering alcoholics. Addiction, 2004, 99(9): 1121-1132.
22. Lichstein KL, Stone KC, Donaldson J, et al. Actigraphy validation with insomnia. Sleep, 2005, 29(2): 232-239.
23. Litlner M, Kushida CA, Anderson WM, et al. Practice parameters for the role of actigraphy in the study of sleep and circadian rhythms: An update for 2002. Sleep, 2003, 26(3): 337-341.
24. Buysse DJ, Ancoli-Israel S, Edinger JD, et al. Recommendations for a standard research assessment of insomnia. Sleep, 2006, 29(9): 1155-1173.

《中國循證醫學雜志》

認知行為療法對乳腺癌患者失眠治療效果的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

《中國循證醫學雜志》

認知行為療法對乳腺癌患者失眠治療效果的系統評價

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

上一篇

下一篇

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料