PDF(Pubmed)
Abstract：
Elevated blood pressure is one of the major risk factors for cardiovascular diseases. Available evidence on mind-body medicine (MBM) techniques on blood pressure is inconclusive and provides conflicting results. The objective of the current systematic review and meta-analysis is to evaluate the effect of MBM techniques on blood pressure in patients with cardiovascular disease. Randomized control trials (RCTs) done between the years 2000 and 2020 on cardiovascular disease, using MBM techniques such as meditation, mindfulness-based stress reduction and relaxation techniques were searched through electronic databases such as PubMed, Cumulative Index to Nursing & Allied Health (CINAHL), EMBASE and Cochrane Library. Three authors independently performed article selection, data extraction and validation. Meta-analysis was performed using a random effect model and standardized mean difference (SMD) with 95% confidence interval (CI) estimated for the effect size. Fifteen RCTs with 927 patients were included in the meta-analysis. Heterogeneity among the studies was very high for all analyses (I2>94%). For studies comparing systolic blood pressure, MBM interventions show a significant (p=0.01) effect when compared to conventional treatment, an overall estimated effect size of SMD - 0.78 (95% CI: -1.36, -0.20). For studies comparing the diastolic blood pressure, MBM intervention did not show any significant effect when compared to the conventional treatment, an overall effect size of SMD -0.26 (95% CI: -0.91, 0.39). The findings of the meta-analysis suggest that MBM interventions may improve systolic blood pressure alone in patients with cardiac diseases. With high heterogeneity and low quality of the included studies, more robust evidence is required before suggesting MBM as an effective treatment modality for reducing blood pressure in cardiovascular diseases.
摘要：
血压升高是心血管疾病的主要危险因素之一。关于血压的身心医学（MBM）技术的现有证据尚无定论，并提供了相互矛盾的结果。当前系统评价和荟萃分析的目的是评估MBM技术对心血管疾病患者血压的影响。在2000年至2020年之间进行的关于心血管疾病的随机对照试验（RCT），使用MBM技术，如冥想，通过电子数据库搜索基于正念的减压和放松技术，如PubMed，护理和相关健康累积指数（CINAHL），EMBASE和Cochrane图书馆。三位作者独立进行文章选择，数据提取和验证。使用随机效应模型和标准化平均差（SMD）进行荟萃分析，对效应大小进行95％置信区间（CI）估计。15个RCTs，927例患者被纳入荟萃分析。对于所有分析,研究之间的异质性非常高(I2>94%)。为了比较收缩压，与常规治疗相比，MBM干预措施显示出显着（p=0.01）效果，SMD的总体估计效应大小为0.78（95%CI：-1.36，-0.20）。为了比较舒张压，与常规治疗相比，MBM干预没有显着效果，SMD的总体效应大小为-0.26（95%CI：-0.91，0.39）。荟萃分析的结果表明，MBM干预措施可以改善心脏病患者的收缩压。纳入研究的异质性高，质量低，在提示MBM作为降低心血管疾病血压的有效治疗方式之前,需要更有力的证据.
