PDF(Pubmed)
Abstract：
UNASSIGNED: Studies of hyperbaric oxygen therapy (HBOT) treatment of mild traumatic brain injury persistent postconcussion syndrome in military and civilian subjects have shown simultaneous improvement in posttraumatic stress disorder (PTSD) or PTSD symptoms, suggesting that HBOT may be an effective treatment for PTSD. This is a systematic review and dosage analysis of HBOT treatment of patients with PTSD symptoms.
UNASSIGNED: PubMed, CINAHL, and the Cochrane Systematic Review Database were searched from September 18 to November 23, 2023, for all adult clinical studies published in English on HBOT and PTSD. Randomized trials and studies with symptomatic outcomes were selected for final analysis and analyzed according to the dose of oxygen and barometric pressure on symptom outcomes. Outcome assessment was for statistically significant change and Reliable Change or Clinically Significant Change according to the National Center for PTSD Guidelines. Methodologic quality and bias were determined with the PEDro Scale.
UNASSIGNED: Eight studies were included, all with < 75 subjects/study, total 393 subjects: seven randomized trials and one imaging case-controlled study. Six studies were on military subjects, one on civilian and military subjects, and one on civilians. Subjects were 3-450 months post trauma. Statistically significant symptomatic improvements, as well as Reliable Change or Clinically Significant changes, were achieved for patients treated with 40-60 HBOTS over a wide range of pressures from 1.3 to 2.0 ATA. There was a linear dose-response relationship for increased symptomatic improvement with increasing cumulative oxygen dose from 1002 to 11,400 atmosphere-minutes of oxygen. The greater symptomatic response was accompanied by a greater and severe reversible exacerbation of emotional symptoms at the highest oxygen doses in 30-39% of subjects. Other side effects were transient and minor. In three studies the symptomatic improvements were associated with functional and anatomic brain imaging changes. All 7 randomized trials were found to be of good-highest quality by PEDro scale scoring.
UNASSIGNED: In multiple randomized and randomized controlled clinical trials HBOT demonstrated statistically significant symptomatic improvements, Reliable Changes, or Clinically Significant Changes in patients with PTSD symptoms or PTSD over a wide range of pressure and oxygen doses. The highest doses were associated with a severe reversible exacerbation of emotional symptoms in 30-39% of subjects. Symptomatic improvements were supported by correlative functional and microstructural imaging changes in PTSD-affected brain regions. The imaging findings and hyperbaric oxygen therapy effects indicate that PTSD can no longer be considered strictly a psychiatric disease.
UNASSIGNED: PubMed, CINAHL, and the Cochrane Systematic Review Database were searched from September 18 to November 23, 2023, for all adult clinical studies published in English on HBOT and PTSD. Randomized trials and studies with symptomatic outcomes were selected for final analysis and analyzed according to the dose of oxygen and barometric pressure on symptom outcomes. Outcome assessment was for statistically significant change and Reliable Change or Clinically Significant Change according to the National Center for PTSD Guidelines. Methodologic quality and bias were determined with the PEDro Scale.
UNASSIGNED: Eight studies were included, all with < 75 subjects/study, total 393 subjects: seven randomized trials and one imaging case-controlled study. Six studies were on military subjects, one on civilian and military subjects, and one on civilians. Subjects were 3-450 months post trauma. Statistically significant symptomatic improvements, as well as Reliable Change or Clinically Significant changes, were achieved for patients treated with 40-60 HBOTS over a wide range of pressures from 1.3 to 2.0 ATA. There was a linear dose-response relationship for increased symptomatic improvement with increasing cumulative oxygen dose from 1002 to 11,400 atmosphere-minutes of oxygen. The greater symptomatic response was accompanied by a greater and severe reversible exacerbation of emotional symptoms at the highest oxygen doses in 30-39% of subjects. Other side effects were transient and minor. In three studies the symptomatic improvements were associated with functional and anatomic brain imaging changes. All 7 randomized trials were found to be of good-highest quality by PEDro scale scoring.
UNASSIGNED: In multiple randomized and randomized controlled clinical trials HBOT demonstrated statistically significant symptomatic improvements, Reliable Changes, or Clinically Significant Changes in patients with PTSD symptoms or PTSD over a wide range of pressure and oxygen doses. The highest doses were associated with a severe reversible exacerbation of emotional symptoms in 30-39% of subjects. Symptomatic improvements were supported by correlative functional and microstructural imaging changes in PTSD-affected brain regions. The imaging findings and hyperbaric oxygen therapy effects indicate that PTSD can no longer be considered strictly a psychiatric disease.
摘要：
■高压氧疗法（HBOT）治疗军事和民用受试者轻度创伤性脑损伤持续性脑震荡后综合征的研究表明，创伤后应激障碍（PTSD）或PTSD症状同时改善，提示HBOT可能是治疗PTSD的有效方法。本文是对有PTSD症状的患者HBOT治疗的系统评价和剂量分析。
■PubMed,CINAHL,并在2023年9月18日至11月23日的Cochrane系统评价数据库中检索了所有以英文发表的关于HBOT和PTSD的成人临床研究.选择具有症状结局的随机试验和研究进行最终分析，并根据氧气剂量和气压对症状结局的影响进行分析。根据国家PTSD中心指南，结果评估是统计上的显着变化和可靠变化或临床上的显着变化。用PEDro量表测定方法学质量和偏倚。
■纳入了8项研究，所有<75个科目/研究，共393名受试者:7项随机试验和1项影像学病例对照研究.六项研究是关于军事主题的，一个关于民事和军事主题，还有一个关于平民。受试者在创伤后3-450个月。统计学上显着的症状改善，以及可靠的变化或临床重大变化，在1.3至2.0ATA的广泛压力范围内接受40-60HBOTS治疗的患者均可获得。随着累积氧气剂量从1002增加到11,400大气压-分钟的氧气，症状改善的线性剂量-反应关系增加。在30-39％的受试者中，在最高的氧气剂量下，更大的症状反应伴随着情绪症状的更大和严重的可逆性恶化。其他副作用是短暂的和轻微的。在三项研究中，症状改善与功能和解剖脑成像变化有关。通过PEDro量表评分，所有7项随机试验均具有最高质量。
■在多项随机和随机对照临床试验中，HBOT显示出统计学上显著的症状改善，可靠的变化,或在广泛的压力和氧气剂量范围内患有PTSD症状或PTSD的患者的临床显着变化。在30-39％的受试者中，最高剂量与情绪症状的严重可逆性恶化有关。受PTSD影响的大脑区域的相关功能和微结构影像学变化支持症状改善。影像学发现和高压氧治疗效果表明，PTSD不再被严格视为精神疾病。
■PubMed,CINAHL,并在2023年9月18日至11月23日的Cochrane系统评价数据库中检索了所有以英文发表的关于HBOT和PTSD的成人临床研究.选择具有症状结局的随机试验和研究进行最终分析，并根据氧气剂量和气压对症状结局的影响进行分析。根据国家PTSD中心指南，结果评估是统计上的显着变化和可靠变化或临床上的显着变化。用PEDro量表测定方法学质量和偏倚。
■纳入了8项研究，所有<75个科目/研究，共393名受试者:7项随机试验和1项影像学病例对照研究.六项研究是关于军事主题的，一个关于民事和军事主题，还有一个关于平民。受试者在创伤后3-450个月。统计学上显着的症状改善，以及可靠的变化或临床重大变化，在1.3至2.0ATA的广泛压力范围内接受40-60HBOTS治疗的患者均可获得。随着累积氧气剂量从1002增加到11,400大气压-分钟的氧气，症状改善的线性剂量-反应关系增加。在30-39％的受试者中，在最高的氧气剂量下，更大的症状反应伴随着情绪症状的更大和严重的可逆性恶化。其他副作用是短暂的和轻微的。在三项研究中，症状改善与功能和解剖脑成像变化有关。通过PEDro量表评分，所有7项随机试验均具有最高质量。
■在多项随机和随机对照临床试验中，HBOT显示出统计学上显著的症状改善，可靠的变化,或在广泛的压力和氧气剂量范围内患有PTSD症状或PTSD的患者的临床显着变化。在30-39％的受试者中，最高剂量与情绪症状的严重可逆性恶化有关。受PTSD影响的大脑区域的相关功能和微结构影像学变化支持症状改善。影像学发现和高压氧治疗效果表明，PTSD不再被严格视为精神疾病。
