正念疗法对青少年抑郁症患者情绪症状与生活质量干预效果的Meta分析

The Intervention Effects of Mindfulness-Based Therapy on Emotional Symptoms and Quality of Life in Adolescents with Depression: A Meta-Analysis

摘要: 目的：讨论正念疗法(Mindfulness-Based Therapy, MBT)对青少年抑郁症患者情绪症状和生活质量的干预效果。方法：系统检索中英文主流数据库PubMed、Web of Science、Cochrane Central Register of Controlled Trials、中国知网、万方数据知识服务平台、维普中文期刊服务平台、中国生物医学文献数据库，检索跨度为自建库至2023年12月24日。由研究小组中两名研究人员分别独立进行文献筛选，并使用Cochrane偏倚风险评估工具进行文献质量评价，Reman 5.4软件进行数据分析。结果：最终纳入5篇文献随机对照试验，涉及研究对象共计516例。Meta分析结果显示与常规药物治疗相比，正念疗法联合药物治疗可显著缓解青少年抑郁症状(SMD = −1.24, 95% CI: −1.86~−0.62, P < 0.001)及降低焦虑水平(SMD = −0.89, 95% CI: −1.35~−0.43, P < 0.001)。然而在生活质量的提升方面未达预期效果，可能与数据不足及异质性较高(I² = 85%)有关。结论：正念疗法在改善青少年抑郁及焦虑核心症状方面具有潜在优势，但其对生活质量(主要是疼痛、睡眠障碍)的干预效果仍需进一步验证。未来需开展大样本、高质量研究，规范干预方案并评估长期疗效。

Abstract: Objective: To evaluate the intervention effects of Mindfulness-Based Therapy (MBT) on emotional symptoms and quality of life in adolescents with depression. Methods: We systematically searched PubMed, Web of Science, Cochrane Central Register of Controlled Trials, CNKI, Wanfang Data, VIP Chinese Journal Database, and China Biology Medicine disc from inception to December 24, 2023. Two researchers independently screened literature, assessed risk of bias using the Cochrane Risk of Bias Tool, and analyzed data with RevMan 5.4 software. Results: Five randomized controlled trials (RCTs) involving 516 participants were included. Meta-analysis showed that compared with pharmacotherapy alone, MBT combined with pharmacotherapy significantly alleviated depressive symptoms (SMD = −1.24, 95% CI: −1.86 to −0.62; P < 0.001) and reduced anxiety (SMD = −0.89, 95% CI: −1.35 to −0.43; P < 0.001), but demonstrated no significant improvement in quality of life (particularly in domains of pain and sleep disorders), potentially due to insufficient data and high heterogeneity (I² = 85%). Conclusion: MBT shows potential advantages in improving core depressive and anxiety symptoms among adolescents, yet its efficacy on quality of life requires further validation through large-sample, high-quality studies with standardized protocols and long-term assessments.