自我管理干预对冠心病患者预后影响的Meta分析

Effect of Self-Management Intervention on Prognosis of Patients with Coronary Heart Disease: A Meta-Analysis

摘要: 目的：系统评价自我管理干预对冠心病患者预后的影响。方法：计算机检索PubMed、The Cochrane Library、Web of Science、中国知网(CNKI)、万方数据库和维普数据库中关于自我管理干预应用于冠心病患者预后的研究，检索时限为1999年1月1日至2021年12月31日。由2名研究员独立进行文献筛选、提取资料和质量评价，并且采用RevMan5.3软件进行Meta分析。结果：最终纳入12篇文献，共1360名病人。Meta结果分析显示，与常规护理相比，自我管理干预能够有效缓解躯体疼痛[SMD = 0.67, 95% CI (0.22, 1.12), P = 0.004]，加强情绪管理[SMD = 0.82, 95% CI (0.47, 1.16), P < 0.00001]，进一步提高患者的疾病知识水平[SMD = 1.41, 95% CI (0.78, 2.04), P < 0.0001]和治疗依从性[SMD = 1.37, 95% CI (0.58, 2.16), P = 0.0007]，改善其生活质量[SMD = 1.02, 95% CI (0.58, 1.46), P < 0.00001]，且其敏感性分析均显示结果稳定可信。但生活质量漏斗图两侧不对称。结论：现有证据表明，自我管理干预能够缓解躯体疼痛，加强情绪管理，提高冠心病患者的疾病知识水平和治疗依从性，进一步改善其生活质量。

Abstract: Objective: To systematically evaluate the influence of self-management intervention on the prognosis of patients with coronary heart disease. Methods: The research on the application of self-management intervention to the prognosis of patients with coronary heart disease in PubMed, The Cochrane Library, Web of Science, China Knowledge Network (CNKI), Wan fang database and VIP database for the research on the application of self-management intervention to the prognosis of patients with coronary heart disease. The search time is from January 1, 1999 to December 31, 2021. Literature screening, Meta extraction and quality evaluation were independently conducted by two researchers, and meta-analysis was conducted by RevMan5.3 software. Results: A total of 1360 patients were included in 12 articles. Meta-analysis showed that, compared with routine nursing, self-management intervention can effectively relieve physical pain [SMD = 0.67, 95% CI (0.22, 1.12), P = 0.004], and strengthen emotional control management [SMD = 0.82, 95% CI (0.47, 1.16), P < 0.0001]. P < 0.0001] and treatment compliance [SMD = 1.37, 95% CI (0.58, 2.16), P = 0.0007], improving their quality of life [SMD = 1.02, 95% CI (0.58, 1.46), P < 0.00001] and their sensitivity analysis showed that the results were stable and reliable. But the funnel chart of quality of life is asymmetrical on both sides. Conclusion: Existing evidence shows that self-management intervention can relieve physical pain, strengthen emotional management, improve the disease knowledge and treatment compliance of patients with coronary heart disease, and further improve their quality of life.