Yoga for schizophrenia: a systematic review and meta-analysis.
Yoga for schizophrenia: a systematic review and meta-analysis.
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DOI：
10.1186/1471-244x-13-32
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发表时间：
2013-01-18
期刊：
影响因子：
4.4
通讯作者：
Dobos G
中科院分区：
文献类型：
--
作者：
Cramer H;Lauche R;Klose P;Langhorst J;Dobos G
本综述的目的是系统回顾和荟萃分析瑜伽对精神分裂症患者的症状、生活质量、功能和住院治疗的影响。MEDLINE/Pubmed、Scopus、Cochrane Library、PsycInfo和IndMED的筛选截止到2012年8月。在评估精神分裂症患者的症状或生活质量时，对比较瑜伽与常规护理或非药物干预的随机对照试验（rct）进行了分析。认知功能、社会功能、住院和安全性被定义为次要结局。使用Cochrane Back Review Group推荐的偏倚风险评估工具评估偏倚风险。计算标准化平均差（SMD）和95%置信区间（CI）。纳入5项随机对照试验，共337例患者；2项rct偏倚风险较低。两项随机对照试验比较了瑜伽和常规护理；1项随机对照试验比较了瑜伽和运动；以及2项3臂随机对照试验，将瑜伽与常规护理和锻炼进行比较。没有证据表明，与常规护理相比，瑜伽对阳性症状（SMD = -0.58; 95% CI -1.52至0.37;P = 0.23）或阴性症状（SMD = -0.59; 95% CI -1.87至0.69;P = 0.36）有短期影响。与常规护理相比，中度证据显示对生活质量有短期影响（SMD = 2.28; 95% CI 0.42 ~ 4.14; P = 0.02）。这些效应只存在于高偏倚风险的研究中。未发现对社会功能有短期影响的证据（SMD = 1.20; 95% CI -0.78 ~ 3.18; P = 0.23）。将瑜伽与运动相比较，没有证据表明瑜伽对阳性症状（SMD = -0.35; 95% CI -0.75至0.05;P = 0.09）、阴性症状（SMD = -0.28; 95% CI -1.42至0.86;P = 0.63）、生活质量（SMD = 0.17; 95% CI -0.27至0.61;P = 0.45）或社会功能（SMD = 0.20; 95% CI -0.27至0.67;P = 0.41）有短期影响。只有1项随机对照试验报告了不良事件。这一系统综述只发现了瑜伽对生活质量有短期影响的适度证据。由于这些影响不能与偏倚明显区分，而且干预的安全性尚不清楚，因此不能建议将瑜伽作为精神分裂症患者的常规干预措施。
The aim of this review was to systematically review and meta-analyze the effects of yoga on symptoms of schizophrenia, quality of life, function, and hospitalization in patients with schizophrenia. MEDLINE/Pubmed, Scopus, the Cochrane Library, PsycInfo, and IndMED were screened through August 2012. Randomized controlled trials (RCTs) comparing yoga to usual care or non-pharmacological interventions were analyzed when they assessed symptoms or quality of life in patients with schizophrenia. Cognitive function, social function, hospitalization, and safety were defined as secondary outcomes. Risk of bias was assessed using the risk of bias tool recommended by the Cochrane Back Review Group. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Five RCTs with a total of 337 patients were included; 2 RCTs had low risk of bias. Two RCTs compared yoga to usual care; 1 RCT compared yoga to exercise; and 2 3-arm RCTs compared yoga to usual care and exercise. No evidence was found for short-term effects of yoga compared to usual care on positive symptoms (SMD = -0.58; 95% CI -1.52 to 0.37; P = 0.23), or negative symptoms (SMD = -0.59; 95% CI -1.87 to 0.69; P = 0.36). Moderate evidence was found for short-term effects on quality of life compared to usual care (SMD = 2.28; 95% CI 0.42 to 4.14; P = 0.02). These effects were only present in studies with high risk of bias. No evidence was found for short-term effects on social function (SMD = 1.20; 95% CI -0.78 to 3.18; P = 0.23). Comparing yoga to exercise, no evidence was found for short-term effects on positive symptoms (SMD = -0.35; 95% CI -0.75 to 0.05; P = 0.09), negative symptoms (SMD = -0.28; 95% CI -1.42 to 0.86; P = 0.63), quality of life (SMD = 0.17; 95% CI -0.27 to 0.61; P = 0.45), or social function (SMD = 0.20; 95% CI -0.27 to 0.67; P = 0.41). Only 1 RCT reported adverse events. This systematic review found only moderate evidence for short-term effects of yoga on quality of life. As these effects were not clearly distinguishable from bias and safety of the intervention was unclear, no recommendation can be made regarding yoga as a routine intervention for schizophrenia patients.