家庭干预对精神分裂症患者康复作用的系统性评价

关键词：家庭干预 精神分裂症 系统性评价 随机对照临床试验 Meta分析

Keywords:family intervention  schizophrenia  systematic review  randomized control trial  Meta analysis

摘要：

      目的：探讨家庭干预对精神分裂症患者康复作用的临床研究质量及疗效。方法：计算机检索中国生物医学文献数据库（CBMdisk）和中文科技期刊数据库（VIP，1989—2005），收集有关家庭干预对精神分裂症患者康复作用与常规药物治疗相比较的随机对照试验文献．由两名评价者独立评价纳入研究的文献质量，并进行了Meta分析。结果：符合纳入标准的随机对照实验（randomized control trial，RCT）共9个，但其方法学质量均欠佳（C级）。与对照组相比，家庭干预对精神分裂症患者的服药依从性有明显的增效作用[RR1．69，95％CI（1．21，2．37），P=0．0021，敏感性分析后得到的结果略有下降[RR1．46，95％CI（1．22，1．75），P〈0．0001]。结论：目前有关家庭干预对精神分裂症患者康复作用的临床研究在科研方法学的应用方面仍有差距。本研究提示，家庭干预可能对精神分裂症患者的服药依从性有一定的增效作用，但不排除与实验方法学质量低下及发表性偏倚有关。

Abstract:

      Objective:To assess the methodological quality of clinical studies using family intervention as a therapy and to evaluate its efficacy.Method:A comprehensive search strategy was designed to identify all randomized control trials(RCT) comparing family intervention versus routine drug treatment alone by searching for the CBMdisc and VIP database(1989-2005) .The methodological quality of the trials was assessed by two reviewers independently for which a meta analysis was performed.Result:Nine RCTs met the inclusion criteria.methodological quality was poor(all the trials included were level C) .Compared with the control group,the compliance outcome of drug treatment increased by family intervention,[RR 1.69,95%CI(1.21,2.37) ,P=0.002],and the outcome of susceptivity analysis decreases slightly [RR 1.46,95%CI(1.22,1.75) ,P<0.0001].Conclusion:The methodological quality of the trails using family intervention should be improved.Based on the results of the review and the meta-analysis,family intervention may have positive effects on drug treatment in patients with schizophrenia,although the evidence is weak.No serious adverse events are reported.Further well-designed clinical trials should be performed.