漸進式肌肉放鬆於癌症病患焦慮、憂鬱及噁心嘔吐之系統性文獻回顧及統合分析

Effects of Progressive Muscle Relaxation on Anxiety, Depression, Nausea and Vomiting in Cancer Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials

目的：漸進式肌肉放鬆訓練被廣泛運用於緩解癌症病患焦慮、憂鬱及化學治療期間所帶來的噁心、嘔吐之副作用，但文獻中並無提供完整臨床實證成效。本文經由分析隨機實驗研究，整合並探討漸進式肌肉放鬆訓練於癌症病患焦慮、憂鬱及噁心嘔吐之成效。方法：使用系統性文獻及統合方法，搜尋時間至2017年8月，搜尋包含MEDLINE、PubMed、Cochrane Library、Embase、PsycINFO、Web of Science、 CEPS、碩博士論文網等電子資料庫，選取漸進性肌肉放鬆訓練對於癌症病患的相關文獻，共收集十篇符合評選標準之隨機臨床對照試驗，進行系統性文獻整理及分析，測量變項為焦慮、憂鬱及噁心嘔吐。結果：研究發現，漸進性肌肉放鬆訓練對於改善癌症病患之噁心、嘔吐程度達到顯著差異，綜合效果量為0.84（95%CI=[0.18,1.49]）。但在改善焦慮及憂鬱程度部分則未達到顯著差異。結論：本研究應用系統性文獻回顧及統合分析方法，發現漸進式肌肉放鬆訓練能夠顯著改善癌症病患之噁心嘔吐程度。此成果可以提供更客觀的實證證據，協助醫護人員提供癌症病患更具體的護理措施。

Purposes Progressive muscle relaxation (PMR) training has been used to alleviate anxiety, depression, and chemotherapy-related complications, such as nausea and vomiting. However, literature did not provide a complete clinical empirical efficacy of PMR. This paper analyzes randomized clinical trials, and compiles and examines the efficacy of PMR training on anxiety, depression, nausea, and vomiting in cancer patients.. Methods Systematic review and meta-analysis were used. Searches on the effects of PMR training on cancer patients were conducted in databases including MEDLINE, PubMed, Cochrane Library, Embase, PsycINFO, Web of Science, CEPS, and National Digital Library of Theses and Dissertations in Taiwan. Ten articles on randomized controlled clinical trials that fulfilled the selection criteria were extracted. The main outcomes assessed were anxiety, depression, nausea, and vomiting. Results The 10 studies showed that PMR intervention had significant effects on nausea and vomiting with effect sizes of 0.84 (95% CI=[0.18, 1.49]). There was no significant effect on anxiety and depression. Conclusions This study used systematic review and meta-analysis and found that PMR training may alleviate nausea and vomiting in patients with cancer. These results can provide more objective empirical data to assist medical staff in providing more specific care measures for cancer patients.