摘要目的? 系统评价网络化认知行为疗法(Internet-delivered cognitive-behavioral therapy, ICBT)对癌症患者症状管理的干预效果.方法? 计算机检索Web of Science、PubMed、Cochrane Library、Embase、中国生物医学文献数据库、CNKI、万方数据库中关于应用ICBT对癌症患者进行症状管理的随机对照试验,检索时间自建库至2018年8月20日.经文献筛选、资料提取、质量评价后,采用RevMan5.3软件进行Meta分析.结果? 最终纳入11项RCT研究,共2 329例研究对象.结果显示,ICBT有利于改善癌症患者的心理痛苦[SMD=5.02,95%C(I 0.80,9.25),P=0.02]、睡眠质量[SMD=0.35,95%CI (0.02,0.68),P=0.04]和癌因性疲乏[SMD=0.50,95%C(I 0.01,0.99),P=0.04];但ICBT没有减轻癌症患者的抑郁(P＞0.05).结论? ICBT有利于降低癌症患者心理痛苦、提高睡眠质量、缓解癌因性疲乏,但在减轻患者抑郁方面未显示出明显优势.未来研究仍需聚焦特定癌症类型,开展多中心、大样本、长期干预研究予以验证.

abstractsObjective? To assess the application effects of internet-delivered cognitive-behavioral therapy(ICBT) on symptom management in cancer patients. Methods? All randomised controlled trials (RCTs) about applying ICBT in symptom management in cancer patients in the following databases were searched from the establishment date up until 20th August 2018: Web of Science, PubMed, Cochrane Library, Embase, CBMdisc, Chinese National Knowledge Infrastructure databases(CNKI) and Wanfang. After literature screening, data extraction and quality evaluation, RevMan 5.3 software was used for meta-analysis. Results? Finally, 11 RCT studies were included, totaling 2329 subjects. The results showed that ICBT was beneficial to improve mental distress [SMD=5.02, 95%CI (0.80, 9.25), P=0.02], sleep quality [SMD=0.35, 95%CI (0.02, 0.68), P=0.04]and cancer-related fatigue [SMD=0.50, 95%CI (0.01, 0.99), P=0.04]; but ICBT did not have depression relieving effects in cancer patients (P＞0.05). Conclusions? ICBT is beneficial to reduce psychological pain, improve sleep quality and alleviate cancer-related fatigue in cancer patients, but it has no obvious advantage in alleviating depression. Future studies still need to focus on specific cancer types and validate them with multi-center, large-sample and long-term intervention studies.