Meta-analysis Of Psychological Intervention For Functional Dyspepsia

Objective1.To systematically evaluate the effect of psychological intervention alone or in combination with drug on functional dyspepsia(FD)patients.2.To systematically evaluate the effect of psychological intervention on FD patients with anxiety/depression.Methods1.Randomized controlled trials of psychological intervention for FD were collected and reviewed through searching PubMed,Embase,Ovid,Cochrane Library,CNKI,WanFang database,VIP database and grey literature database.2.Clinical efficacy rate,dyspepsia symptom score,depression/anxiety score,and QOL score were extracted from the included studies by two persons independently.Jadad quality scale was used to assess the quality of included trails.3.Review Manager 5.3 software was used for meta-analysis of the data extracted from the included studies.Results1.A total of 21 group studies were included in the analysis,including1661 FD patients,831 in the psychological intervention group and 830 in the conventional treatment group.2.Meta-analysis results:1)Clinical efficacy rate: The clinical efficacy rate of psychological intervention combined with drug for FD was significantly higher than that of drug treatment alone(OR = 4.48,95% CI: 3.26~6.17,Z = 9.21,P <0.00001).2)Dyspepsia symptom score: The dyspepsia symptom score of psychological intervention group was significantly lower than that in the corresponding drug group(SMD =-1.40,95% CI:-2.59~-0.21,Z = 2.31,P = 0.02);the dyspepsia symptom score of psychological intervention group was significantly lower than that in the blank/placebo group(SMD =-1.94,95% CI:-3.32 ~-0.57,Z = 2.77,P = 0.006).Psychological intervention can significantly enhance the impact of other treatments on dyspepsia symptom score(SMD =-1.73,95% CI:-2.60~-0.87,Z = 3.93,P< 0.0001).3)Quality of life(QOL)score : The QOL score of psychological intervention group was higher than that of blank/placebo group,there was no significant difference between the two groups(SMD = 6.44,95% CI:-9.73~22.61,Z = 0.78,P = 0.44).4)Symptom Checklist-90(SCL-90)score: The SCL-90 score of psychological intervention group was lower than that of the blank/placebo group,there was no significant difference between the two groups(SMD =0.00,95% CI:-0.48 ~ 0.48,Z = 0.00,P = 1.00);the SCL-90 score of psychological intervention combined with drugs group was significantly lower than that of the corresponding drug group(SMD =-0.71,95% CI:-1.33~-0.09,Z = 2.25,P = 0.02).5)Depression score: The depression score of psychological intervention group combined with drugs was lower than that in the group of corresponding drugs alone,there was no significant difference between the two groups(SMD =-0.75,95% CI:-1.55~0.05,Z = 1.83,P = 0.07).6)Anxiety score: Psychological intervention can significantly enhance the effect of other treatments on anxiety score(SMD =-1.06,95%CI:-1.79~-0.32,Z = 2.82,P = 0.005).The anxiety score of psychological intervention group was significantly lower than that of the corresponding drug group(SMD =-0.78,95% CI:-1.41~-0.15,Z = 2.44,P = 0.01);the anxiety score of the psychological intervention group was significantly lower than that of the blank/placebo group(SMD =-2.45,95% CI:-3.11~-1.79,Z = 7.30,P < 0.00001).Conclusion1.Psychological intervention alone has no obvious effect on FD.Psychological intervention can enhance the effect of drugs on FD,but it hasno significant effect on the quality of life of FD patients.2.There are differences in the efficacy of different psychological interventions on FD,among which cognitive behavior therapy may be more suitable for FD patients.3.Psychological intervention may be suitable for FD patients with anxiety symptoms,not suitable for FD patients with depression.