瑜珈輔助療法改善思覺失調症病人正性和負性症狀之系統性文獻回顧暨統合分析

A Systematic Review and Meta-Analysis of Yoga Adjunctive Therapy to Improve Positive and Negative Symptoms of Schizophrenia Patients

蔡佳玲(Chia-Ling Tsai) ； 黃心樹(Hsin-Shu Huang)

《源遠護理》 15卷3期 (2021/11) Pp. 54-65

https://doi.org/10.6530/YYN.202111_15(3).0008

摘要

背景：藥物治療是思覺失調症最主要的治療方法，而輔助療法改善藥物副作用和舒緩症狀已普遍受到重視。目的：檢視瑜珈輔助療法於思覺失調症之訓練處方，並探討瑜珈輔助療法改善思覺失調症病人正性和負性症狀之成效。方法：以系統性文獻回顧方法，搜尋2020年3月前發表於The Cochrane Library、PubMed、CINAHL、Medline及臺灣碩博士論文系統、臺灣期刊論文索引系統、華藝線上圖書館共7個資料庫之文獻，設立關鍵字：Schizophrenia or schizoaffective or psychosis or psychotic／思覺失調症或情感性思覺失調症或精神病、yoga or yogic or yogi／瑜珈，進行檢索搜查共有1227篇相關期刊文獻，經篩選最後採納12篇隨機對照試驗文章，以2017年JBI隨機對照試驗檢核表評讀研究品質；以RevMan 5.3版套裝軟體進行統合分析比較瑜珈、運動、及常規治療改善思覺失調症病人正性與負性症狀的成效。結果：在專業瑜珈教練指導之下進行為期4～8週短期性訓練最多，進行瑜珈頻率每週3～7天不等，每次60分鐘；第8週瑜珈組和常規治療組相較於改善正向症狀達顯著成效（p=.05），但未顯著改善負性症狀成效（p=.40）。第12週瑜珈組和常規治療組相較於改善整體PANSS總分具有顯著成效（p＜0.00001）。瑜珈組和運動組在第16週對改善正性症狀（p=.08）和負性症狀（p=.55）並無顯著差異。結論／實務應用：短期瑜珈輔助療法對思覺失調症病人改善正性症狀和提高PANSS總分是有益的，然而長期瑜珈輔助療法對改善正性和負性症狀之成效證據尚需更多研究加以證實。

關鍵字

瑜珈 ； 輔助療法 ； 思覺失調症 ； 系統性文獻回顧 ； 統合分析

並列摘要

Background: Drug therapy is the major treatment for schizophrenia, and adjunctive therapy has been widely recognized for improving drug side effects and soothing symptoms. Purpose: The purpose of this study was to examine the training prescriptions for yoga adjunctive therapy in schizophrenic patients. Investigate the effect of yoga adjunctive therapy on the improvement of positive and negative symptoms of schizophrenic patients. Methods: In the systematic reviews examine the training prescriptions and meta- analysis of yoga adjunctive therapy in schizophrenic patients to compare the effects of yoga, exercise, and conventional treatment on positive and negative symptoms of schizophrenia. According to empirical research, we process from the formation of problems, literature search, screening of literature, literature quality evaluation, extraction integration, and evaluation of results. And search for related literature in The Cochrane Library, PubMed, CINAHL, Medline and Taiwan Master's Thesis System, Taiwan Journal Paper Index System, Airiti Library Huayi Online Library, etc. before March 2020. Search for keywords: Schizophrenia or schizoaffective or psychosis or psychotic, yoga or yogic or yogi, also search for literature published in Chinese and English journals at home and abroad, to find out that it is relevant for the purpose of this study. The article was included in the review for meta-analysis. Results: A total of 12 research samples were included for systematic reviews. The yoga training was guided by a yoga professional or coach. The short-term intervention was 4-8 weeks. The frequency of yoga was 3 to 7 days per week and each session no more than 60min. Seven of the study samples entered the meta-analysis and found that 8-week yoga adjunctive therapy had a significant effect on improving positive symptoms compared with conventional therapy (p = .05), but did not achieve a significant effect on improving negative symptoms (p = .40). Compared with conventional treatment, the 12-week comparison of yoga adjunctive therapy had a significant effect on improving the PANSS total score (p ＜ 0.00001). There was no significant difference between the improvement of positive symptoms (p = .08) and negative symptoms (p = .55) between the yoga group and the exercise group at 16 weeks. Conclusions: Short term Yoga therapy is effective for the positive symptoms and PANSS total score of schizophrenic patients. Yet the effectiveness of long term Yoga therapy for positive and negative symptoms needs further researches.

並列關鍵字

Yoga ； adjunctive therapy ； schizophrenic ； systematic review ； meta-analysis

參考文獻

Behere, R. V., Arasappa, R., Jagannathan, A., Varambally, S., Venkatasubramanian, G., Thirthalli, J., Subbakrishna, D. K., Nagendra, H. R., & Gangadhar, B. N. (2011). Effect of yoga therapy on facial emotion recognition deficits, symptoms and functioning in patients with schizophrenia. Acta Psychiatrica Scandinavica, 123(2), 147-153. https://doi.org/10.1111/j.1600

Bhatia, T., Mazumdar, S., Wood, J., He, F., Gur, R. E., Gur, R. C., Nimgaonkar, V. L., & Deshpande, S. N. (2017). A randomised controlled trial of adjunctive yoga and adjunctive physical exercise training for cognitive dysfunction in schizophrenia. Acta Neuropsychiatrica, 29(2), 102-114. https://doi.org/10.1017/neu.2016.42

Broderick, J., Crumlish, N., Waugh, A., & Vancampfort, D. (2017). Yoga versus non-standard care for schizophrenia. Cochrane Database of Systematic Reviews, 9, CD012052. https://doi.org/10.1002/14651858. cd012052.pub2

Broderick, J., Knowles, A., Chadwick, J., & Vancampfort, D. (2015). Yoga versus standard care for schizophrenia. Cochrane Database of Systematic Reviews, 10, CD010554. https://doi.org/10.1002/14651858.cd010554.pub2

Cabral, P., Meyer, H. B., & Ames, D. (2011). Effectiveness of yoga therapy as a complementary treatment for major psychiatric disorders: A meta-analysis. The Primary Care Companion for CNS Disorders, 13(4), PCC.10r01068. https://doi.org/10.4088/PCC.10r01068