目的 系统评价不同非药物干预方式对社区脊髓损伤脊髓损伤（spinal cord injury，SCI）患者抑郁的短期及长期效果。方法 检索PubMed、Web of Science、Cochrane Library、Embase、ProQuest、Scopus、知网、维普、万方、中国生物医学文献数据库中关于非药物干预方式对社区SCI患者抑郁影响的随机对照试验，检索时限为建库至2024年1月。使用ReviewManager 5.4软件进行Meta分析。结果 共纳入26项随机对照试验、1943例社区SCI患者，涉及5种非药物干预方式。以干预结束后随访时间是否超过 3个月区分长期、短期效果:（1）心理干预短期内可改善抑郁（P=0.01），长期效果不显著（P=0.56）;（2）运动疗法短期内可改善抑郁（P＜0.001），长期效果证据不足;（3）健康教育短期内可改善抑郁（P=0.03），长期效果证据不足;（4）职业康复仅1项研究，长短期效果证据不足;（5）混合疗法短期效果不显著（P=0.09），长期效果证据不足。结论 各类非药物干预方式中，心理干预、运动疗法、健康教育能够在短期内有效改善社区SCI患者的抑郁，缺乏足够的证据支持各类非药物干预对社区SCI患者抑郁的长期效果。

Objective To systematically evaluate the short-and long-term effects of different non-pharmacological interventions on depression among community-dwelling patients with spinal cord injury(SCI).Methods Randomized controlled trials(RCTs) assessing the impact of non-pharmacological interventions on depression among community-dwelling SCI patients were retrieved from PubMed,Web of Science,Cochrane Library,Embase,ProQuest,Scopus,CNKI,VIP,Wanfang,and China Biology Medicine disc from the inception of each database to January 2024.Meta-analysis was performed using Review Manager 5.4 software.Results A total of 26 RCTs involving 1943 community-dwelling SCI patients were included,covering five types of non-pharmacological interventions. The long-term and short-term effects were distinguished based on whether the follow-up period after the intervention exceeded 3 months: (1) Psychological intervention could relieve depression in the short term (P=0.01), but the long-term effect was not significant (P=0.56). (2) Exercise therapy could relieve depression in the short term (P＜0.001), but the evidence for long-term effects was insufficient. (3)Health education could relieve depression in the short term (P=0.03), but the evidence for long-term effects was insufficient. (4) Vocational rehabilitation had only one study, and the evidence for both long-and short-term effects was insufficient. (5) Combined therapy showed no significant short-term effect (P=0.09), and the evidence for long-term effects was insufficient. Conclusions Among various non-pharmacological interventions,psychological interventions,exercise therapy,and health education showed short-term effectiveness in reducing depression in community-dwelling SCI patients.However,evidence supporting the long-term effectiveness of these interventions remains insufficient.

R471

国家自然科学基金面上项目（72374229）；广东省自然科学基金面上项目（2021A1515011800）