Abstract: Background　Depression，anxiety and other symptoms are common psychiatric symptoms in patients with Parkinson's disease，ranking the top 5 among all the symptoms.Depression and anxiety not only cause different degrees of functional damage，but also seriously affect patients’ quality of life.However，traditional medicines have many side effects and are addictive，while psychotherapies have fewer adverse reactions and reduce economic costs.Cognitive behavioral therapy （CBT） is widely used，and a large number of studies have confirmed its effectiveness in patients with Parkinson's disease.Objective　To systematically evaluate the effect of CBT on the symptoms of depression and anxiety and the quality of life in patients with Parkinson's disease（PD）.Methods　We searched the databases of PubMed，EMBase，Web of Science，Cochrane Library，Science Direct，CNKI，VIP，Wanfang Data Knowledge Service Platform and CBM.And randomized controlled trials（RCT）related to using CBT to relieve depression and anxiety in patients with PD included since the inception to May 2018 were collected.RCT were screened，data extraction was performed and qualities of eligible RCT were assessed.Meta-analysis was implemented with RevMan 5.3.Results　Nine RCT with 401 patients were included.Meta-analyses of depression symptom score 〔SMD
=-1.15，95%CI（-2.18，-0.13），P=0.03〕，anxiety symptom score 〔SMD=-0.80，95%CI（-1.40，-0.21），P=0.008〕 and general psychological health 〔SMD=-1.27，95%CI（-1.96，-0.59），P=0.000 3〕 after treatment showed the superiority of the experimental group over the control group.However，there was no significant difference in post-treatment quality of life between the groups（P>0.05）.Subgroup analyses showed that CBT had a poor effect on depression and anxiety after treatment immediately（P>0.05）.However，follow-up results showed that it significantly relieved the symptoms of depression and anxiety （P<0.05）.Conclusion　CBT helps to relieve the symptoms of depression and anxiety in PD.And long-term use of it can bring significant effect.However，its short-term effect and its effect on improving the quality of life need to be verified by further clinical studies.

Key words: Parkinson disease, Depression, Anxiety, Cognitive-behavioral therapy, Meta-analysis

摘要： 背景　抑郁、焦虑等症状是帕金森患者常见的精神症状，在患者所有症状中排名前5名。不仅导致患者不同程度的功能损害，还严重影响患者的生命质量。但传统药物治疗不良反应多、易成瘾，心理疗法不良反应少且节省经济成本。认知行为疗法（CBT）是被众多心理疗法中应用较广泛的一种，大量研究证实其应用于帕金森患者效果显著。目的　系统评价CBT减轻帕金森患者抑郁、焦虑症状，改善生活质量的效果。方法　计算机检索PubMed、EMBase、Web of Science、Cochrane Library、Science Direct、中国知网、维普网、万方数据知识服务平台、中国生物医学文献数据库（CBM）等数据库，检索时限为建库至2018年5月，收集有关CBT治疗帕金森患者抑郁、焦虑症状的随机对照试验，并对文献进行筛选、质量评价和资料提取，采用RevMan 5.3进行Meta分析。结果　共纳入9篇文献，总样本量401例，Meta分析结果显示，试验组抑郁评分〔标准化均数差（SMD）=-1.15，95%CI（-2.18，-0.13），P=0.03〕、焦虑评分〔SMD=-0.80，95%CI（-1.40，-0.21），P=0.008〕、心理一般健康状况评分〔SMD=-1.27，95%CI（-1.96，-0.59），P=0.000 3〕较对照组降低；试验组与对照组生活质量评分比较，差异无统计学意义（P>0.05）。亚组分析显示，CBT对改善帕金森病患者治疗后即刻抑郁评分、焦虑评分效果不佳（P>0.05），但可明显改善随访时评价的抑郁评分、焦虑评分（P<0.05）。结论　CBT有助于帕金森病患者抑郁、焦虑症状的恢复，尤其是治疗结束长期随访的效果，但短期治疗后的效果以及在提升生活质量方面仍需进一步的临床研究证实其干预有效性。

关键词: 帕金森病, 抑郁, 焦虑, 认知行为疗法, Meta分析