论文部分内容阅读
目的:探索有氧运动对类风湿关节炎(rheumatoid arthritis,RA)患者自评健康状况的影响。方法:采用计算机检索Pub Med、Cochrane Library、EMbase、中国生物医学文献数据库、维普中文科技期刊全文数据库、万方数据库、中国期刊全文数据库,自建库以来至2015年7月公开发表的,关于有氧运动对RA患者干预效果的中、英文随机和半随机对照试验,并辅以手工检索,追踪纳文献和相关综述的参考文献。按照纳入排除标准选择并评价文献质量,采用Rev Man 5.3软件进行荟萃分析。结果:最终纳入7篇英文文献,共644例RA患者,其中包括有氧运动组(干预组)327例,常规治疗组(对照组)317例。荟萃分析结果显示,干预组的健康评估问卷-残疾指数量表(Health Assessment Questionnaire-Disability Index,HAQ-DI)评分高于对照组[加权均数差(mean difference,MD)=-0.14,95%CI为-0.23~-0.05,P=0.001]。亚组分析显示,短期干预(≤16周)效果(MD=-0.35,95%CI为-0.52~-0.19,P<0.001)优于长期干预(≥24周)效果(MD=-0.08,95%CI为-0.16~0.00,P=0.04);干预组的疲乏评分高于对照组[标准化均数差(standardized mean difference,SMD)=-0.16,95%CI为-0.31~-0.01,P=0.04],而短期干预对RA患者疲乏的改善效果(SMD=-0.16,95%CI为-0.31~-0.01,P=0.04)优于长期干预(SMD=-0.09,95%CI为-0.30~0.12),P=0.41);疼痛评分在2组间差异无统计学意义(SMD=-0.13,95%CI为-0.32~0.05,P=0.16)。结论 :有氧运动可明显改善RA患者的躯体功能,对缓解疲乏症状具有一定的积极作用,但仍需行更多高质量的随机对照研究以验证。
Objective: To explore the effect of aerobic exercise on self-rated health status of patients with rheumatoid arthritis (RA). Methods: PubMed, Cochrane Library, EMbase, Chinese Biomedical Literature Database, VIP Chinese Science and Technology Journal Full-text Database, Wanfang Database, Chinese Journal Full-text Database, published since July, 2015, Randomized and quasi-randomized controlled trials of Chinese and English randomized controlled trials on the interventional effects of aerobic exercise on patients with RA were performed. Manual references were also searched to trace the references in the literature and related reviews. The quality of the literature was selected and evaluated according to the exclusion criteria, and Rev Man 5.3 software was used for meta-analysis. RESULTS: A total of 7 English articles were included in the study. A total of 644 RA patients were included, including 327 in the aerobic exercise group (intervention group) and 317 in the conventional treatment group (control group). The meta-analysis showed that the score of Health Assessment Questionnaire-Disability Index (HAQ-DI) in the intervention group was higher than that of the control group [mean difference (MD) = - 0.14, 95% CI -0.23 ~ -0.05, P = 0.001]. Subgroup analyzes showed that the effect of short-term intervention (≤16 weeks) (MD = -0.35, 95% CI -0.52-0.19, P <0.001) was superior to the long-term intervention (≥24 weeks) % CI was -0.16 ~ 0.00, P = 0.04). The fatigue score of the intervention group was higher than that of the control group [standardized mean difference (SMD) = - 0.16, 95% CI -0.31 ~ -0.01, P = 0.04], while the effect of short-term intervention on fatigue of patients with RA was better than that of long-term intervention (SMD = -0.16,95% CI -0.31 ~ -0.01, P = 0.04) (SMD = -0.09,95% CI -0.30 ~ 0.12), P = 0.41). There was no significant difference in pain score between the two groups (SMD = -0.13, 95% CI -0.32 ~ 0.05, P = 0.16). Conclusion: Aerobic exercise can significantly improve physical function of RA patients and relieve fatigue symptoms. However, more high-quality randomized controlled studies are still needed to verify.