摘要
目的系统评价有氧运动、抗阻运动、有氧结合抗阻运动对非透析慢性肾病患者的干预效果。方法计算机检索PubMed、The Cochrane Library、EMbase、EBSCO、Web of Science、VIP、WanFang Data和CNKI数据库,搜集三种运动疗法治疗非透析慢性肾病患者的随机对照试验(RCT),检索时限从2012年1月20日至2022年1月20日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.4软件和R软件进行网状Meta分析。结果共纳入22个RCT,包括1633例患者。网状Meta分析结果显示:与对照组相比,有氧运动、抗阻运动均可降低静息收缩压;有氧运动、抗阻运动可降低静息舒张压;有氧运动可降低总胆固醇,提高最大摄氧量;有氧结合抗阻运动可延长六分钟步行试验距离;有氧运动、抗阻运动、有氧结合抗阻运动均可改善预估肾小球滤过率。最佳概率排序结果显示:有氧运动改善最大摄氧量、高密度脂蛋白,降低C反应蛋白、低密度脂蛋白、总胆固醇水平效果最显著;抗阻运动降低收缩压、舒张压、预估肾小球滤过率效果最显著;有氧结合抗阻运动降低身体质量指数、甘油三酯、延长六分钟步行试验距离的效果最显著。结论当前证据表明,针对非透析慢性肾病患者,有氧运动对于降低总胆固醇、提高最大摄氧量,抗阻运动能降低血压和预估肾小球滤过率,有氧结合抗阻运动对于提高步行能力可能是最佳的运动方式。
Objective To systematically review the efficacy of aerobic training,resistance training and aerobic training combined with resistance training on non-dialysis patients with chronic kidney diseases.Methods PubMed,The Cochrane Library,EMbase,EBSCO,Web of Science,VIP,WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials(RCTs)of three types of exercise therapy on patients with chronic kidney disease from January 2012 to January 2022.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies;then,network meta-analysis was performed by using RevMan 5.4 software and R software.Results A total of 22 RCTs involving 1633 patients were included.The results of network meta-analysis showed that:compared with the control group,aerobic training,and resistance training reduced resting systolic blood pressure;aerobic training,resistance training reduced resting diastolic blood pressure;aerobic training reduced total cholesterol levels;aerobic training improved peak oxygen uptake;aerobic training combined with resistance training improved six-minute walking test.Aerobic training,resistance training,and aerobic training combined with resistance training improved glomerular filtration rate.The probability sorting results showed that aerobic training had the most significant effect on the improvement of peak oxygen uptake,C-reactive protein,total cholesterol,low-density lipoproteins,and high-density lipoproteins;resistance training had the most significant effect on the improvement of systolic blood pressure,diastolic blood pressure and glomerular filtration rate;aerobic exercise combined with resistance training had the most significant effect on the improvement of body mass index,triglycerides,and six-minute walking test.Conclusion Current evidence shows that aerobic training has an advantage in reducing total cholesterol levels and increasing peak oxygen uptake,resistance training has an advantage in improving blood pressure and gl
作者
李阳阳
李添
赵祥虎
孟一
李佳航
桑静
杨翼
LI Yangyang;LI Tian;ZHAO Xianghu;MENG Yi;LI Jiahang;SANG Jing;YANG Yi(Graduate School,Wuhan Sports University,Wuhan 430079,P.R.China;Department of Rehabilitation,Zhongda Hospital,Southeast University,Nanjing 210009,P.R.China;Fitness Monitoring and Chronic Disease Intervention Research Center,Wuhan Sports University,Wuhan 430079,P.R.China)
出处
《中国循证医学杂志》
CSCD
北大核心
2023年第1期34-40,共7页
Chinese Journal of Evidence-based Medicine
基金
国家自然科学基金项目(编号:81970261、82100440)
湖北省自然科学基金项目(编号:2021CFB496)
武汉体育学院科研创新团队项目(编号:21KT04)。
关键词
运动疗法
非透析慢性肾病
网状Meta分析
随机对照试验
Exercise therapy
Non-dialysis chronic kidney disease
Network meta-analysis
Randomized controlled trial
