摘要
目的:系统评价导引疗法治疗冠心病稳定型心绞痛的治疗效果和生活质量改善情况。方法:通过计算机检索中国学术期刊全文数据库(CNKI)、维普数据库(VIP)、万方数据库(Wanfang)、中国生物医学数据库(SinoMed)、PubMed、Cochrane Library、Embase、Web of Science 8个中英文数据库,筛选导引疗法治疗稳定型心绞痛的随机对照试验(RCTs),检索时间均为建库至2021年12月。使用Cochrane Reviewers Handbook5.1提供的偏倚风险评估工具进行文献质量评估,运用RevMan 5.3软件(Cochrane协作网提供)对3个主要结局指标[心绞痛发作次数、心绞痛持续时间、西雅图心绞痛量表(SAQ)]和4个次要结局指标[焦虑自评量表(SAS)、抑郁自评量表(SDS)、6 min步行试验(6MWT)、代谢当量(METs)]进行Meta分析,连续性变量资料的效应量用均数差(MD)和95%CI表示。若纳入研究具有同质性(P>0.1,I^(2)≤50%),采用固定效应模型进行分析;若纳入研究具有异质性(P≤0.1,I^(2)>50%),采用随机效应模型进行分析。结果:共纳入15篇RCTs,涉及1261例研究对象,其中导引组631例,对照组630例。纳入研究的整体文献质量不高。Meta分析结果显示,与对照组相比,导引疗法可以减少稳定型心绞痛的发作次数[MD=-1.70,95%CI(-2.07,-1.34),P<0.00001],缩短心绞痛的持续时间[MD=-1.17,95%CI(-1.38,-0.96),P<0.00001],降低SAS得分[MD=-4.71,95%CI(-7.12,-2.31),P=0.0001]和SDS得分[MD=-3.91,95%CI(-5.75,-2.07),P<0.0001],提高METs[MD=1.20,95%CI(0.39,2.01),P=0.004]和SAQ评分[MD=7.62,95%CI(5.97,9.27),P<0.00001];与对照组相比,太极拳[MD=39.52,95%CI(19.30,59.74),P=0.0001]和少林内功(P<0.0001)可改善6MWT,而八段锦[MD=1.39,95%CI(-9.13,11.92),P=0.80]和益心操(P=0.30)对于增加6MWT差异无统计学意义。结论:在常规疗法/运动基础上联合或单纯使用导引疗法治疗冠心病稳定型心绞痛,可以提高治疗效果,减轻焦虑抑郁情况,改善生活质量。
Objective:To evaluate the therapeutic effect and quality of life of Daoyin therapy in the treatment of stable angina pectoris of coronary heart disease.Methods:Eight databases,including CNKI,VIP,Wanfang,SinoMed,PubMed,Cochrane Library,Embase,and Web of Science were searched through the computer retrieval system,and the RCTs of Daoyin therapy for stable angina pectoris were screened.The retrieval time was from inception to December 2021.The risk of bias assessment tool provided by the Cochrane Reviewers Handbook 5.1 was used to assess the quality of the literature,and the RevMan 5.3 software(provided by the Cochrane Collaboration)was used to perform a meta-analysis.Primary outcomes included the number of angina attacks,the angina duration and Seattle angina questionnaire(SAQ)scores.Secondary outcomes included Self-Rating Anxiety Scale(SAS)scores,SelfRating Depression Scale(SDS)scores,6-minutes walk test(6MWT)and Metabolic Equivalents(METs).Continuous variables were expressed by Mean Difference(MD)and 95%confidence interval(CI).If the included studies were homogeneous(P>0.1,I^(2)≤50%),a fixed effects model would be used;if the included studies were heterogeneous(P≤0.1,I^(2)>50%),a random-effects model would be used.Results:A total of 15 RCTs were included,involving 1261 cases,with 631 in the Daoyin group and 630 in the control group.The overall quality of the included studies was not high.Meta-analysis showed that compared with the control group,Daoyin therapy can significantly reduce the number of angina pectoris attacks[MD=-1.70,95%CI(-2.07,-1.34),P<0.00001],shorten the duration of angina pectoris[MD=-1.17,95%CI(-1.38,-0.96),P<0.00001],reduce SAS scores[MD=-4.71,95%CI(-7.12,-2.31),P=0.0001]and SDS scores[MD=-3.91,95%CI(-5.75,-2.07),P<0.0001],and improve METs[MD=1.20,95%CI(0.39,2.01),P=0.004]and SAQ scores[MD=7.62,95%CI(5.97,9.27),P<0.00001];Taijiquan[MD=39.52,95%CI(19.30,59.74),P=0.0001]and Shaolin Neigong(P<0.0001)can improve 6MWT,while Baduanjin[MD=1.39,95%CI(-9.13,11.92),P=0.80]and Yixincao(P=0.30)have no
作者
乔萌
王志飞
谭超仁
代金刚
QIAO Meng;WANG Zhifei;TAN Chaoren;DAI Jingang(Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences,Beijing 100700,China;Experimental Research Center,China Academy of Chinese Medical Sciences,Beijing 100700,China)
出处
《康复学报》
CSCD
2023年第1期77-89,共13页
Rehabilitation Medicine
基金
中国中医科学院科技创新工程项目(CI2021A00702)。
关键词
稳定型心绞痛
导引疗法
疗效
生活质量
META分析
stable angina pectoris
Daoyin therapy
therapeutic effect
quality of life
meta-analysis
