Cochrane评价:绝经后妇女骨质疏松运动干预效果的比较  

Cochrane Review:Comparison of Exercise Intervention's Effect on Postmenopausal Osteoporosis

作　　者：乔玉成[1] 

机构地区：[1]山西师范大学体育学院,山西临汾041000

出　　处：《中国体育科技》2010年第6期121-128,137,共9页China Sport Science and Technology

摘　　要：目的:系统评价运动干预绝经后妇女骨质疏松症的效果。方法:以"绝经后骨质疏松症"、"运动(或锻炼)"为主题词,联机检索中国知网(CNKI)全文数据库、中文科技期刊全文数据库(VIP)1984—2009年全部文献,并辅以文献追溯、手工检索等方法,获取所有涉及运动干预绝经后骨质疏松症的随机对照试验,选择符合纳入标准的临床试验,评价其方法学质量,并从中提取患者基本情况、干预措施、疗效指标和试验结果,采用Cochrane协作网提供的专用统计分析软件RevMan 4.2进行分析。结果:共纳入研究文献20篇,全部文献均为低质量研究文献。Meta分析结果显示:运动对延缓、逆转绝经后骨质疏松症患者骨密度(BMD)、骨矿含量(BMC)下降均有一定疗效;在改善绝经后骨质疏松症患者骨代谢相关指标方面,对血清骨碱性磷酸酶(ALP)、骨钙素(BGP)、尿羟脯氨酸与尿肌酐比值(HOP/Cr)的干预效果较为明显,而对血清钙磷水平、血浆酸性磷酸酶(ACP)、抗酒石酸酸性磷酸酶(TRAP)、尿钙与尿肌酐比值(Ca/Cr)、血清激素水平的影响较小。结论:目前有限的纳入试验显示,运动对延缓、逆转绝经后骨质疏松症患者骨量丢失有肯定的作用,其机制主要是促进成骨细胞活性与骨质形成,而对降低骨质吸收的作用较弱。但由于纳入的文献研究质量较低,难以提供循证医学所需的最佳证据。因此,对于运动干预绝经后骨质疏松症效果的判断仍需更多质量高、内在真实性好的随机对照试验来证实。Purpose：to systematically evaluate exercise intervention＇s effect on postmenopausal osteoporosis.Methods：taking ＂postmenopausal osteoporosis＂and ＂exercise＂ as key words,search all literature from 1984 to 2009 in CNKI Full-text Database and Chinese Sci-tech Periodical Full-text Database,and supplemented by means like literature trace back and manual retrieval,obtain all randomized control trials that are related to exercise intervention for postmenopausal osteoporosis,then select clinical trials that met the inclusion criteria,assess their methodological quality,and extract the basic information of patients,intervention measures,curative effectiveness indicators and test results,analyze these using statistical-analysis-specific software RevMan 4.2 which is provided by Cochrane collaboration network.Results：a total of 20 documents were included,all of which are of low quality.Meta analysis shows that exercise has certain effect in delaying and reversing the decrease of bone mineral density（BMD） and bone mineral content（BMC） for postmenopausal osteoporosis patients.Also,in improving postmenopausal osteoporosis patients＇ bone metabolism related indicators,sports have relatively notable intervention effect for serum bone alkaline phosphatase（ALP）,osteocalcin（BGP）,urinary hydroxyproline and urinary creatinine ratio（HOP/Cr）,while having less effect for serum calcium and phosphorus levels,plasma acid phosphatase（ACP）,tartrate-resistant acid phosphatase（TRAP）,urinary calcium and urinary creatinine ratio（Ca/Cr） and serum hormone level.Conclusions：The included limited tests show that exercise has a positive effect in delaying and reversing bone loss of postmenopausal osteoporosis patients,its mechanism is mainly to promote osteoblast activity and bone formation,and has less effect in reducing bone absorption.However,the low quality of included literature makes it difficult to provide the best evidence for evidence-based medicine.Therefore,more high-quality and inherently a

关 键 词：系统评价 干预效果 绝经后骨质疏松症 运动干预 

分 类 号：G804.5[文化科学—运动人体科学]