功能锻炼对类风湿关节炎患者效果评价的meta分析  

Effect of functional exercises on patients with rheumatoid arthritis: a meta-analysis

作　　者：王莉[1] 高超[1] 朱笛 陈立红[1] WANG Li;GAO Chao;ZHU Di;CHEN Li-hong(Department of Rheumatology and hnmunology,Peking University People＇s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院风湿免疫科,北京100044

出　　处：《北京大学学报（医学版）》2018年第6期991-997,共7页Journal of Peking University:Health Sciences

基　　金：北京市科技计划项目(Z171100000417007)~~

摘　　要：目的:评价功能锻炼对改善类风湿关节炎(rheumatoid arthritis,RA)患者的疾病活动度、关节功能、生活质量等方面的效果。方法:计算机检索Cochrane Library、Pub Med、中国知网(China National Knowledge Infrastructure,CNKI)、维普、万方数据库中符合标准的随机对照试验(randomized controlled trials,RCTs),根据纳入与排除标准,由两人对上述数据库分别进行文献筛选、提取及文献质量评价后,采用Review Manager 5. 3软件对结局指标进行meta分析。结果:初步检索获得文献2 173篇(英文1 522篇,中文651篇),经过End Note软件去除重复文献913篇,通过阅读文题和摘要排除不符合纳入标准的文献1 194篇,经过阅读全文、剔除数据不全等最终纳入13篇文献(英文8篇,中文5篇),纳入的总样本数812例,其中实验组426例,常规组386例。13篇文献中5篇文献采用疾病活动评分(disease activity score 28,DAS28)作为其中的结局指标,8篇文献采用健康评定调查表(health assessment questionnaire,HAQ)作为其中的结局指标,6篇文献采用视觉模拟疼痛评分(visual analogue score,VAS)作为其中的结局指标,3篇文献采用晨僵时间作为其中的结局指标。meta分析结果显示,功能锻炼在一定程度上能够缓解RA患者的疾病活动度(mean difference=-0. 76; 95%CI:-1. 13,-0. 38; P <0. 001),改善患者关节功能(mean difference=-0. 36; 95%CI:-0. 47,-0. 24; P <0. 001),降低关节疼痛感(mean difference=-1. 75; 95%CI:-1. 98,-1. 53;P <0. 001)以及减少关节晨僵时间(mean difference=-17. 65; 95%CI:-22. 09,-13. 21; P <0. 001)。结论:功能锻炼可以降低RA患者的关节疼痛感,减少晨僵时间,缓解患者病情,对改善关节功能、提高患者生存质量有积极作用。Objective： To evaluate the effect of functional exercises on disease activity,joint function and quality of life of patients with rheumatoid arthritis（ RA）. Methods： Randomized controlled trials were searched in Cochrane Library,PubMed,China National Knowledge Infrastructure（ CNKI）,VIP database and Wanfang database with keywords being ＂rheumatoid arthritis/RA＂,＂function exercise（ training）/joint exercise（ training）/physical exercise（ training）/resistance movement（ exercise）/isotonic and isometric/stretching exercise/muscle exercise＂,and ＂trials/clinical trials＂. Then literature selection,extraction and literature quality evaluation were carried out by two of the authors independently following the including and excluding standards. Then the outcome indicators were analyzed with Review Manager 5. 3 software. Results： In the study,2 173 articles were achieved by searching in databases,including 1 522 English papers and 651 Chinese papers. Then 913 duplicated papers were identified and removed using EndNote software. After reading the titles and abstracts,1 194 papers were excluded that did not satisfy the including standards. Finally,the full texts of these papers were read and papers with insufficient data were excluded,resulting in 13 included papers for systematic review,including 8 English and 5 Chinese papers. A total of 812 cases were studied in these papers,including 426 in the experimental groups and 386 in the conventional groups. For the outcome index in these articles,disease activity score 28（ DAS28） was used in 5 of them,health assessment questionnaire（ HAQ） was used in 8 articles,visual analogue scale（ VAS） for pain was used in 6 articles,and morning stiffness duration was used in 3 articles. The meta-analysis showed that functional exercises could delay the development of the disease activity of RA patients（ mean difference =-0. 76; 95% CI：-1. 13,-0. 38; P〈0. 001）,improve the joint function（ mean difference =-0. 36; 95% CI：-0. 47,-0. 2

关 键 词：功能锻炼 类风湿关节炎 关节功能 生活质量 

分 类 号：R593.22[医药卫生—内科学]