抗阻运动在类风湿关节炎病人中应用效果的系统评价  

Application effect of resistance exercises in patients with rheumatoid arthritis:a systematic review

作　　者：冷雨飞 胡佳琪 詹刘莉 胡琳莉 杜世正[1] 孙志岭[1] LENG Yufei;HU Jiaqi;ZHAN Liuli;HU Linli;DU Shizheng;SUN Zhiling(School of Nursing,Nanjing University of Traditional Chinese Medicine,Jiangsu 210023 China)

机构地区：[1]南京中医药大学护理学院,江苏210023

出　　处：《护理研究》2020年第17期3041-3048,共8页Chinese Nursing Research

基　　金：国家自然科学基金资助项目,编号:81774383。

摘　　要：[目的]系统评价抗阻运动在类风湿关节炎病人中的应用效果。[方法]计算机检索PubMed、Web of Science、Cochrane Library、EBSCO、中国知网、维普、万方数据库和中国生物医学文献数据库中有关类风湿关节炎病人进行抗阻运动的随机对照试验,检索时限为自建库起至2019年7月1日。由2名研究员独立筛选文献、提取资料及评价纳入研究的偏倚风险后,采用RevMan 5.3软件对数据进行Meta分析。[结果]最终纳入10项研究,共997例病人。Meta分析结果显示,与对照组相比,抗阻运动在一定程度上可以改善病人的活动能力[MD=-0.21,95%CI(-0.35,-0.07),P=0.002],降低关节疼痛感[SMD=-0.22,95%CI(-0.42,-0.02),P=0.03],缓解疾病活动度[MD=-0.53,95%CI(-1.01,-0.06),P=0.03],提高肌肉力量[SMD=1.02,95%CI(0.22,1.83),P=0.01],降低红细胞沉降率[MD=-6.75,95%CI(-10.27,-3.23),P=0.000 2],但在步行测试方面改善不明显[MD=-1.37,95%CI(-3.13,0.39),P=0.13]。[结论]现有证据表明抗阻运动可以缓解类风湿关节炎病人的病情,降低关节疼痛感,降低红细胞沉降率,改善关节功能,提高肌肉力量。Objective:To systematically review the application effect of resistance exercises on patients with rheumatoid arthritis.Methods:Databases including Pub Med,Web of Science,Cochrane Library,EBSCO,CNKI,VIP,Wan Fang Data and CBM were searched from inception to July 2019.The randomized controlled trials(RCTs) about resistance exercises applying in patients with rheumatoid arthritis.Two researchers independently screened literatures,extracted data and assessed the risk of bias.Then Meta-analysis was performed using Rev Man 5.3 software.Results:A total of ten RCTs involving 997 participants were included.Compared with the control group,resistance exercises could improve mobility in sone degree[MD=-0.21,95%CI(-0.35,-0.07),P=0.002],reduce joint pain[SMD=-0.22,95%CI(-0.42,-0.02),P=0.03],relieve disease activity[MD=-0.53,95%CI(-1.01,-0.06),P=0.03],improve muscle strength[SMD=1.02,95%CI(0.22,1.83),P=0.01]and decrease erythrocyte sedimentation rate[MD=-6.75,95%CI(-10.27,-3.23),P=0.000 2].However,there was no statistically significant difference in walking test[MD=-1.37,95%CI(-3.13,0.39),P=0.13].Conclusions:The available evidences showed that resistance exercise could alleviate the disease exacerbation of rheumatoid arthritis patients,reduce joint pain and erythrocyte sedimentation rate,improve joint function and muscle strength.

关 键 词：类风湿关节炎 抗阻运动 关节功能 疼痛 肌肉力量 系统评价 

分 类 号：R473.5[医药卫生—护理学]