渐进性抗阻训练在乳腺癌中应用效果的系统评价和Meta分析  

Systematic review and Meta-analysis of application effect of progressive resistance training in breast cancer

作　　者：张弛[1] 赵仕奇 唐少文[2] 尤华[2] Zhang Chi;Zhao Shiqi;Tang Shaowen;You Hua(School of Nursing, Nanjing Medical University, Nanjing 211166,China;School of Public Health,Nanjing Medical University,Nanjing 211166,China)

机构地区：[1]南京医科大学护理学院,南京211166 [2]南京医科大学公共卫生学院,南京211166

出　　处：《中华现代护理杂志》2022年第13期1717-1726,共10页Chinese Journal of Modern Nursing

基　　金：国家自然科学基金(72074122);江苏高校哲学社会科学研究项目(2020SJA0306);江苏省大学生创新训练计划项目(202010312066Z);江苏高校优势学科建设工程项目"护理学"(苏政办发[2018]87号);"十三五"江苏省重点学科建设项目"护理学"(苏教研[2016]9号)。

摘　　要：目的分析渐进性抗阻训练(PRT)在乳腺癌患者中的应用效果。方法计算机检索PubMed、Web of Science、Embase、Medline、Cochrane Library、中国知网、万方数据知识服务平台、维普网和SinoMed数据库,搜索PRT应用于乳腺癌患者的随机对照试验(RCT),检索时限为建库至2020年11月30日。采用Revman 5.3和Stata 16.1进行Meta分析。结果共纳入22个RCT。Meta分析显示,PRT可提高乳腺癌患者的肌肉力量[握力(MD=1.43,95%CI为0.57~2.30,P=0.001)、仰卧推举力(MD=13.0,95%CI为9.39~16.61,P<0.00001)、腿部推举力(MD=43.88,95%CI为27.85~59.91,P<0.00001)]、肩关节前屈(MD=9.62,95%CI为5.16~14.09,P<0.0001)、瘦体重(MD=1.03,95%CI为0.71~1.35,P<0.00001)和生活质量(SMD=0.51,95%CI为0.25~0.78,P=0.0001)。PRT可降低乳腺癌患者的上肢淋巴水肿症状的数量(SMD=-0.23,95%CI为-0.42~-0.04,P=0.020)、症状的严重性(SMD=-0.26,95%CI为-0.44~-0.07,P=0.006)、体脂率(MD=-1.49,95%CI为-1.94~-1.04,P<0.00001)、脂肪量(MD=-0.87,95%CI为-1.48~-0.26,P=0.005),但对肩关节外展、后伸、体重、体重指数的影响差异无统计学意义(P>0.05)。描述性分析表明,PRT可一定程度地降低上肢淋巴水肿的发生率。结论PRT较对照组可提高乳腺癌患者的肌肉力量、肩关节前屈、瘦体重含量和生活质量,能够降低上肢淋巴水肿症状的数量和严重性、体脂率和脂肪量。Objective To analyze the application effect of progressive resistance training(PRT)in breast cancer patients.Methods PubMed,Web of Science,Embase,Medline,Cochrane Library,CNKI,Wanfang Data Knowledge Service platform,VIP and SinoMed databases were searched for randomized controlled trial(RCT)of PRT in breast cancer patients.The retrieval period was from the establishment of databases to November 30,2020.Meta-analysis was performed using Revman 5.3 and Stata 16.1.Results A total of 22 RCT were included.Meta-analysis showed that PRT could improve muscle strength[grip strength(MD=1A3995%C/0.57-2.30,P=0.001),supine lifting force(MZ)=13.0,95%C/9.39-16.61,P<0.00001),leg lifting force(MD=43.88,95%C/27.85-59.91,P<0.00001)],shoulder flexion(MD=9.62,95%C/5.16-14.09,P<0.000 l),lean body weight(A/D=1.03,95%CI 0.71-1.35,P<.0.00001),quality of life(SMD=0.5l y 95%CI 0.25-0.78,P=0.0001).PRT could reduce the number of symptoms of upper limb lymphedema in breast cancer patients(SMD=-0.23,95%CI-0.42--0.04,P=0.020),severity of symptoms(SMD=-0.26,95%C/-0.44-0.07,P=0.006),body fat percentage(MD=-1.49,95%C/-1.94-1.04,P<0.00001),fat content(MD=-0.S7,95%CI-1.48--0.26,P=0.005),but there were no statistically significant differences in shoulder joint abduction,extension,body weight and body mass index(P>0.05).Descriptive analysis showed that PRT could reduce the incidence of upper limb lymphedema to a certain extent.Conclusions The existing evidence shows that compared with the control group,PRT can improve the muscle strength,shoulder anterior flexion,lean body weight content and quality of life of patients with breast cancer and reduce the number and severity of upper extremity lymphedema symptoms,body fat percentage and fat mass.

关 键 词：乳腺肿瘤 渐进性抗阻训练 系统评价 META分析 

分 类 号：R473.73[医药卫生—护理学]