基于社区卫生工作者管理下的运动干预对2型糖尿病影响的Meta分析  

Effect of Exercise Interventions Based on Community Health Workers'Management on Type 2 Diabetes Mellitus:a Meta-analysis

作　　者：董晨阳 李然 刘若亚 黄志扬 杨阳[1] DONG Chenyang;LI Ran;LIU Ruoya;HUANG Zhiyang;YANG Yang(School of Sport Science,Beijing Sport University,Beijing 100084,China)

机构地区：[1]北京体育大学运动人体科学学院,北京市100084

出　　处：《中国全科医学》2024年第5期577-588,共12页Chinese General Practice

基　　金：国家重点研发计划(2020YFC2006703)。

摘　　要：背景2型糖尿病患者通常缺乏足够的安全运动意识,运动依从性不高,需要专业人员进行运动干预管理以更好地改善2型糖尿病患者的病情。值得参考的策略就是利用社区卫生工作者为患者提供运动干预的管理。目前关于运动干预管理方面的研究缺乏,且通常2型糖尿病患者健康管理的研究仅提及运动而没有具体的运动管理措施,尚缺少相关的定量系统评价。目的系统评价基于社区卫生工作者管理下的运动干预对2型糖尿病患者的健康影响及具体的运动干预方案。方法计算机检索8个中英文数据库,包括PubMed、Cochrane Library、Web of Science、Embase、中国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库(CBM),筛选基于社区卫生工作者管理下的运动干预对2型糖尿病患者影响的随机对照试验,其中干预组采取基于社区卫生工作者管理下的运动干预方案,对照组采取常规护理。检索时间从建库至2022-10-17。文献筛选、质量评价和数据提取由2名研究人员独立完成。使用RevMan 5.4和Stata 15.1软件进行Meta分析。通过亚组分析和敏感性分析寻找异质性来源。预先确定的亚组为干预周期(3个月、6个月、>6个月)、运动频率(3次/周、>3次/周)和单次运动时间(≤30 min/次、>30 min/次)。结果本研究最终纳入11篇文献,共有受试者1079例,其中干预组550例,对照组529例。Meta分析结果显示,基于社区卫生工作者管理模式下的运动干预较对照组更能降低2型糖尿病患者的糖化血红蛋白(MD=-1.07,95%CI=-1.31~-0.83,P<0.00001)、空腹血糖(MD=-1.26,95%CI=-1.57~-0.96,P<0.00001)、餐后2 h血糖(MD=-1.47,95%CI=-1.90~-1.04,P<0.00001)、总胆固醇(MD=-1.02,95%CI=-1.52~-0.51,P<0.0001)、低密度脂蛋白(MD=-0.62,95%CI=-0.87~-0.37,P<0.00001)和三酰甘油水平(MD=-0.71,95%CI=-1.13~-0.28,P=0.001),而对高密度脂蛋白的改善程度无显著差异(MD=0.09,95%CI=-0.02~0.21,P=Background Patients with type 2 diabetes usually lack sufficient awareness of safe exercise and have poor exercise compliance,which requires the management of exercise interventions by professionals to improve the health status of patients with type 2 diabetes.A strategy worth considering is the management of exercise interventions for patients by community health workers.Currently,there is a lack of research on the management of exercise interventions,and studies on the health management of patients with type 2 diabetes usually only mention exercise without specific exercise management measures.Additionally,there is a lack of quantitative systematic reviews.Objective To systematically review the health effects of exercise interventions based on community health workers'management for patients with type 2 diabetes and specific exercise intervention programs.Methods Eight Chinese and English databases,including PubMed,Cochrane Library,Web of Science,Embase,CNKI,Wanfang Data,VIP and CBM were searched by computer from inception to October 17,2022,to screen randomized controlled trials on the effects of exercise interventions based on community health workers'management for patients with type 2 diabetes,in which the intervention group adopted an exercise intervention program based on community health workers'management and the control group adopted conventional care.Literature screening,quality assessment,and data extraction were performed independently by 2 investigators.Meta-analysis was performed using RevMan 5.4 and Stata 15.1 software.Sensitivity and subgroup analyses were carried out to find sources of heterogeneity.Pre-identified subgroups were intervention duration(3 months;6 months;>6 months),frequency of exercise(3 times/week;>3 times/week),and duration of the single exercise session(≤30 min/session;>30 min/session).Results A total of 1079 subjects from 11 articles were finally included in this review,of which 550 were in the intervention group and 529 in the control group.The results of the Meta-analysis

关 键 词：糖尿病 2型 运动干预 社区卫生工作者 管理 META分析 

分 类 号：R587.1[医药卫生—内分泌]