冷水浸泡剂量对骨骼肌运动性疲劳恢复效果的系统评价与Meta分析  

Effect of cold water immersion dose on the recovery of skeletal muscle fatigue induced by exercise:a systematic review and Meta-analysis

作　　者：李强 季煜钦 叶强[3] Li Qiang;Ji Yuqin;Ye Qiang(Jiangnan Vocational College of Media Arts,Wuxi 214153,Jiangsu Province,China;School of Sport and Health,Nanjing Sport Institute,Nanjing 210014,Jiangsu Province,China;School of Physical Education and Humanities,Nanjing Sport Institute,Nanjing 210014,Jiangsu Province,China)

机构地区：[1]江南影视艺术职业学院体育部,江苏省无锡市214153 [2]南京体育学院运动与健康学院,江苏省南京市210014 [3]南京体育学院体育教育与人文学院,江苏省南京市210014

出　　处：《中国组织工程研究》2024年第35期5732-5740,共9页Chinese Journal of Tissue Engineering Research

基　　金：科技部国家重点研发计划(2020YFC2007002),项目参与人:叶强。

摘　　要：目的:冷水浸泡恢复方法在浸泡水温、时长及深度等操作性指标上暂无统一方案,导致在骨骼肌运动性疲劳恢复疗效方面产生争议。文章以此分析不同因素下冷水浸泡对肌肉损伤、肌肉酸痛及肌力恢复的影响,以期探寻最佳的浸泡实施方案,从而为肌肉组织疲劳恢复提供证据。方法:对中国知网、万方数据、Web of Science、PubMed数据库进行检索,检索跨度为2000-01-01/2023-08-15,共得文献4759篇,通过筛选排除4735篇,最终纳入文献24篇。采用物理治疗证据数据库量表对纳入文献进行方法学质量评估,并使用Stata-MP 16软件进行效应量合并、亚组分析、Meta回归、敏感性检验和发表偏倚分析。结果:(1)共纳入24项随机对照试验,包括617例受试者,整体上方法学质量较高;(2)Meta分析结果显示:冷水浸泡能显著降低肌酸激酶血值(SMD=-0.17,95%CI:-0.29至-0.05,P<0.01),减轻肌肉酸痛(SMD=-0.60,95%CI:-0.81至-0.38,P<0.01)和促进最大肌力恢复(SMD=0.17,95%CI:0.05-0.30,P<0.01);(3)亚组分析结果显示,水温>14℃(SMD=-0.48,95%CI:-0.76至-0.20,P<0.01)和时长12-14min(SMD=-0.38,95%CI:-0.61至-0.15,P<0.01)的浸泡方案降低肌酸激酶血值效果最好,且对耐力运动(SMD=-0.45,95%CI:-0.71至-0.20,P<0.01)后的干预疗效更显著;水温<10℃(SMD=-0.61,95%CI:-0.79至-0.43,P<0.01)、时长<12 min(SMD=-0.76,95%CI:-0.98至-0.53,P<0.01)以及髂棘以上(SMD=-0.74,95%CI:-0.97至-0.52,P<0.01)的浸泡深度缓解肌肉酸痛效果最好,且对耐力运动(SMD=-0.42,95%CI:-0.61至-0.22,P<0.01)后的镇痛效果更明显;(4)Meta回归结果显示,浸泡水温、浸泡时长及运动类型是影响肌酸激酶效应量的重要调节因子;浸泡水温及浸泡深度是影响目测类比评分效应量的重要调节因子,运动类型是影响最大等长肌力效应量的重要调节因子。结论:(1)极低到中等强度证据显示,冷水浸泡能有效减轻肌肉损伤、缓解肌肉酸痛和促进肌力恢复;(2)在减轻OBJECTIVE:Cold water immersion methods are not standardized in terms of operational indicators such as immersion temperature,duration and depth,leading to controversy over the efficacy of recovery from exercise fatigue in skeletal muscle.In this article,we analyze the effects of cold water immersion on muscle injury,muscle soreness and muscle strength recovery under different factors,in order to find the best immersion implementation plan,and thus provide evidence for the recovery of muscle fatigue.METHODS:A search of CNKI,WanFang Data,Web of Science,and PubMed databases was conducted for relevant literature published from January 1,2000 to August 15,2023.A total of 4759 articles were initially retrieved,with 4735 articles excluded through screening and 24 articles finally included.The Physical Therapy Evidence Database Scale was used to assess the methodological quality of the included literature,and Stata-MP 16 software was used to perform effect size combinations,subgroup analyses,Meta-regression,sensitivity tests,and publication bias analyses.RESULTS:(1)The article included a total of 24 randomized controlled trial studies,including 617 subjects,with overall high legal quality.(2)Meta-analysis showed that cold water immersion can significantly reduce creatine kinase blood value[standardized mean difference(SMD)=-0.17,95%confidence interval(CI):-0.29 to-0.05,P<0.01],alleviate muscle pain(SMD=-0.60,95%CI:-0.81 to-0.38,P<0.01),and promote maximum muscle strength recovery(SMD=0.17,95%CI:0.05 to 0.30,P<0.01).(3)Subgroup analysis showed that:The immersing regimen with water temperature>14°C(SMD=-0.48,95%CI:-0.76 to-0.20,P<0.01)and duration of 12-14 minutes(SMD=-0.38,95%CI:-0.61 to-0.15,P<0.01)had the best effect in reducing creatine kinase blood values,and had a more significant intervention effect on endurance exercise(SMD=-0.45,95%CI:-0.71 to-0.20,P<0.01),while the immersion regimen with water temperature<10°C(SMD=-0.61,95%CI:-0.79 to-0.43,P<0.01),duration<12 minutes(SMD=-0.76,95%CI:-0.98 to-0.53,P<0.01),and im

关 键 词：冷疗 冷水浸泡 肌酸激酶 肌肉损伤 炎症反应 延迟性肌肉酸痛 最大肌力 运动性疲劳 疲劳恢复 META分析 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R605