不同运动方式对冠心病患者心肺储备功能和运动耐力影响的网状Meta分析  

Reticular Meta-analysis of the effects of different exercise practices on cardiopulmonary reserve function and exercise endurance in CAD patients

作　　者：谢荣桂 邓贵玉 裴景茹 唐云[3] 唐明明 赵鸿[5] XIE Ronggui;DENG Guiyu;PEI Jingru;TANG Yun;TANG Mingming;ZHAO Hong(School of Nursing,Hunan University of Chinese Medicine,Changsha 410208,China;Department of Traditional Chinese Medicine Classics,First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;Department of Cardiology,First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;Ophthalmology,First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;Personnel Department,First Affiliated Hospital of Hunan University of Chinese Medicine,Changsha 410007,China)

机构地区：[1]湖南中医药大学护理学院,湖南长沙410208 [2]湖南中医药大学第一附属医院中医经典科,湖南长沙410007 [3]湖南中医药大学第一附属医院心内科,湖南长沙410007 [4]湖南中医药大学第一附属医院眼科,湖南长沙410007 [5]湖南中医药大学第一附属医院人事部,湖南长沙410007

出　　处：《现代医学》2024年第11期1639-1651,共13页Modern Medical Journal

基　　金：2021年度湖南省中医药科研计划项目(2021064);湖南中医药大学科研基金项目(2019XJJJ061)。

摘　　要：目的:系统评价不同运动方式对冠心病患者心肺储备功能和运动耐力的效果。方法:检索中国知网(CNKI)、万方数据知识服务平台(Wanfang Data)、维普网(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、Web of Science、The Cochrane Library、Embase数据库中关于运动方式改善冠心病患者心肺储备功能和运动耐力的随机对照研究,检索时间为建库至2023年4月。由2名研究者独立筛选文献、提炼资料和评价纳入文献的偏倚风险后,选择RevMan 5.3、Stata 16.0、R4.2.2进行统计分析。结果:共纳入30项研究,2433例冠心病患者,网状Meta分析结果显示:在提高左室射血分数(left ventricular ejection fraction,LVEF)方面,最好的2种运动方式是有氧结合抗阻运动和有氧运动;在提高6分钟步行试验(six minutes walk test,6MWT)距离方面,最好的2种运动方式是抗阻运动和有氧结合抗阻运动;在改善肺功能方面,最好的2种运动方式是抗阻运动和瑜伽。但由于纳入研究的质量和数量等存在一定的局限性,仍需高质量研究进一步验证。结论:运动可以改善冠心病患者的心肺储备功能和运动耐力,但不同运动改善心功能的侧重点不同,其中有氧结合抗阻运动在提高LVEF和6MWT方面效果最显著,抗阻运动在提高6MWT和FEV1/FVC%方面效果较好。Objective:To systematically evaluate the effects of different exercise on cardiopulmonary reserve function and exercise endurance in patients with coronary heart disease.Methods:A randomized controlled study was searched from the databases of China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform(Wanfang Data),VIP,SinoMed,PubMed,Web of Science,The Cochrane Library,and Embase on improving cardiovascular reserve function and exercise endurance in patients with coronary heart disease through exercise methods.The search was conducted from inception through April 2023.After two researchers independently screened the literature,extracted data,and evaluated the risk of bias in the included literature,RevMan 5.3,Stata16.0,and R4.2.2 were selected for statistical analysis.Results:A total of 30 studies were included,with 2433 patients with coronary heart disease.The results of a network Meta-analysis showed that in terms of improving LVEF,the best 2 exercise modes were aerobic combined with resistance exercise and aerobic exercise;the two best exercise methods for increasing 6MWT were resistance exercise and aerobic combined resistance exercise;in terms of improving lung function,the two best exercise methods were resistance exercise and yoga.However,due to limitations in the quality and quantity of studies included,high-quality research is still needed for further validation.Conclusion:Exercise can improve cardiovascular reserve function and exercise endurance in patients with coronary heart disease,but the focus of different exercises on improving heart function varies,among which,aerobic combined with resistance exercise has the most significant effect on improving LVEF and 6MWT,while resistance exercise has a better effect on improving 6MWT and FEV1/FVC%.

关 键 词：冠心病 运动方式 心肺储备功能 运动耐力 网状Meta分析 

分 类 号：R541.4[医药卫生—心血管疾病]