癌症患者化疗期间运动干预焦虑和抑郁状态效果的Meta分析  

Effect of exercise on cancer patients with anxiety and depression during chemotherapy:a meta-analysis

作　　者：杨益成 王丹丹 沈群策 张磊 吴雪萍 YANG Yicheng;WANG Dandan;SHEN Qunce;ZHANG Lei;WU Xueping(School of Physical Education,Shanghai University of Sport,Shanghai 200438,China;Department of Physical Education,University of Shanghai for Science and Technology,Shanghai 200093,China;Guangdong Country Garden School,Foshan,Guangdong 528312,China)

机构地区：[1]上海体育大学体育教育学院,上海市200438 [2]上海理工大学体育教学部,上海市200093 [3]广东碧桂园学校,广东佛山市528312

出　　处：《中国康复理论与实践》2025年第2期184-193,共10页Chinese Journal of Rehabilitation Theory and Practice

基　　金：上海市海外高层次人才项目(No.TP2020063)。

摘　　要：目的探讨运动干预对化疗期间癌症患者焦虑和抑郁状态的改善效果和最佳运动剂量。方法构建PICO架构,系统检索PubMed、Web of Science、The Cochrane Library、Embase、Medline、中国知网、维普和万方数据库,纳入有关运动干预对化疗期间癌症患者焦虑和抑郁状态影响的随机对照试验。检索时限建库至2023年11月。采用Cochrane偏倚风险评估工具和物理治疗证据数据库(PEDro)量表对纳入文献进行质量评价,采用Rev Man5.3进行数据合并和分析,采用Stata 18.0进行偏倚风险评估。结果最终纳入13篇随机对照试验,涉及1340例患者。PEDro量表评分5~8分。运动干预对化疗期间癌症患者的焦虑(SMD=-0.70,95%CI-1.18~-0.22,P=0.004)和抑郁(SMD=-0.89,95%CI-1.43~-0.34,P=0.002)状态的改善效果均显著优于对照组。亚组分析发现,改善焦虑状态的最佳运动剂量为每次≤45 min(SMD=-0.26,95%CI-0.46~-0.05,P=0.01),每周≥3次(SMD=-0.26,95%CI-0.46~-0.05,P=0.01),干预周期≤12周(SMD=-0.21,95%CI-0.36~-0.07,P=0.005);改善抑郁状态的最佳运动剂量为单次运动时长≤45 min(SMD=-0.69,95%CI-1.29~-0.08,P=0.03),每周≥3次(SMD=-0.69,95%CI-1.29~-0.08,P=0.03),干预周期≤12周(SMD=-0.52,95%CI-0.92~-0.13,P=0.01)。中高强度的运动干预对焦虑(SMD=-0.21,95%CI-0.37~-0.06,P=0.007)和抑郁(SMD=-0.21,95%CI-0.41~-0.01,P=0.04)状态的改善效果显著优于对照组。结论运动干预能有效改善化疗期间癌症患者的焦虑和抑郁状态,推荐中高强度运动,每次≤45 min,每周≥3次,不超过12周。Objective To explore the effect of exercise on anxiety and depression in cancer patients during chemotherapy,as well as the optimal exercise dosage.Methods A PICO framework was constructed,and randomized controlled trials(RCTs)on the effect of exercise on anxiety and depression in cancer patients during chemotherapy were retrieved from databases of PubMed,Web of Science,Cochrane Library,Embase,Medline,CNKI,VIP and Wanfang data,from the establishment to November,2023.The quality of the literature was evaluated with Cochrane Risk of Bias Tool and Physiotherapy Evidence Database(PEDro)scale.Data were synthesized and analyzed using RevMan 5.3,and the risk of bias was evaluated using Stata 18.0.Results A total of 13 RCTs involving 1340 subjects were included.The scores of PEDro scale were five to eight.Exercise interventions significantly improved anxiety(SMD=-0.70,95%CI-1.18 to-0.22,P=0.004)and depression(SMD=-0.89,95%CI-1.43 to-0.34,P=0.002)compared to the control group.Subgroup analyses showed that,the exercise effect on anxiety was less than 45 minutes a time(SMD=-0.26,95%CI-0.46 to-0.05,P=0.01),more than three times a week(SMD=-0.26,95%CI-0.46 to-0.05,P=0.01),and less than twelve weeks(SMD=-0.21,95%CI-0.36 to-0.07,P=0.005).For depression,it was less than 45 minutes a time(SMD=-0.69,95%CI-1.29 to-0.08,P=0.03),more than three times a week(SMD=-0.69,95%CI-1.29 to-0.08,P=0.03),and less than twelve weeks(SMD=-0.52,95%CI-0.92 to-0.13,P=0.01).Moderate to high-intensity exercise interventions significantly outperformed the control group in improving anxiety(SMD=-0.21,95%CI-0.37 to-0.06,P=0.007)and depression(SMD=-0.21,95%CI-0.41 to-0.01,P=0.04).Conclusion Exercise interventions can effectively improve anxiety and depression in cancer patients during chemotherapy,and it suggests for high-intensity exercise,less than 45 minutes a time,more than three times a week,and less than twelve weeks.

关 键 词：癌症 化疗 焦虑 抑郁 运动干预 META分析 

分 类 号：R730.9[医药卫生—肿瘤]