癌因性疲乏患者瑜伽运动管理的最佳证据总结

doi:10.3761/j.issn.0254-1769.2023.01.013

摘要/Abstract

摘要：

目的系统检索、提取、汇总和分析癌因性疲乏患者瑜伽运动管理的最佳证据，为临床制订基于证据的癌因性疲乏患者瑜伽运动决策和干预提供循证依据。方法计算机检索BMJ最佳临床实践、UpToDate、英国国家卫生与临床优化研究所指南网、加拿大安大略注册护士协会指南网、苏格兰学院间指南网、美国国家综合癌症网络、指南国际网络、医脉通、澳大利亚乔安娜布里格斯研究所循证卫生保健中心图书馆、Cochrane图书馆、PubMed、Web of Science、CINAHL、万方数据库、中国知网、中国生物医学文献数据库、美国癌症研究学会网站和美国肿瘤护理学会网站中关于癌因性疲乏患者瑜伽运动的所有证据，包括临床实践指南、证据总结、临床决策、专家共识、系统评价等，检索时间为建库至2021年12月。由2名研究人员独立进行文献筛选和质量评价，根据主题进行证据提取、归纳和汇总。结果最终共纳入7篇文献，包括1篇指南和6篇系统评价。通过2名研究人员共同讨论，提取归纳癌因性疲乏患者瑜伽运动管理相关证据共22条，汇总9个主题，分别为运动认知、运动效果、瑜伽类型、运动评估、运动指导与监督、运动对象、制订原则、运动参数、评价工具。结论医疗保健人员应结合国内临床情境，根据不同癌症人群特点，开展癌症患者个性化瑜伽运动处方的最佳证据实践，以减轻癌症患者疲乏，改善生存质量。

关键词: 肿瘤, 疲乏, 瑜伽, 证据总结, 循证护理学

Abstract:

Objective To provide solid evidence for clinical development and implementation of yoga exercise for patients with cancer-related fatigue，we systematically retrieve，extract，summarize and analyze both the latest and the best evidence of yoga exercise for patients with cancer-related fatigue. Methods We searched BMJ Best Practice，UpToDate，NICE，RNAO，SIGN，NCCN，GIN，Yimaitong Guideline，JBI Library，Cochrane Library，PubMed，Web of Science，CINAHL，Wanfang Database，CNKI，CBM，AACR and ONS website to collect all relevant evidence，including guidelines，evidence summaries，best practice，expert consensuses，systematic reviews and et al. published from establishment of the database to December，2021. There were 2 researchers who independently screened articles and evaluated methodological quality. Evidence was extracted and summarized according to the theme. Results A total of 7 articles were finally included，containing 1 guideline and 6 systematic reviews. 22 pieces of evidence related to yoga exercise for patients with cancer-related fatigue were extracted and summarized into 9 themes，including exercise cognition，effects，yoga type，assessment，guidance and supervision，target population，principles formulation，exercise parameters and measurements. Conclusion Health care providers should carry out the best evidence practice of personalized yoga exercise prescription for cancer patients according to the characteristics of different cancer population，in order to reduce their fatigue and improve their quality of life.

Key words: Neoplasms, Fatigue, Yoga, Evidence Summary, Evidence-Based Nursing

袁书琪, 王园园, 贾凌莹, 胡雁. 癌因性疲乏患者瑜伽运动管理的最佳证据总结[J]. 中华护理杂志, 2023, 58(1): 91-97.

YUAN Shuqi, WANG Yuanyuan, JIA Lingying, HU Yan. Evidence summary of yoga management for patients with cancer-related fatigue[J]. Chinese Journal of Nursing, 2023, 58(1): 91-97.

图/表 4

图1 文献检索流程图

Figure 1 Flow chart of literature search and screening

表1 纳入文献的基本特征（n=7）

Table 1 The characteristics of the included studies（n=7）

表2 纳入系统评价的方法学质量评价结果（n=6）

Table 2 Quality evaluation results of included systematic reviews methodology（n=6）

表3 癌因性疲乏患者瑜伽运动的最佳证据总结

Table 3 Summary of the best evidence of yoga for patients with cancer-related fatigue

参考文献 26

[1]	National Comprehensive Cancer Network. Cancer-related fatigue[EB/OL].(2020-12-01)[2022-03-10]. https://www.nccn.org/professionals/physician_gls/pdf/fatigue.pdf.
[2]	Ma Y, He B, Jiang M, et al. Prevalence and risk factors of can-cer-related fatigue:a systematic review and meta-analysis[J]. Int J Nurs Stud, 2020, 111:103707. DOI URL
[3]	Porro B, Michel A, Zinzindohoué C, et al. Quality of life,fatigue and changes therein as predictors of return to work during breast cancer treatment[J]. Scand J Caring Sci, 2019, 33(2):467-477. DOI URL
[4]	Joly F, Lange M, Dos Santos M, et al. Long-term fatigue and cog-nitive disorders in breast cancer survivors[J]. Cancers (Basel), 2019, 11(12): E1896.
[5]	张妍欣, 杨丽, 李家燕, 等. 鼻咽癌患者同步放化疗后自我管理积极度现状及影响因素分析[J]. 中华护理杂志, 2022, 57(15):1853-1859. DOI
	Zhang YX, Yang L, Li JY, et al. Analysis on the current situation and influencing factors of the self-management positivity of patients in the recovery period after simultaneous radiotherapy for nasopharyngeal carcinoma[J]. Chin J Nurs, 2022, 57(15):1853-1859. DOI
[6]	Lin PJ, Peppone LJ, Janelsins MC, et al. Yoga for the management of cancer treatment-related toxicities[J]. Curr Oncol Rep, 2018, 20(1):5. DOI URL
[7]	Raveendran AV, Deshpandae A, Joshi SR. Therapeutic role of yoga in type 2 diabetes[J]. Endocrinol Metab(Seoul), 2018, 33 (3):307-317.
[8]	Gautam S, Kumar U, Dada R. Yoga and its impact on chronic inflammatory autoimmune arthritis[J]. Front Biosci (Elite Ed), 2021, 13(1):77-116. DOI PMID
[9]	Song J, Wang T, Wang Y, et al. The effectiveness of yoga on cancer-related fatigue:a systematic review and meta-analysis[J]. Oncol Nurs Forum, 2021, 48(2):207-228. DOI URL
[10]	Alper BS, Haynes RB. EBHC pyramid 5.0 for accessing prea-ppraised evidence and guidance[J]. Evid Based Med, 2016, 21(4):123-125. DOI URL
[11]	朱政, 胡雁, 邢唯杰, 等. 不同类型循证问题的构成[J]. 护士进修杂志, 2017, 32(21):1991-1994.
	Zhu Z, Hu Y, Xing WJ, et al. Composition of different types of evidence-based problems[J]. J Nurses Train, 2017, 32(21):1991-1994.
[12]	Brouwers MC, Kho ME, Browman GP, et al. AGREE Ⅱ:advancing guideline development,reporting and evaluation in health care[J]. CMAJ, 2010, 182(18):E839-E842. DOI URL
[13]	顾莺, 张慧文, 周英凤, 等. JBI循证卫生保健中心关于不同类型研究的质量评价工具:系统评价的方法学质量评价[J]. 护士进修杂志, 2018, 33(8):701-703.
	Gu Y, Zhang HW, Zhou YF, et al. JBI evidence-based health center’s quality assessment tool for different types of research,the quality evaluation of diagnostic and economic eva-luation[J]. J Nurses Train, 2018, 33(8):701-703.
[14]	王春青, 胡雁. JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015, 30(11):964-967.
	Wang CQ, Hu Y. JBI evidence pre-classification and evidence rank system(2014 edition)[J]. J Nurses Train, 2015, 30(11):964-967.
[15]	Jiang M, Ma Y, Yun B, et al. Exercise for fatigue in breast cancer patients:an umbrella review of systematic reviews[J]. Int J Nurs Sci, 2020, 7(2):248-254.
[16]	O’Neill M, Samaroo D, Lopez C, et al. The effect of yoga interventions on cancer-related fatigue and quality of life for women with breast cancer:a systematic review and meta-analysis of randomized controlled trials[J]. Integr Cancer Ther, 2020, 19:1534735420959882.
[17]	周帅, 江锦芳, 张玲, 等. 不同运动疗法对癌症患者癌因性疲乏干预效果的网状Meta分析[J]. 解放军护理杂志, 2021, 38(8):65-68,88.
	Zhou S, Jiang JF, Zhang L, et al. Different exercise therapies in patients with cancer-related fatigue:a network meta-analysis[J]. Nurs J Chin PLA, 2021, 38(8):65-68,88.
[18]	Hilfiker R, Meichtry A, Eicher M, et al. Exercise and other non-pharmaceutical interventions for cancer-related fatigue in patients during or after cancer treatment:a systematic review incorporating an indirect-comparisons meta-analysis[J]. Br J Sports Med, 2018, 52(10):651-658. DOI URL
[19]	Dong B, Xie C, Jing X, et al. Yoga has a solid effect on cancer-related fatigue in patients with breast cancer:a meta-analysis[J]. Breast Cancer Res Treat, 2019, 177(1):5-16. DOI URL
[20]	Mehl A, Reif M, Zerm R, et al. Impact of a multimodal and combination therapy on self-regulation and internal coherence in German breast cancer survivors with chronic cancer-related fatigue:a mixed-method comprehensive cohort design study[J]. Integr Cancer Ther, 2020, 19:1534735420935618.
[21]	Kuntze G, Nesbitt C, Whittaker JL, et al. Exercise therapy in juvenile idiopathic arthritis:a systematic review and meta-analysis[J]. Arch Phys Med Rehabil, 2018, 99(1):178-193. DOI URL
[22]	王璐, 孙倩, 丁四清, 等. 青年癌症患者运动疗法实施策略的研究进展[J]. 中华护理杂志, 2019, 54(6):945-949. DOI
	Wang L, Sun Q, Ding SQ, et al. Research progress on the implementation strategy of exercise therapy in young cancer patients[J]. Chin J Nurs, 2019, 54(6):945-949.
[23]	World Health Organization. WHO guidelines on physical activity and sedentary behaviour[EB/OL].(2020-11-26)[2022-01-08]. https://apps.who.int/iris/bitstream/handle/10665/336657/97-89240015111-eng.pdf.
[24]	Thong MSY, Steindorf K, et al. Cancer-relat-ed fatigue:causes and current treatment options[J]. Curr Treat Options Oncol, 2020, 21(2):17. DOI URL
[25]	薛秀娟, 许翠萍, 杨雪莹, 等. 癌因性疲乏测评工具及评价指标的研究进展[J]. 中华护理杂志, 2012, 47(9):859-861.
	Xue XJ, Xu CP, Yang XY, et al. Research progress on measurement instruments for cancer patients’ symptom distress[J]. Chin J Nurs, 2012, 47(9):859-861.
[26]	中国抗癌协会癌症康复与姑息治疗专业委员会, 中国临床肿瘤学会肿瘤支持与康复治疗专家委员会. 癌症相关性疲乏诊断与治疗中国专家共识[J]. 中华医学杂志, 2022, 102(3):180-189.
	China Anti-Cancer Association, Chinese Society of Clinical Oncology Experts Committee on Cancer Support and Rehabilitation. Chinese expert consensus on diagnosis and treatment of cancer-related fatigue[J]. Natl Med J Chin, 2022, 102(3):180-189.