抗阻训练对绝经后患者骨密度影响的Meta分析

doi:10.3761/j.issn.0254-1769.2019.11.026

摘要/Abstract

摘要：

目的通过Meta分析明确抗阻训练对于绝经后骨质减少或骨质疏松症患者骨密度的影响。方法计算机检索PubMed、CINAHL、Embase、Web of Science、万方、中国知网及中国生物医学文献数据库,收集关于抗阻训练对于绝经后骨质减少或骨质疏松症患者骨密度影响的随机对照试验,检索时限为建库至2019年4月。由2名评价人员按照纳入与排除标准独立进行文献筛选、资料提取和文献质量评价后,采用RevMan 5.3软件进行Meta分析。结果共纳入7篇文献,包括698例研究对象,Meta分析结果显示,抗阻训练较常规运动对绝经后骨质减少或骨质疏松症患者腰椎骨密度有积极影响,合并效应具有统计学意义[MD=0.02,95%CI（0.00,0.05）,P=0.04]。抗阻训练对股骨颈[MD=0.01,95%CI（-0.00,0.02）,P=0.17]、髋部[MD=0.01,95%CI（-0.01,0.02）,P=0.41]、大转子[MD=0.01,95%CI（-0.00, 0.03）,P=0.16]的骨密度以及血清骨钙素[MD=1.44,95%CI（-2.23,5.12）,P=0.44]无明显作用。结论抗阻训练可明显改善绝经后骨质减少或骨质疏松症患者腰椎骨密度,对股骨颈、髋部、大转子骨密度和血清骨钙素的改善不明显。目前关于抗阻训练对于绝经后骨质减少或骨质疏松症患者的骨密度影响的研究证据尚不充足,且各研究样本量差异较大,后期需进行更多高质量研究进行验证。

关键词: 骨质疏松, 绝经后, 抗阻训练, 骨密度, 康复护理, Meta分析

Abstract:

Objective To identify the effects of resistance training on bone mineral density in patients with postmenopausal osteopenia or osteoporosis using meta-analysis.Methods We performed a systematic search in PubMed,CINAHL,Embase,Web of Science,Wanfang,CNKI and CBM to collect studies about effects of resistance training on bone mineral density in patients with postmenopausal osteopenia or osteoporosis published from inception to April 2019. Meta-analysis was performed using RevMan 5.3 software after two independent reviewers conducted independent literature screening,data extraction,and literature quality evaluation according to inclusion and exclusion criteria.Results Seven studies were recruited,including 698 cases. The results of meta-analysis showed that resistance training had a positive effect on bone mineral density at the lumbar spine in patients with postmenopausal osteopenia or osteoporosis compared with conventional exercise. The combined effect was statistically significant[MD=0.02,95%CI（0.00,0.05）,P=0.04]. Resistance training had no significant effect on bone mineral density at the femoral neck[MD=0.01,95%CI（-0.00,0.02）,P=0.17],hip[MD=0.01,95%CI（-0.01,0.02）,P=0.41],greater tro-chanter[MD=0.01,95%CI（-0.00,0.03）,P=0.16]and serum osteocalcin[MD=1.44.95%CI（-2.23,5.12）,P=0.44].Conclusion Resistance training significantly improved bone mineral density in the lumbar spine,but did not improve bone mineral density in the femoral neck,hip,greater trochanter and serum osteocalcin in patients with postmenopausal osteopenia or osteoporosis. At present,there is insufficient evidence for the effects of resistance training on bone mineral density in patients with postmenopausal osteopenia or osteoporosis,the sample size varies greatly,and more high-quality studies are needed for future research.

Key words: Osteoporosis, Postmenopausal, Resistance Training, Bone Density, Rehabilitation Nursing, Meta-analysis

梁艳婷, 尚红彦, 邢曼霞, 刘姜红, 孙龙凤. 抗阻训练对绝经后患者骨密度影响的Meta分析[J]. 中华护理杂志, 2019, 54(11): 1722-1728.

LIANG Yanting, SHANG Hongyan, XING Manxia, LIU Jianghong, SUN Longfeng. Effects of resistance training on bone mineral density in patients with postmenopausal osteopenia or osteoporosis：a meta-analysis[J]. Chinese Journal of Nursing, 2019, 54(11): 1722-1728.

图/表 6

表1 纳入文献的基本特征

表2 纳入文献的方法学质量评价

图1 抗阻训练对绝经后骨质减少或骨质疏松症患者腰椎骨密度影响的森林图

图2 抗阻训练对绝经后骨质减少或骨质疏松症患者股骨颈骨密度影响的森林图

图3 抗阻训练对绝经后骨质减少或骨质疏松症患者髋部骨密度影响的森林图

图4 抗阻训练对绝经后骨质减少或骨质疏松症患者股骨大转子骨密度影响的森林图

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