不同有氧运动对膝骨关节炎患者干预效果的网状Meta分析

doi:10.3761/j.issn.1672-9234.2023.06.019

摘要/Abstract

摘要：

目的分析不同有氧运动对膝骨关节炎（knee osteoarthritis，KOA）患者干预效果的差异，为临床医护人员选择有氧运动方式提供依据。方法系统检索CNKI、万方、维普、SinoMed、PubMed、Web of Science、Embase、Cochrane Library数据库中有氧运动干预膝骨关节炎的随机对照试验，检索时限为建库至2022年11月。由2名经过循证培训的研究者独立筛选文献、提取资料，并使用Cochrane的随机对照试验偏倚风险评估工具评价纳入研究质量，使用Stata 15.0软件进行网状Meta分析。结果共纳入21项研究，1 209例KOA患者。网状Meta分析结果显示，水下跑步、步行对缓解KOA患者疼痛的效果优于常规治疗（P<0.05），水下跑步最优（SUCRA=87.1%）。各有氧运动对僵硬、关节功能指标干预效果的两两比较结果显示，均无统计学差异（P>0.05）；僵硬、关节功能指标干预效果累积排序概率图下面积排序第一位分别为自行车（SUCRA=77.3%）、步行（SUCRA=79.3%）。结论当前证据显示，水下跑步为减轻KOA患者疼痛的最佳方法，自行车可能为缓解僵硬的最佳方法，步行可能为改善关节功能的最佳方法。受纳入研究数量和质量的限制，上述结论仍需更多高质量研究进一步验证。

关键词: 运动疗法, 骨关节炎，膝, 循证护理学, 疼痛, 僵硬, 关节功能

Abstract:

Objective To analyze the difference in the effect of aerobic exercise on knee osteoarthritis（KOA） through network meta-analysis，so as to provide the evidence for clinical doctors and nurses in selecting the type of aerobic exercise. Methods The databases of CNKI，Wanfang，VIP，SinoMed，PubMed，Web of Science，Embase and Cochrane Library were systematically searched to collect randomized controlled trial（RCT） of aerobic exercise intervention in patients with knee osteoarthritis. The retrieval time limit was set from the establishment of the database to November 2022. Two trained researchers independently screened the literature，extracted unqualified data，and evaluated the quality of the included studies using the RCT bias risk assessment tool recommended by Cochrane evidence-based center. Stata 15.0 software was employed for network meta-analysis. Results A total of 21 studies were included，covering 1 209 KOA patients. The results of network meta-analysis showed that the effect of aquatic running and walking was better than that of conventional treatment（P<0.05） in relieving pain of KOA patients，and aquatic running was the best（SUCRA=87.1%）. The comparison of intervention effects on aerobic exercise in stiffness and joint function displayed no statistical difference（P>0.05）. Meanwhile，the first place of SUCRA in stiffness and joint function was bicycle （77.3%） and walking（79.3%）. Conclusion The current evidence showed that aquatic running demonstrated to be the best way to relieve pain of KOA patients，bicycle might be the best way to relieve stiffness，and walking might be the best way to improve function. Limited by the number and quality of included studies，the current conclusions are still need to be further verified by more high-quality studies.

Key words: Exercise Therapy, Osteoarthritis，Knee, Evidence-Based Nursing, Pain, Rigidity, Joint dysfunction

蔡明瑾,侯朝铭,高静,柏丁兮,刘锐芮,卢贤英,王薇,宫笑颜. 不同有氧运动对膝骨关节炎患者干预效果的网状Meta分析[J]. 中华护理教育, 2023, 20(6): 745-751.

CAI Mingjin,HOU Chaoming,GAO Jing,BAI Dingxi,LIU Ruirui,LU Xianying,WANG Wei,GONG Xiaoyan. Intervention effect of aerobic exercise on knee osteoarthritis patients：a network meta-analysis[J]. Chinese Journal of Nursing Education, 2023, 20(6): 745-751.

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