瑜伽训练对绝经综合征妇女身心健康影响的系统评价

doi:10.3761/j.issn.1672-9234.2021.11.016

摘要/Abstract

摘要：

目的系统评价瑜伽训练对绝经综合征妇女身心健康影响的效果。方法检索PubMed、Embase、Cochrane Library、中国期刊全文数据库、万方数据库中关于瑜伽训练对绝经综合征妇女身心健康影响的随机对照试验,检索时限为建库至2021年2月,由2名研究人员独立完成文献筛选、资料提取和偏倚风险评价后,采用Revman 5.2软件对纳入的文献进行分析,并用GRADE Profiler 3.6.1软件进行评级。结果共纳入11篇文献,包括923例研究对象,纳入的11篇文献质量均为B,meta分析结果显示,瑜伽训练后,试验组较对照组绝经综合征妇女的血管及自主神经症状[SMD=-0.89,95%CI（-1.35,-0.44）,P<0.001]、躯体活动[SMD=-1.07,95%CI（-1.44,-0.70）,P<0.001]、泌尿生殖道症状[SMD=-0.68,95%CI（-1.17,-0.18）,P=0.007]有明显改善;试验组较对照组绝经综合征妇女的精神心理症状[SMD=-0.51,95%CI（-1.26,0.24）,P=0.190]无明显改善;描述性分析结果表明,瑜珈训练可改善血压情况,但在BMI的改善情况方面的研究结果不一致。经GRADE系统评级,证据体的质量为低等级别。结论瑜伽训练能有效改善绝经综合征妇女的血管及自主神经症状、躯体活动、泌尿生殖道症状、血压,但对于绝经综合征妇女的精神心理症状、BMI还有待于更多研究进行验证。而且仍需要更大样本量、长期的高质量研究进一步证明瑜伽训练对绝经综合征妇女身心健康影响的有效性。

关键词: 瑜伽, 绝经期, 护理学,循证

Abstract:

Objective To systematically evaluate the effectiveness of yoga on physical and mental health of menopausal women by meta-analysis. Methods We performed a systematic search in PubMed,Embase,Cochrane Library,CNKI,Wanfang to collect studies about effects of yoga on the mental and physical health of menopausal women published from inception to February 2021. Meta-analysis was performed using RevMan 5.2 software after two independent reviewers finished literature screening,data extraction,and literature quality evaluation. The GRADE Profiler 3.6.1 software was used for evidence quality evaluation. Results Eleven studies were recruited,including 923 participants. The quality of all included studies was rated as B level. The results of meta-analysis showed that the sympathetic autonomic nerve system score[SMD=-0.89,95%CI（-1.35,-0.44）,P<0.001],orthopedic system score [SMD=-1.07,95%CI（-1.44,-0.70）,P<0.001],and genitourinary system score[SMD=-0.68,95%CI（-1.17,-0.18）,P=0.007] of the yoga group were significantly improved. However,there was no statistically significant differences of psychological and spiritual symptom score between the two groups[SMD=-0.51,95%CI（-1.26,0.24）,P=0.190]. The results of descriptive analysis showed that yoga can improve menopausal women’s blood pressure,but the results on the improvement of BMI were inconsistent. The evidences were all of low quality in the GRADE system. Conclusion Yoga can improve the sympathetic autonomic nerve system,orthopedic system,genitourinary system and blood pressure of menopausal women. However,the psychological symptoms and BMI of women with menopausal syndrome need to be verified by more studies. It still needs a larger sample size,longer time of higher quality research in the future to prove the effectiveness of yoga for the physical and mental health of menopausal women.

Key words: Yoga, Menopause, Nursing,Evidence-Based

杨娜,王颖,武莉莉. 瑜伽训练对绝经综合征妇女身心健康影响的系统评价[J]. 中华护理教育, 2021, 18(11): 1046-1052.

YANG Na,WANG Ying,WU Li-li. The effects of yoga on physical and mental health of menopausal women：a systematic review[J]. Chinese Journal of Nursing Education, 2021, 18(11): 1046-1052.

图/表 2

参考文献 15

[1]	谢幸, 孔北华, 段涛. 妇产科学[M]. 北京: 人民卫生出版社, 2019.
	Xie X, Kong BH, Duan T. Obstetrics gynecolegy[M]. Beijing: People’s Medical Publishing House, 2019.
[2]	曹晓航, 拜争刚, 高彩云, 等. 瑜伽缓解围绝经期失眠症状有效性的meta分析[J]. 中国计划生育学杂志, 2018, 26(2):86-90.
	Cao XH, Bai ZG, Gao CY, et al. The efficacy of yoga treating menopausal insomnia:a meta-analysis[J]. Chin J Fam Plan, 2018, 26(2):86-90.
[3]	Elavsky S, McAnley E. Lack of perceived sleep improvement after 4-month structured exercise programs[J]. Menopause, 2007, 14(3):535-540.
[4]	Joshi S, Khandwe R, Bapat D, et al. Effect of yoga on menopausal symptoms[J]. Menopause Int, 2011, 17(3):78-81. doi: 10.1258/mi.2011.011020
[5]	Afonso RF, Hachul H, Kozasa EH, et al. Yoga decreases insomnia in postmenopausal women:a randomized clinical trial[J]. Menopause, 2012, 19(2):186-193.
[6]	戴玉琴, 周志红, 段功香. 瑜伽运动对中年妇女更年期症状困扰的影响[J]. 中华现代护理杂志, 2013, 19(12):1373-1376.
	Dai YQ, Zhou ZH, Duan GX. Influence of Yoga on perimenopausal disturbance of middle-aged women[J]. Chin J Mod Nurs, 2013, 19(12):1373-1376.
[7]	裘鹏. 瑜伽练习对缓解更年期女性更年期症状困扰的效果研究[J]. 中国妇幼保健, 2014, 29(22):3580-3583.
	Qiu P. Influence of yoga on perimenopausal disturbance of menopausal women[J]. Maternal and Child Health Care of China, 2014, 29(22):3580-3583.
[8]	Ngowsiri K, Tanmahasamut P, Sukonthasab S. Rusie Dutton traditional Thai exercise promotes health related physical fitness and quality of life in menopausal women[J]. Complement Ther Clin Pract, 2014, 20(3):164-171. doi: 10.1016/j.ctcp.2014.05.002
[9]	Avis NE, Legault C, Russell G, et al. Pilot study of integral yoga for menopausal hot flashes[J]. Menopause, 2014, 21(8):846-854.
[10]	Lee H, Caguicla JM, Park S, et al. Effects of 8-week Pilates exercise program on menopausal symptoms and lumbar strength and flexibility in postmenopausal women[J]. J Exerc Rehabil, 2016, 12(3):247-251. doi: 10.12965/jer.1632630.315
[11]	Kai Y, Nagamatsu T, Kitabatake Y, et al. Effects of stretching on menopausal and depressive symptoms in middle-aged women:a randomized controlled trial[J]. Menopause, 2016, 23(8):827-832.
[12]	Jones SM, Guthrie KA, Reed SD, et al. A yoga & exercise randomized controlled trial for vasomotor symptoms:effects on heart rate variability[J]. Complement Ther Med, 2016, 26:66-71. doi: 10.1016/j.ctim.2016.03.001
[13]	Ahmadinezhad M, Kargar M, Vizeshfar F, et al. Comparison of the effect of acupressure and Pilates-based exercises on sleep quality of postmenopausal women:a randomized controlled trial[J]. Iran J Nurs Midwifery Res, 2017, 22(2):140-146. doi: 10.4103/1735-9066.205954 pmid: 28584553
[14]	Crowe BM, Van Puymbroeck M. Enhancing problem-and emotion-focused coping in menopausal women through yoga[J]. Int J Yoga Therap, 2019, 29(1):57-64.
[15]	Erdoğan Yüce G, Muz G. Effect of yoga-based physical activity on perceived stress,anxiety,and quality of life in young adults[J]. Perspect Psychiatr Care, 2020, 56(3):697-704.