|
摘要：
|
|
摘要：目的 采用Meta分析探讨非药物干预方法对肝硬化患者肌少症的改善效果。方
法 检索PubMed、Embase、CINAHL、Cochrane Library、Web of Science、中国知网、
万方数据中公开发表的随机对照试验。根据纳入排除标准筛选文献并提取文献信息，
采用2023版乔安娜布里格斯研究所（Joanna Briggs Institute，JBI）循证卫生保健中心
的评价工具对纳入的文献进行质量评价。通过STATA 14.0软件进行网状Meta分析并
进行发表偏倚分析，通过累积排序概率图下面积反映每种干预方法成为最佳干预的
可能性。结果 本研究共纳入20篇文献，共计900例肝硬化患者，涉及10种非药物干预
方法，分别为低强度有氧运动、中强度有氧运动、抗阻力运动、有氧运动+抗阻力运
动、拉伸运动、太极拳、口服支链氨基酸、中强度有氧运动+口服支链氨基酸、低强
度有氧运动+抗阻力运动+口服支链氨基酸、神经肌肉电刺激。网状Meta分析表明中
强度有氧运动+口服支链氨基酸（MD = 54.89，95%CI：51.21～58.58，P ＜ 0.001）、
中强度有氧运动（MD = 52.69，95% CI：46.59～58.79，P ＜ 0.001）可有效改善肝硬
化患者的骨骼肌指数；口服支链氨基酸+有氧运动可有效改善肝硬化患者的体重指数
（MD = 1.94，95%CI：0.24～3.64，P = 0.025）；有氧运动+抗阻力运动可有效改善肝
硬化患者的大腿围（MD = 1.8，95%CI：0.27～3.33，P = 0.021）；口服支链氨基酸+
有氧运动（MD = 3.8，95%CI：0.17～7.47，P = 0.04）、中强度有氧运动（MD = 2.8，
95%CI：1.64～3.92，P ＜ 0.001）、低强度有氧运动（MD = 2.8，95%CI：1.38～4.18，
P ＜ 0.001）可有效改善肝硬化患者的中臂围；中强度有氧运动（MD = 6.1，95%CI：
2.93～9.27，P ＜ 0.001）、口服补充支链氨基酸+有氧运动（MD = 5.56，95%CI：
1.61～9.52，P = 0.006）可有效改善肝硬化患者手握力；非药物干预方式对肝硬化患者
6 min步行距离无改善效果（P均＞ 0.05）。结论 中强度有氧运动联合口服支链氨基酸、
中强度有氧运动、抗阻力运动联合有氧运动可有效改善肝硬化患者的肌肉质量；中强度
有氧运动、中强度有氧运动联合口服支链氨基酸可有效改善肝硬化患者的肌肉力量。中
强度有氧运动联合口服支链氨基酸对改善肝硬化肌少症效果最好，可优先考虑应用。
|
|
Abstract: Objective To evaluate the improvement effects of non-drug interventions
on sarcopenia in patients with liver cirrhosis by Meta analysis. Methods The published
randomized controlled trials in Pubmed, Embase, CINAHL, Cochrane Library, Web of
Science, CNKI and Wanfang Data were searched. Literature were selected according to
the inclusion and exclusion criteria and the information were extracted. The quality of
literatures was evaluated by evaluation tool of Joanna Briggs Institute (JBI) evidence-based
Health Care Center (version 2023). Mesh Meta analysis and publication bias analysis were
performed by STATA 14.0 software. The probability of each intervention being the best
intervention was presented by the area under the cumulative ranking probability graph.
Results A total of 20 literature were included in this study, involving 900 patients with liver
cirrhosis and 10 non-drug intervention methods (low aerobic exercise, moderate aerpbic
exercise, resistance exercise, aerpbic exercise + resistance exercise, stretching exercise, Tai
Chi, oral administration of branched-chain amino acids, moderate aerpbic exercise + oral
administration of branched-chain amino acids, low aerobic exercise + resisstance + oral
administration of branched-chain amino acids and neuromusclar eletrical stimulation). The
results of mesh Meta-analysis showed that moderate aerpbic exercise + oral administration of
branched-chain amino acids (MD = 54.89, 95%CI: 51.21～58.58, P ＜ 0.001) and moderate
aerpbic exercise (MD = 52.69, 95%CI: 46.59～58.79, P ＜ 0.001) could effectively improve
the skeletal muscle index of patients with liver cirrhosis. Oral administration of branchedchain
amino acids + aerpbic exercis could effectively improve the body mass index of patients
with liver cirrhosis (MD = 1.94, 95%CI: 0.24～3.64, P = 0.025). Aerobic exercise + resistance
could effectively improve the thigh circumference of patients with liver cirrhosis (MD =
1.8, 95%CI: 0.27～3.33, P = 0.021). Oral administration of branched-chain amino acids +
aerpbic exercis (MD = 3.8, 95%CI: 0.17～7.47, P = 0.04) and low aerobic exercise (MD =
2.8, 95%CI: 1.38～4.18, P ＜ 0.001) could effectively improve the middle arm circumference
of patients with liver cirrhosis. Moderate aerobic exercise (MD = 6.1, 95%CI: 2.93～9.27,
P ＜ 0.001) and oral administration of branched-chain amino acids + aerobic exercise (MD =
5.56, 95%CI: 1.61～9.52, P = 0.006) could effectively improve the grip strength of patients
with liver cirrhosis. Non-drug intervention had no effects on the 6 min walking distance of
patients with liver cirrhosis (all P ＞ 0.05). Conclusions Moderate intensity aerobic exercise
combined with oral administration branched-chain amino acids, moderate intensity aerobic
exercise and resistance exercise combined with aerobic exercise could effectively improve the
muscle mass of patients with liver cirrhosis. Moderate intensity aerobic exercise and moderate
intensity aerobic exercise combined with oral administration branched-chain amino acids
could effectively improve muscle strength in patients with liver cirrhosis. Moderate intensity
aerobic exercise combined with oral administration branched-chain amino acid had the best
effect on the improvement of cirrhosis of sarcopenia, which should be given priority.
|
|
基金项目：
|
|
|
|
作者简介：
|
|
|
|
参考文献：
|
|
|
|
服务与反馈：
|
|
【文章下载】【加入收藏】
|
|
|
|