运动疗法在血液透析不宁腿综合征治疗中有效性的Meta分析

摘要

Objective To assess the efficacy of exercise for hemodialysis restless legs syndrome. Methods All randomized controlled trials(RCTs)of exercise for hemodialysis restless legs syndrome were collected from CNKI,CBM,Wan Fang Data,Springer and Pub Med.Two reviewers independently screened the published studies,extracted the data,assessed the quality,and cross-checked.Then RevMan 5.01 software was used for mate-analysis.Results A total of 4 RCTs were enrolled in the review.The results of meta-analysis showed that compared with the control group,exercise improved the restless legs syndrome severity scale effectively with significant differences[WMD=-7.29,95%CI(-10.33,-4.24),P<0.00001 ].The same results were found in Zung self-rating depression scale[WMD=-6.27,95%CI (-9.53,-3.00),P=0.0002],and Epworth sleepiness scale[WMD=-1.32,95%CI(-2.50,-0.14),P=0.03 ].Meanwhile,SF-36 scale in mental component summary (P=0.07 )and physical component summary (P=0.08)were with no statistical difference.Conclusions The researches show that exercise effectively improved the restless legs syn-drome severity scale,Zung self-rating depression scale,Epworth sleepiness scale for patients with hemodialysis restless legs syndrome. However,the improvement of SF-36 scale lacked of evidences.The large sample,double-blinded RCTs and patients'end point target in-cluding lifetime,risk of cardiovascular are needed.%目的 系统分析运动疗法在血液透析不宁腿综合征治疗中的有效性.方法 依据PICOS原则通过电子检索和人工检索综合检索公开发表的中文或英文相关运动治疗血液透析不宁腿综合征的随机对照试验文献,检索年限均为建库至2015年5月.按照纳入标准和排除标准筛选文献,提取资料和进行质量评价后,采用RevMan5.1软件进行分析.结果 纳入4个随机对照试验,Meta分析结果显示:(1)运动可有效改善病人不宁腿综合征量表积分,和对照组相比有统计学意义[WMD=-7.29,95%CI(-10.33,-4.24),P<0.00001].(2)负荷运动可有效改善病人ZUNG抑郁量表积分,和对照组相比有统计学意义[WMD=-6.27,95%CI(-9.53,-3.00),P=0.0002].(3)负荷运动可有效改善病人Epworth嗜睡量表评积分,和对照组相比有统计学意义[WMD=-1.32,95%CI(-2.50,-0.14),P=0.03].(4)负荷运动可有效改善病人SF-36量表心理维度积分,和对照组相比无统计学意义[WMD=12.02,95%CI(-1.20,-25.23),P=0.07],心理维度积分,和对照组相比无统计学意义[WMD=17.76,95%CI(-2.23,37.75),P=0.08].结论 该系统评价结果显示,运动可有效改善血液透析不宁腿综合征病人的症状、改善抑郁及睡眠质量,但在改善生活质量方面缺乏足够证据.未来应开展大样本、多中心的、双盲的随机对照试验,并增加相关终点指标的研究.