八段锦对血液透析患者干预效果的Meta分析

Meta-analysis of the effects of traditional Chinese medicine exercise therapy baduanjin on hemodialysis patients

关键词:  血液透析  八段锦  不良身心症状群  随机对照研究  Meta分析

Key words:  hemodialysis  baduanjin  adverse physical and mental symptom cluster  randomized controlled trial  Meta-analysis

摘要:

[目的] 系统评价八段锦对维持性血液透析（MHD）患者的干预效果。[方法] 计算机检索中国知网、万方数据知识服务平台、维普资讯中文期刊服务平台、中国生物医学文献数据库（CBM）、PubMed、Embase、The Cochrane Library及Web of science数据库，收集各数据库自建库至2024年12月有关八段锦治疗MHD患者的临床随机对照研究。由2名研究者独立进行文献筛选、资料提取及质量评价后，运用Revman 5.4.1和Stata 18软件进行统计分析。[结果] 纳入15篇相关文献，共计1 322例患者。Meta分析结果显示，与对照组相比，八段锦干预组能够显著降低MHD患者的匹兹堡睡眠质量指数（PSQI）[MD=-4.46，95%CI（-4.72，-4.20）]、Piper疲乏修订量表（RPFS）评分[MD= -0.87，95%CI（-1.09，-0.66）]、汉密尔顿抑郁量表（HAMD）评分[MD=-4.47，95%CI（-5.15，-3.79）]、汉密尔顿焦虑量表（HAMA）评分[MD=-4.68，95%CI（-5.46，-3.89）]、抑郁自评量表（SDS）评分[MD=-7.22，95%CI（-7.94，-6.50）]与焦虑自评量表（SAS）评分[MD=-6.14，95%CI（-6.79，-5.49）]。[结论] 现有证据表明，八段锦在改善MHD患者的睡眠质量、疲乏程度、抑郁/焦虑等不良身心症状群方面具有良好疗效，为MHD患者的非药物治疗方案提供了可靠依据。但受限于纳入研究数量、方法学质量及潜在发表偏倚，其疗效与安全性的确切结论尚待开展更多高质量研究进一步验证。

Abstract:

[Objective] To systematically evaluate the intervention effect of Baduanjin on maintenance hemodialysis（MHD） patients. [Methods] CNKI，Wanfang，VIP，CBM，PubMed，Embase，The Cochrane Library，and Web of Science databases were searched by computer to collect clinical randomized controlled trials（RCTs） on Baduanjin for MHD patients from the inception of each database to December 2024. Two reviewers independently performed literature screening，data extraction，and quality assessment. Statistical analysis was conducted using RevMan 5.4.1 and Stata 18 software. [Results] A total of 15 studies involving 1 322 patients were included. Meta-analysis results showed that，compared with the control group，the Baduanjin intervention group significantly reduced the Pittsburgh Sleep Quality Index（PSQI） score in MHD patients [MD=-4.46，95%CI（-4.72，-4.20）]，the Revised Piper Fatigue Scale（RPFS） score [MD=-0.87，95%CI（-1.09，-0.66）]，the Hamilton Depression Scale（HAMD） score [MD=-4.47， 95%CI（-5.15，-3.79）]，the Hamilton Anxiety Scale（HAMA） score [MD=-4.68，95%CI（-5.46，-3.89）]，the Self-rating Depression Scale（SDS） score [MD=-7.22，95%CI（-7.94，-6.50）]，and the Self-rating Anxiety Scale（SAS） score [MD=-6.14，95%CI（-6.79，-5.49）]. [Conclusion] Current evidence indicates that Baduanjin has a good effect on improving sleep quality，fatigue，and adverse physical and mental symptoms such as depression and anxiety in MHD patients，providing a reliable basis for non-pharmacological treatment of MHD patients. However，due to the limited number of included studies，methodological quality，and potential publication bias，more high-quality studies are needed to further verify the exact conclusions regarding its efficacy and safety.