冠心病的康复疗法:Meta分析

Rehabilitation therapy for coronary heart disease:Meta analysis

心脑血管疾病,尤其是冠心病已成为中国中老年人群,特别是坐位工作者的常见病和多发病。运动与心血管疾病的发展和预后密切相关,有规律的运动对冠心病有积极的预防和治疗作用,与冠心病的发病率和死亡率呈负相关。但其机制尚未完全阐明。本研究试图通过Meta分析(荟萃分析)借助ChineseCochraneCenter的资源和循证医学的原理,对运动康复疗法治疗心血管系统疾病的机制,方案的选择等进行研究,为冠心病的运动康复方案的选择和运动处方的制定等提供理论依据。Meta分析是对具有相同研究目的的多个医学研究进行综合分析的一系列过程。是汇总多个相关研究的结果并分析评价其合并效应量的一系列过程,包括提出研究问题,制定纳入和排除标准检索相关研究、汇总基本信息、综合分析并报告结果等,Meta分析结果能够帮助解决重要的公共健康问题或使个体直接受益,同时能作为可靠证据指导临床实践及卫生决策的科学化。研究选择近年来有关以冠心病预防,治疗,康复为目的的国内外相关的重大研究进展,包括国家体育总局和国家自然科学基金项目。如运动和营养对动脉粥样硬化斑块的形成和预防,运动对纤维蛋白溶解系统的影响,运动对有载脂蛋白基因缺陷的动物的影响,过度训练对机体的影响,不同运动强度对心肌促血管内皮生长因子,成纤维?

Cardiocerebral vascular disease, especially coronary heart disease(CHD) has become a common disease in the middle old age and sedentary people.Exercise has a close relationship with the development and prognosis of cardiovascular disease.Regular exercise has a positively preventive and therapeutical effect on CHD,and is negatively related with its incidence and mortality.However,its mechanism has not been explained.This study was to investigate the curing mechanism and selection of the treatments of sports rehabilitation therapy by Meta analyzing the data of Chinese Cochrane Center and the Evidence Based Medicine(EBM) to provide theoretical evidence for selecting sports rehabilitation plan and making physical exercise prescription.Meta analysis sums up many correlated result,analyzes and evaluates series of process of united effect, including putting forward questions, formulating inclusive and exclusive criteria,summing up basic information, analyzing comprehensively and reporting result,etc.Meta analysis result can help solve important public health problem or benefit individuals directly, and meanwhile,can be regarded as reliable evidence for guiding clinical practice and healthy decision scientifically.Important research progresses on CHD prevention,treatment and rehabilitation at home and abroad were selected, including the National Physical Bureau and the National Nature Science Fund Projects, such as the effects of exercise and nutrition on the formation and prevention of atherosclerotic(AS),the effects of exercise on the fibrinolytic and coagulative system, the effects of exercise on the Apo E genome deficiency animals, the effects of overexercise on body, the effects of different exercise intensities on cardiac vascular endothelial growth factor(VEGF), fibroblast growth factor(FGF) gene expression,the induced time of exercise rehabilitation therapy, gene therapy of the CHD,etc.EBM study on sports rehabilitation and CHD treatment:①Surgical operation coronary artery bypaso grafting;②Gene therapy: bimolecular “build across bridge surgery”;③Exercise rehabilitation therapy “build across bridge surgery”. Results showed that, the formation of CHD and AS is a product of multiple levels, multiple factors and multiple genes,therefore,these diseases should be treated and prevented with a model of multiple levels, multiple factors and multiple genes(three multi modes).Effects of exercise therapy on body are mostly in accordance with this therapy model. Early intervention of “across bridge surgery”of sports rehabilitation therapy is very correspondent with AS preventive treatment and rehabilitative method in China,and has best social and economic benefits.Therefore,it is considered very important that setting up the model of multiple levels,multiple factors and multiple genes on exercise therapy rehabilitation,and improving sports medicine and sports rehabilitation therapy of China to world leading level.