身体锻炼治疗抑郁症的元-元分析

A Meta-Meta-Analysis of the Effect of Physical Exercise as a Treatment on Depression

目的:身体锻炼作为良好的健康促进方式是普遍的共识,并且已被推荐为抑郁症治疗手段,但已有的文献用于处方开具还需要依据循证医学的规律进行全面的总结和详细说明,故对身体锻炼治疗抑郁症效应的元分析文献进行系统综述。方法:基于循证医学研究范式,按照对综述进行综述的思路,采用元-元分析量化计算程序获得更高质量和更全面的数据,首先系统搜索并筛选出7篇符合要求的高质量元分析文献,随后基于62项研究所包含的3 723名被试的数据进行效果量等指标的统计。结果:身体锻炼对抑郁症治疗有中等效应(SMD=-0.63;95%CI=-0.78～-0.48,P<0.000 01);进一步的亚组分析表明,太极、气功的锻炼形式最为有效,每周3次以上、每次锻炼30 min以上、小/中等强度、25～36次的锻炼疗程效应更好;相对其他抑郁种类而言,身体锻炼治疗重度抑郁症MDD效果更佳;与药物治疗、心理治疗和宣传教育等其他治疗手段区别不明显,但身体锻炼合并其他治疗手段的疗效优于单一手段。结论:身体锻炼能够有效治疗抑郁症,未来可以根据这些内容进行运动处方的实践。

Objective: Physical exercise as a good way to promote health is a common consensus,and has been recommended as a treatment for depression.However,the existing literature for prescribing still needs to be comprehensively summarized and detailed description according to evidence-based medicine.The aim of study is to summarize the meta-analysis literatures on the antidepressant effect of physical exercise systematically.Methods: Based on the review of review paradigm,we summarized the meta-analysis literatures on the antidepressant effect of physical exercise systematically by using meta-meta-analysis to ob-tain high quality and comprehensive data.Firstly,a systematic search identified eight high-quality meta-analytic outcomes.The subsequent effect size analysis was based on a total of 62 studies with 3723 participants.Results: Physical exercise reduces depression by a medium effect(SMD=-0.63;95% CI=-0.78^-0.48,P<0.00001).Further sub-group analysis showed that Tai Ji and Qi Gong exercises are the most effective forms;more than 3 times a week,more than 30 minutes per session,small/medium intensity,and 25~36 exercise sessions have better antidepressant effects;compared with other types of depression,physical exercise has a better effect on MDD;The difference from other treatments such as drug treatment,psychotherapy and education is not obvious,but the effect of physical exercise combined with other treatments is better than single treatment.Conclusions: Physical exercise reduces depression effectively,and physical exercise prescriptions can be practiced based on above contents.