绿色锻炼对心率变异性和血压影响的系统评价

A systematic review on effects of green exercise on heart rate variability and blood pressure

[背景]绿色锻炼是指人在有植物分布的自然环境中进行的锻炼,其对心理的积极作用已被广泛证实,但相关生理效益尚不明确。[目的]探究绿色锻炼对心率变异性与血压的影响。[方法]本研究以血压、心率变异性、潜在绿色环境描述(森林或花园等),以及常见运动锻炼描述(散步或慢跑等)为关键词,从数据库Pubmed、Web of Science、Embase、Medline、Green FILE、Environment Complete、ERIC、Sport Discus、中国知网、维普和万方中纳入了包含随机对照、非随机对照及前后对照设计的相关研究,并进行了系统评价与meta分析。涉及心率变异性指标包括正常心率间期的标准差(SDNN)、相邻NN间期差值的均方根(RMSSD)、庞加莱图短轴SD1、低频功率(LF)、高频功率(HF)以及低频高频比(LF/HF);血压指标包括收缩压(SBP)和舒张压(DBP)。[结果]初次检索出文献1138篇,去除无关和无效数据文献后,最终纳入22篇,总计样本含量1233人。相较于非绿色锻炼,绿色锻炼过程中伴随更高的HF(SMD=-0.37;95%CI:-0.48~-0.26;P<0.001)和更低的LF/HF(SMD=-0.37;95%CI:-0.48~-0.26;P<0.001);但绿色与非绿色锻炼后其他心率变异性指标变化的差异尚具有不确定性。血压方面,绿色锻炼后SBP降低(MD=-5.25;95%CI:-7.47~-3.02;P<0.001),且下降强于非绿色锻炼(MD=-5.27;95%CI:-8.60~-1.93;P<0.01);同样,DBP下降(MD=-4.03;95%CI:-5.63~-2.42;P<0.001),且幅度强于非绿色锻炼(MD=-4.60;95%CI:-7.80~-1.40;P<0.01)。[结论]绿色锻炼可以有效降低SBP与DBP,且降压效果优于非绿色锻炼。

[Background]Green exercise means exercise carried out in natural environment with plants,which has been widely accepted to benefit mental well-being,but related physiological effects remain unclear.[Objective]This study aims to explore the effects of green exercise on heart rate variability and blood pressure.[Methods]In the current study,blood pressure,heart rate variability,potential green environment(forest or garden,etc.),and common exercise(walking or jogging,etc.)were used as key words,and relevant studies that contained randomized controlled,non-randomized controlled,and prepost controlled designs were included via Pubmed,Web of Science,Embase,Medline,Green FILE,Environment Complete,ERIC,Sport Discus,CNKI,VIP,and Wanfang databases.A systematic review using meta-analysis was performed.Measurements of heart rate variability were standard deviation of normal-normal interval(SDNN),root mean square of successive differences in adjacent NN intervals(RMSSD),short axis of Poincare diagram SD1,low frequency power(LF),high frequency power(HF),and LF/HF.Measurements of blood pressure included systolic blood pressure(SBP)and diastolic blood pressure(DBP).[Results]A total of 1138 articles were screened.After removing irrelevant and invalid studies,22 articles were included,involving a total of 1233 subjects.Compared with non-green exercise,green exercise was associated with higher HF(SMD=-0.37;95%CI:-0.48--0.26;P<0.001)and lower LF/HF(SMD=-0.37;95%CI:-0.48--0.26;P<0.001),but the differences post green and non-green exercise was still unclear.In terms of blood pressure,SBP decreased after green exercise(MD=-5.25;95%CI:-7.47--3.02;P<0.001),and the decrease was greater than that after non-green exercise(MD=-5.27;95%CI:-8.60--1.93;P<0.01);similarly,DBP also decreased after green exercise(MD=-4.03;95%CI:-5.63--2.42;P<0.001),and the decrease was greater than that after non-green exercise(MD=-4.60;95%CI:-7.80--1.40;P<0.01).[Conclusion]Green exercise can effectively lower SBP and DBP and show better antihypertensive performance than non-green exercise.