不同运动方式干预毒品依赖效果的网状Meta分析

Network Meta Analysis of Effect of Different Exercise Mode in the Treatment of Drug Dependence

目的:借助网状Meta分析法比较有氧运动、肌力训练、有氧运动结合肌力训练、身心运动、高强度间歇性训练及常规康复方式干预毒品依赖的效果。方法:检索中国知网、中国生物医学文献数据库、万方数据知识服务平台、维普网等中文数据库,PubMed、EBSCO、Embase、The Cochrane Library、Web of Science等外文数据库公开发表的与"运动干预毒品依赖"相关的随机对照试验,检索时间截至2021年4月10日。由两名研究者独立筛选文献、提取数据和评价纳入研究的方法学质量后,采用Stata 14.0和Review Manager 5.3软件进行相应统计分析和作图。结果:最终纳入27个随机对照试验,共计1717名毒品依赖者。网状Meta分析结果显示:在降低渴求度方面,有氧运动(SMD=-0.87,95%CI:-1.48,-0.25,P<0.05)、身心运动(SMD=-1.23,95%CI:-2.14,-0.32,P<0.05)显著优于常规康复;在改善焦虑情绪状态方面,有氧运动(SMD=-1.35,95%CI:-1.97,-0.73,P<0.001)、有氧结合肌力训练(SMD=-1.20,95%CI:-1.57,-0.84,P<0.001)、身心运动(SMD=-0.47,95%CI:-0.71,-0.23,P<0.001)较常规康复而言,具有统计学差异;在提升生命质量方面,身心运动(SMD=0.53,95%CI:0.05,1.01,P<0.05)与常规康复相比,具有统计学差异。SUCRA概率排序结果显示,身心运动对于改善渴求度指标(SUCRA=73.6)、生命质量指标(SUCRA=80.9)起最显著作用;有氧结合肌力训练对于改善抑郁指标(SUCRA=77.9)起最显著作用;有氧运动对于改善焦虑指标(SUCRA=91.4)起最显著作用。结论:身心运动、有氧运动、有氧结合肌力训练可能是干预毒品依赖最有效的运动方式,尤其是在降低渴求度、提升生命质量,减轻抑郁、焦虑方面有较好的效果。

Objective:Comparing the effects on aerobic exercise,muscle strength training,aerobic exercise combined with muscle strength training,mind body exercise,high intensity intermittent training and routine rehabilitation on drug dependence by network Meta analysis.Methods:The Chinese database including CNKI,CBM,WanFang Data,CQVIP,and the English database including PubMed,EBSCO,EMBASE,The Cochrane Library and Web of Science databases,the randomized controlled trials related to"exercise intervention in drug dependence"published in the above databases were searched up to April 10 th,2021.Two reviewers independently screened literature,extracted data and assessed risk of bias of included studies and then using Stata 14.0 and Review Manager 5.3 software to conduct corresponding statistical analysis and chart drawing.Results:A total of 27 randomized controlled trials involving 1717 drug dependence patients.The results of network Meta analysis showed that:In reducing cravings,aerobic exercise(SMD=-0.87,95%CI:-1.48,-0.25,P<0.05),mind body exercise(SMD=-1.23,95%CI:-2.14,-0.32,P<0.05)had statistical significance in decreasing the score of craving of drug dependence patients;aerobic exercise(SMD=-1.35,95%CI:-1.97,-0.73,P<0.001),aerobic combined with muscle strength training(SMD=-1.20,95%CI:-1.57,-0.84,P<0.001),mind body exercise(SMD=-0.47,95%CI:-0.71,-0.23,P<0.001)had very significant influence in reducing the total score of anxiety for drug dependence patients;mind body exercise(SMD=0.53,95%CI:0.05,1.01,P<0.05)had significant influence in improving the quality of life for drug dependence patients compared with regular exercise.The SUCRA probability sorting result showed that mind body exercise had the most significant effect on the improvement of craving index(SUCRA=73.6)and quality of life index(SUCRA=80.9);aerobic combined with muscle strength training had the most significant effect on improving depression index(SUCRA=77.9);aerobic exercise had the most significant effect on improving anxiety index(SUCRA=91.4).Conclusions:Mind body exercise,aerobic exercise,aerobic exercise combined with muscle strength training may be the most effective exercise methods to intervene in drug dependence,especially in reducing carving,improving quality of life,and reducing depression and anxiety.