正念运动对慢性心力衰竭患者运动康复效果及负性情绪影响的Meta分析

Meta-analysis of the effect of mindfulness exercise on exercise rehabilitation and negative emotions in patients with chronic heart failure

目的采用Meta分析评价正念运动对慢性心力衰竭(CHF)患者运动康复效果和负性情绪的影响。方法计算机检索PubMed、EMBase、Web of science、The Cochrane Library、CINAHL、EBSCOhost、CNKI、SinoMed和WanFang Data等数据库中关于正念运动对CHF患者作用效果的随机对照试验,检索时限为建库至2020年1月20日。对纳入文献进行严格的质量评价和数据提取,并采用RevMan 5.3软件进行统计分析。结果总共纳入20篇RCT,涉及1330例患者。文献质量1篇为“A”,其余均为“B”,总体质量中等。Meta分析结果显示:与对照组相比,正念运动组患者在6分钟步行距离(MD=51.41,95%CI:37.89~64.93,P<0.001)、峰值摄氧量(MD=1.20,95%CI:0.44~1.95,P=0.002)、无氧阈值(MD=1.94,95%CI:1.63~2.25,P<0.001)、左室射血分数(MD=4.44,95%CI:3.10~5.78,P<0.001)、左心室舒张末期内径(MD=-3.66,95%CI:-5.90~-1.41,P=0.001)、利钠肽水平(SMD=-0.32,95%CI:-0.49~-0.16,P<0.001)和抑郁情绪(SMD=-0.40,95%CI:-0.79~-0.01,P=0.04)指标中均表现优异,差异有统计学意义。结论正念运动能够显著改善CHF患者的运动耐量、心脏功能与负性情绪,可进一步与西方现代运动相互补充,或可为CHF患者的心脏康复提供新思路。

Objective Meta-analysis was used to evaluate the effect of mindfulness exercise on exercise rehabilitation and negative emotions in patients with chronic heart failure.Methods Randomized controlled trials on the effect of mindfulness exercise on patients with chronic heart failure were searched by computer in databases such as PubMed,EMBase,Web of science,The Cochrane Library,CINAHL,EBSCOhost,CNKI,SinoMed and WanFang Data.The search time limit was from January 20,2020.Strict quality evaluation and data extraction were carried out for the included literature,and RevMan 5.3 software was used for statistical analysis.Results A total of 20 RCTs involving 1330 patients were included.The quality of the literature was"A"in one article and"B"in the rest,and the overall quality was moderate.Meta-analysis showed that compared with the control group,the mindfulness exercise group had higher 6-minute walking distance(MD=51.41,95%CI:37.89~64.93,P<0.001),peak oxygen uptake(MD=1.20,95%CI:0.44~1.95,P=0.002),anaerobic threshold(MD=1.94,95%CI:1.63~2.25,P<0.001),left ventricular ejection fraction(MD=4.44,P<0.001,95%CI:3.10~5.78,P<0.001),left ventricular end-diastolic diameter(MD=-3.66,95%CI:-5.90~1.41,P=0.001),natriuretic peptide level(SMD=-0.32,95%CI:-0.49~0.16,P<0.001),and depressive mood(SMD=-0.40,95%CI:-0.79~0.01,P=0.04)were all excellent,with significant differences.Conclusion Mindfulness exercise can significantly improve exercise tolerance,cardiac function and negative emotions in patients with chronic heart failure,which can further complement with modern Western sports,or provide new ideas for cardiac rehabilitation in patients with chronic heart failure.