以有氧运动为核心的综合运动对造血干细胞移植病人疲乏的干预效果:Meta分析

Intervention effect of comprehensive exercise with aerobic exercise as the core on fatigue in patients undergoing hematopoietic stem cell transplantation:a Meta-analysis

目的:探讨从有氧运动为核心的综合运动对减轻造血干细胞移植(HSCT)病人疲乏的作用及其适用指征。方法:计算机检索PubMed、Web of Science、the Cochrane Library、Joanna Briggs Institute(JBI)、中国知网(CNKI)、中国生物医学文献数据库(CBM)、维普数据库和万方数据库,收集国内外以有氧运动为核心的综合运动对HSCT病人疲乏影响的随机对照试验(RCT),检索时限为建库至2022年5月31日,由2名评价者根据纳入和排除标准独立筛选文献,提取资料后采用RevMan 5.3软件进行Meta分析。结果:最终纳入7个RCT,包括413例HSCT病人,Meta分析结果显示,与对照组相比,有氧运动可改善HSCT病人疲乏[SMD=-0.22,95%CI(-0.42,-0.03),P=0.03]。亚组分析显示,移植前开始进行有氧运动[SMD=-0.30,95%CI(-0.59,-0.02),P=0.04]、干预时长>3个月[SMD=-0.45,95%CI(-0.73,-0.18),P=0.001],两组病人的疲乏程度差异均有统计学意义。结论:现有证据表明,以有氧运动为核心的运动可提升病人心肺肝肾等多脏器的功能,促进疾病康复,进而缓解HSCT病人的疲乏症状,推荐移植前即开始实施、时长应大于3个月。

Objective:To explore the effect of comprehensive exercise with aerobic exercise as the core on alleviating fatigue in patients undergoing hematopoietic stem cell transplantation(HSCT)and its applicable indications.Methods:Randomized controlled trials(RCTs)of the effects of comprehensive exercise with aerobic exercise as the core on fatigue in HSCT patients at home and abroad was retrieved from PubMed,Web of Science,the Cochrane Library,JBI,CNKI,CBM,VIP,and WanFang Database.The retrieval time was from the inception to May 31,2022.Two evaluators independently selected the literature according to the inclusion criteria,extracted the data,and used RevMan 5.3 software for Meta-analysis.Results:Seven RCTs were included,including 413 HSCT patients.Meta-analysis results showed that compared with the control group,aerobic exercise improved fatigue in HSCT patients[SMD=-0.22,95%CI(-0.42,-0.03),P=0.03].Subgroup analysis showed that aerobic exercise was performed before transplantation[SMD=-0.30,95%CI(-0.59,-0.02),P=0.04],and the duration of intervention was>for 3 months[SMD=-0.45,95%CI(-0.73,-0.18),P=0.001].There was statistically significant difference in fatigue between the two groups.Conclusion:Current evidence shows that comprehensive exercise with aerobic exercise as the core can comprehensively improve the functions of multiple organs,such as heart,lung,liver and kidney,promote the rehabilitation of the disease,and then relieve the fatigue symptoms of HSCT patients.It is recommended to start the exercise before the transplantation and the duration should be longer than 3 months.