运动干预对癌症相关肌少症患者影响的Meta分析

Meta analysis of exercise intervention in patients with tumor-related sarcopenia

目的:运用Meta分析方法综合相关文献,从定量角度评估运动干预对癌症相关肌少症患者的肌肉质量、肌肉力量和身体功能的影响。方法:检索中国知网(CNKI)、万方医学网、中国生物医学文献数据库(CBM)、PubMed、Cochrane Library、CINAHL、Ovid Discovery等数据库收集已发表的评价运动干预对癌症相关肌少症患者影响的随机对照研究。由两位研究者严格按照纳入与排除标准独立筛选,提取数据,完成质量评价。利用RevMan 5.3进行Meta分析。结果:最终纳入8项研究,489例患者。Meta分析表明运动干预可以有效地改善癌症相关肌少症患者的肌肉质量(骨骼肌质量指数)[SMD=0.96,95%CI(0.68,1.23),P<0.05]、肌肉质量(瘦体质量)[SMD=0.64,95%CI(0.35,0.94),P<0.05];肌肉力量(上肢)[MD=4.66,95%CI(2.51,6.81),P<0.05]、肌肉力量(下肢)[SMD=1.05,95%CI(0.64,1.46),P<0.05]和身体表现功能(步速)[MD=0.50,95%CI(0.42,0.58),P<0.05]。结论:现有证据表明运动干预可以有效改善癌症相关肌少症患者的肌肉力量、肌肉质量及身体表现功能,但因纳入癌症类型多样,结局测量标准不统一,结局指标定义存在差异,导致研究结果具有较高的异质性。因此,尚需多中心、大样本的高质量试验验证研究结果。建议后续同类试验应纳入同质人群,并基于统一的标准测量和评价干预效果。

Objective:To evaluate the effects of exercise intervention on muscle mass,muscle strength and physical function in patients with tumor-related sarcopenia patients using meta analysis.Methods:Randomized controlled trials on the effectiveness of exercise intervention on patients with tumor-related sarcopenia were retrieved from electronic databases of CNKI,Wanfang data,CBM,PubMed,Cochrane Library,CINAHL,Ovid Discovery,etc.RevMan 5.3 software was used to perform meta-analysis.Results:Eight studies were included,with 489 patients.Meta analysis results show that,exercise intervention can improve muscle mass of tumor-related sarcopenia(Skeletal Muscle Mass Index)[SMD=0.96,95%CI(0.68,1.23),P<0.05],muscle mass(lean mass weight)[SMD=0.64,95%CI(0.35,0.94),P<0.05];muscle strength(upper limb)[MD=4.66,95%CI(2.51,6.81),P<0.05],muscle strength(leg strength)[SMD=1.05,95%CI(0.64,1.46),P<0.05];Body performance(step rate)[MD=0.50,95%CI(0.42,0.58),P<0.05].Conclusion:Exercise intervention can effectively improve muscle strength,muscle mass and physical function in patients with tumor-related sarcopenia.Due to the diversity of cancer types,inconsistent outcome measurement standards,and differences in the definition of outcome indicators,the research results have high heterogeneity.So,high quality and multi-center RCT researches are needed to explore effective interventions for the treatment of tumor-related sarcopenia and to improve the homogeneity of research results.