运动干预轻度认知功能障碍病人的证据总结与评价

Evidence summary and evaluation on exercise intervention on mild cognitive impairment patients

[目的]获取与轻度认知功能障碍(MCI)运动干预相关的指南、系统评价或Meta分析,对其进行证据总结与评价,以期为MCI病人相关指南推荐意见的制定提供参考性建议。[方法]计算机检索加拿大安大略注册护士协会(Registered Nurses Association of Ontario,RNAO)、美国神经病协会(American Academy of Neurology,AAN)、英国国家卫生与临床优化研究所(National Institute for Health and Clinical Excellence,NICE)、苏格兰院际指南网(Scottish Intercollegiate Guideline Network,SIGN)、PubMed、Cochrane library、Web of science、CINAHL、CNKI、万方及维普数据库获得相关指南及系统评价,检索时限从2014年1月—2018年2月。采用AMSTAR 2评价工具对文献质量进行评价,必要时应用GRADE工具对证据体进行证据分级,针对指南的质量评价采用AGREEⅡ标准进行评价。[结果]最终纳入1篇指南,12篇系统评价/Meta分析,AMASTA 2评价结果显示,9篇文献为中等质量。GRADE证据质量评价显示,3个证据体证据质量为高质量,11个证据体为中等质量,10个证据体为低质量,3个证据体为极低质量。[结论]运动干预具有较好的疗效,可作为MCI病人的临床辅助治疗措施,但运动干预对MCI病人干预效果系统评价的方法学质量总体不高,其真实效果有待大样本、高质量的研究进一步探讨。

Objective:To obtain the guidelines,systematic review or meta-analysis related to exercise intervention on mild cognitive impairment(MCI),summarize and evaluate the evidence,so as to provide the reference for the development of recommendations for MCI patients′ relevant guidelines.Methods:Related guideliness and systematic reviews were retrieved from the Registered Nurses′ Association of Ontario(RNAO),the American Academy of Neurology(AAN),the National Institute for Health and Clinical Excellence(NICE),Scottish Intercollegiate Guideline Network(SIGN),PubMed,Cochrane library,Web of science,CINAHL,China National Knowledge Infrastructure(CNKI),Wanfang Database,and VIP Database from January 2014 to February 2018.The quality of the literatures was evaluated using the AMSTAR 2 evaluation tool.If necessary,the GRADE tool was used to classify the evidence,and the quality of the guideline was evaluated using the AGREE II standard.Results:Finally,a guideline and 12 systematic reviews/meta-analysis were included in this study.AMSTAR 2 evaluation results showed that 9 articles were of medium quality.The GRADE evidence quality evaluation showed that 3 pieces of evidence were of high quality,11 pieces of evidence were of medium quality,10 pieces of evidence were of low quality,and 3 pieces of evidence were of very low quality.Conclusions:The current research results showed that exercise intervention had a good curative effect and could be used as a clinical adjuvant treatment for MCI patients.However,the system evaluation methodological quality of exercise intervention on MCI patients was generally lower,and its true effect needs a larger sample and further high-quality research to explore.