不同运动处方对2型糖尿病患者改善效果的meta分析

发布时间：2018-08-13 16:37

【摘要】：目的:系统评价运动锻炼对中老年2型糖尿病(T2DM)患者生化指标的影响效果,并针对患者的不同情况提出最优运动处方。方法:计算机检索EBSCO host、Science Directs Sports Discus、Springer Link、PubMed和Web of Science数据库,检索期限均从2000年1月~2016年2月,收集运动锻炼影响中老年T2DM患者生化指标的随机对照试验(RCT),应用Cochrane偏倚风险评估工具对纳入的研究进行方法学质量评价,Stata 14.0软件进行统计分析。结果:共纳入16个RCT,1789名中老年T2DM患者,meta分析结果显示,运动锻炼明显降低中老年T2DM患者空腹血糖、LDL、胆固醇水平,标准差分别降低了0.68、0.41、0.286个;敏感性分析剔除2篇质量较差的文献后,运动锻炼能明显降低患者糖化血红蛋白水平(SMD=-0.324,95%CI=-0.528~-0.13),且同质性较好;运动锻炼对中老年T2DM患者BMI、HDL的影响不明显。有氧结合抗阻练习在改善糖化血红蛋白和空腹血糖过高时效果最优,具体方案为:持续运动26周,每周3次,其中,抗阻练习方案为重复10~15次,2组,负荷强度为50%1HRmax,有氧练习方案为持续45 min,负荷强度为60%~90%1HRmax。抗阻练习在改善总胆固醇和LDL方面效果最优,运动处方为:持续运动16周,每周3次,一次45 min,其中,热身5 min、抗阻训练35 min、放松5 min,1~8周采用1RM的60%~80%,10~14周采用1RM的70%~80%,第9、15周进行适中训练将受伤风险将为最低。结论:运动锻炼能明显降低中老年T2DM患者血糖、LDL、胆固醇和糖化血红蛋白含量。建议患者根据自身的具体情况采用不同的运动处方,若糖化血红蛋白、空腹血糖高时,可采用有氧与抗阻结合的运动处方,若LDL、总胆固醇高时,可采用抗阻训练的运动处方。
[Abstract]:Objective: to evaluate the effect of exercise on biochemical indexes in middle-aged and elderly patients with type 2 diabetes mellitus (T2DM), and to put forward the best exercise prescription for patients with type 2 diabetes mellitus (T2DM). Methods: EBSCO hoster, Science Directs Sports Discusinger, Springer, PubMed and Web of Science databases were searched by computer. The retrieval period was from January 2000 to February 2016. A randomized controlled trial (RCT),) was conducted to evaluate the methodological quality of the included studies by using Cochrane bias risk assessment tool and statistical analysis was made by using the software Stata 14.0, which was used to collect the biochemical indexes of middle-aged and elderly patients with T2DM. Results: the results of meta analysis in 1789 middle-aged and elderly T2DM patients showed that exercise significantly decreased fasting blood glucose and cholesterol levels, and the standard deviations were 0.68n0.41 and 0.286, respectively. In sensitivity analysis, after removing two articles of poor quality, exercise could significantly reduce the level of glycosylated hemoglobin (SMD-0.32495 CIQ -0.528 + -0.13), and the effect of exercise on BMIHDL in middle-aged and elderly patients with T2DM was not obvious. Aerobic combined with resistance exercise had the best effect in improving glycosylated hemoglobin and high fasting blood glucose. The specific plan was: continuous exercise for 26 weeks, 3 times a week. The load intensity is 501HRmax, the aerobic exercise program lasts 45 mins, and the load intensity is 600.1HRmax. Resistance exercises are best at improving total cholesterol and LDL. The exercise prescription is: exercise for 16 weeks, 3 times a week, once for 45 minutes, of which, Warm up for 5 min, resist training for 35 min, relax for 5 min or 1 minute for 8 weeks, use 1RM for 10 ~ 14 weeks, use 1RM's 70 / 80 for 10 ~ 14 weeks, and do moderate training at 9 ~ 15 weeks will be the lowest risk of injury. Conclusion: exercise can significantly reduce the content of blood glucose, cholesterol and glycosylated hemoglobin in the aged patients with T2DM. It is suggested that patients should adopt different exercise prescriptions according to their own specific conditions. If the glycosylated hemoglobin and fasting blood glucose are high, the exercise prescriptions combined with aerobic and anti-resistance should be used. If LDL, total cholesterol is high, the exercise prescription of resistance training can be used.
【作者单位】：南京师范大学体育科学学院;
【基金】：国家社会科学基金项目(15BTY023) 江苏省体育局厅级项目(ST14101203) 江苏省普通高校研究生科研创新计划项目(KYLX16_1234)
【分类号】：G804.7

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