规律运动对中国2型糖尿病患者血糖血脂治疗效果的荟萃分析

目的系统评价规律运动对中国2型糖尿病（T2DM）患者的血糖、血脂的影响。方法计算机检索中国生物医学文献数据库（1978-2011．2）、中文科技期刊全文数据库（重庆维普）（1989-2011．2）、万方数据库（1982-2011．2）、中国期刊全文数据库（1994-2011．2）、中国学术会议论文全文数据库（1998-2011．2）并手工检索入选参考文库中未检索出的文献，纳入T2DM患者实施规律运动治疗（运动持续时间I〉3个月）＋常规治疗与仅有常规治疗或随意运动治疗＋常规治疗的随机对照试验（RCTs）。由两位评价者按纳入、排除标准，依据Cochrane系统评价员手册4．2．6的文献质量评价方法独立进行质量评价和资料提取，并交叉核对，然后采用RevMan5．1软件进行荟萃分析。结果共有20篇文献，23项RCTs符合要求，纳入文献总体质量不高，16篇B级，4篇C级。荟萃分析结果显示：与对照组相比，规律体育运动可显著改善血糖控制，降低糖化血红蛋白（HbAlc）加权均数差（WMD）=-1．18，95％CI：-1．6-0．69，P〈0．01]、甘油三酯（TG）（WMD=-0．27，95％CI：一0．36--0．19，P〈0．01）、总胆固醇（TC）（WMD=-0．78，95％CI：-0．88-0．68，P〈0．01），提高高密度脂蛋白胆固醇（HDL-C）（WMD=0．17，95％CI：0．12-0．23，P〈0．01）并降低低密度脂蛋白胆固醇（LDL—c）（WMD=-0．48，95％CI：-0．64--0．32），P〈0．01）。结论尽管现有研究表明，规律运动可明显改善中国T2DM患者血糖控制，降低HbAlC、TG、TC和LDL-C，提高HDL-C，但仍需更多较高质量的RCTs支持相应结论。

Effects of regular physical activity on glucose and lipid control in Chinese type 2 diabetic patients: a meta-analysis

Objective To conduct a meta-analysis of randomized-controlled trials in order to assess the effects of regular physical activity on glycemic and lipid control in Chinese type 2 diabetic patients. Methods All randomized controlled trials （RCTs） that evaluated the effects of physical activity intervention （duration i〉3 months） in Chinese type 2 diabetic patients in China BioMedical literature on disc （CBMdisc） （ 1978 to February 2011 ）, Chinese Science and Technology Academic Journal （ Chongqing VIP） （ 1989 to February 2011）, Wanfang data （1982 to February 2011 ）, China Journals Full text Database （CJFD） （1994 to February 2011 ） , and Papers on Academic Conference of China （1998 to February 2011 ） were retrieved. And also the reference lists of all articles collected were checked to ensure that no relevant suitable studies were missed. The articles concerning comparisons between regular physical activity combined with usual treatments and usual treatments combined with irregular physical activity or alone were included. The trials were selected and assessed by two authors independently. Continuous data were calculated as mean differences （MD）. Random-effects model and fixed-effects model were used to perform meta-analysis for with and without heterogeneity respectively. Results Only twenty papers containing 23 RCTs were available for pooling involving 1444 participants. Compared with the control, the physical activity intervention significantly improved glycemic control as indicated by a decrease in glycated haemoglobin Alc （HbAlc） levels of 1.18% （weighted MD （WMD） = - 1.18, 95% confidence interval （CI） - 1.67 to - 0. 69; P 〈 0. 01 ）. And there was a reduction in triglvcerides （TG） and total cholesterol （TC） levels by 0. 27 mmnl/L （ -0.27,95% CI： - O. 36 to - 0. 19） and 0. 78 mmol/L （ WMD = - 0. 78, 95% CI： - O. 88 to - 0. 68 ） respectively with physical activity intervention. Also high-density lipoprotein cholesterol （HDL-C） increased by 0. 17 mmol/L （WMD = 0. 17, 95% CI：O. 12 to 0. 23） and low-density lipoprotein cholesterol （LDL-C） decreased by 0. 48 mmol/L （ WMD = - 0.48, 95% CI： - O. 64 to - 0. 32 ）. Conclusions The results suggest that regular physical activity decreases HbA1 c, TG, TC and LDL-C and increases HDL-C in Chinese type 2 diabetic patients, additional high quality of randomized-controlled trials are needed on these topics.