抗阻训练对原发性高血压患者血压影响的Meta分析

背景随着社会经济水平发展和人们生活节奏的加快,原发性高血压患病率逐年上升,近年已有研究证实了抗阻训练的降压效果,但临床尚缺乏具体的运动方案,在训练周期、频率等方面缺少循证证据。目的系统评价抗阻训练对原发性高血压患者血压的影响。方法计算机检索Cochrane Library、PubMed、Embase、Web of Science及中国知网、中国生物医学文献数据库、万方数据知识服务平台、维普网公开发表的抗阻训练对原发性高血压患者血压影响的随机对照研究,其中试验组患者接受抗阻训练,对照组患者接受常规宣教。采用Cochrane手册中的偏倚风险评价工具对纳入文献进行方法学质量评价。采用RevMan 5.3软件进行Meta分析,采用Egger检验评估纳入文献是否存在发表偏倚,采用敏感性分析评价本研究结果的稳定性。结果初步检索文献2542篇,经逐层筛选后最终纳入文献9篇,共包含514例患者,其中试验组259例、对照组255例。Meta分析结果显示,试验组患者干预后收缩压(SBP)〔加权均数差(WMD)=-8.21,95%CI(-13.30,-3.13)〕、舒张压(DBP)〔WMD=-4.51,95%CI(-6.39,-2.63)〕低于对照组(P<0.001)。亚组分析结果显示,训练周期≤12周及不同训练频率、训练时间的试验组患者干预后SBP、DBP分别低于对照组患者(P<0.05)。Egger检验结果显示,报道抗阻训练对原发性高血压患者SBP(P=0.207)、DBP(P=0.151)影响的文献无明显发表偏倚。敏感性分析结果显示,逐一剔除各项研究后的点估计值均在合并效应量的95%CI范围内,表明本Meta分析结果较稳定。结论本Meta分析结果表明,抗阻训练可有效降低原发性高血压患者血压,且将抗阻训练周期控制在≤12周的降压效果更佳。

Effect of Resistance Training on Blood Pressure in Patients with Essential Hypertension:a Meta-analysis

Background With the development of social economy and accelerating pace of life,the prevalence of essential hypertension is increasing year by year.In recent years,studies have confirmed the antihypertensive effect of resistance training,but there is still lack of specific exercise programs in clinic and evidence-based evidence in training cycle and frequency.Objective To systematically evaluate the effect of resistance training on blood pressure in patients with essential hypertension.Methods Randomized controlled trials about the effect of resistance training on blood pressure in essential hypertension patients published on the Cochrane Library,PubMed,Embase,Web of Science and CNKI,CBM,Wanfang Data,VIP were searched by computer.The experimental group received resistance training,and the control group received routine education.The methodological quality evaluation of the included literature was evaluated using the risk of bias assessment tool in the Cochrane handbook.RevMan 5.3 software was used for meta analysis,Egger test was used to evaluate whether the included literature had publication bias,and sensitivity analysis was used to evaluate the stability of the results of this study.Results 2542 literature were initially searched,and 9 literature were finally included after tiered screening,containing 514 patients,including 259 cases in the experimental group and 255 cases in the control group.The results of meta-analysis showed that SBP[weighted mean difference(WMD)=-8.21,95%CI(-13.30,-3.13)]and DBP[WMD=-4.51,95%CI(-6.39,-2.63)]in the experimental group were lower than those in the control group after intervention(P<0.001).The results of subgroup analysis showed that the SBP and DBP of essential hypertension patients with training period≤12 weeks,different training frequency,and different training time in the experimental group were lower than those in the control group(P<0.05).Egger test results showed that there is no obvious publication bias in literature reporting the impact of resistance training on SBP(P=0.207)and DBP(P=0.151)of essential hypertension patients.The sensitivity analysis results showed that the point estimates after excluded one study after another were all within the 95%CI range of the combined effect size,indicated that the results of this meta-analysis were relatively stable.Conclusion The results of this meta-analysis show that the resistance training can effectively reduce the blood pressure of patients with essential hypertension,and control the resistance training period is≤12 weeks has a better effect on lowering blood pressure of patients.