目的 系统评价辅助有氧运动干预在精神分裂症群体中的有效性和可行性.方法 检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、Cochrane Library、EMBASE和Web of Science数据库,建库至2023年3月,以获取与精神分裂症患者运动干预相关的随机对照试验.以阳性与阴性症状量表(positive and negative symptom scale,PANSS)及其分量表作为主要结局指标,阴性症状量表(scale for assessment of negative symptoms,SANS)、体质量指数(body mass index,BMI)等作为次要指标,采用R4.1.0和Stata 14.0进行Meta分析.结果 共纳入47项研究,涵盖3 139例精神分裂症患者.基于24项研究的网状Meta分析结果显示,与其他干预措施相比,辅助有氧运动干预可能是降低精神分裂症患者PANSS总分最有效的干预措施.与常规治疗相比,有氧运动辅助治疗可改善患者的 PANSS 总评分(MD=-5.09,95％CI:-5.90～-4.28)、SANS 评分(MD=-12.17,95％CI:-14.25-10.10)以及 BMI(MD=-1.59,95％CI:-1.93～-1.25).同时,亚组分析结果显示,干预持续 2 个月(MD=-6.12,95％CI:-7.22～-5.02)和每周运动总时长在 140～260 min(MD=-8.59,95％CI:-12.93～-4.25)的效果更显著.对比试验组和对照组的依从性发现,有氧运动干预联合常规治疗与单独常规治疗之间差异无统计学意义(P＞0.05).结论 有氧运动干预辅助治疗是缓解精神分裂症患者症状的有效措施,在住院患者中具有较好的依从性.
Meta-analysis of efficacy and feasibility of exercise interventions as adjunctive therapy for patients with schizophrenia
Objective To systematically evaluate the effectiveness and feasibility of aerobic exercise intervention in schizophrenia patients.Methods Randomized controlled trials on exercise interventions for patients with schizophrenia were searched in eight databases from built up to March 2023,including China National Knowledge Infrastructure(CNKI),VIP Database for Chinese Technical Periodicals(VIP),WanFang Data,China Biomedical Literature Database,PubMed,Cochrane Library,EMBASE and Web of Sci-ence.The positive and negative symptom scale(PANSS)and its sub-scales were used as primary outcome indicators,and the negative symptom scale(SANS)and body mass index(BMI)were used as secondary in-dicators,and Meta-analysis was performed using R 4.1.0 and Stata 14.0.Results Forty-seven studies in-eluding 3 139 patients with schizophrenia were included.Results of a network Meta-analysis based on 24 studies showed that aerobic exercise may be the most effective measure for reducing total PANSS scores in patients with schizophrenia.Compared to conventional treatment,combining aerobic exercise intervention im-proved patients'PANSS total score(MD=-5.09,95％CI:-5.90～-4.28),SANS(MD=-12.17,95％CI:-14.25～-10.10),and BMI(MD=-1.59,95％CI:-1.93～-1.25).Meanwhile,subgroup analysis showed that 2 months of intervention was more appropriate(MD=-6.12,95％CI:-7.22～-5.02)and the weekly total exercise time for 140-260 min was more appropriate(MD=-8.59,95％CI:-12.93～-4.25)in terms of total PANSS score.The adherence rates between the trial and control groups showed no significant differ-ence between the aerobic exercise intervention combined with conventional treatment and conventional treat-ment alone(P＞0.05).Conclusion Aerobic exercise intervention is an effective measure to relieve the symptoms of schizophrenia patients and has good compliance among inpatients.
Aerobic exercise interventionSchizophreniaMeta-analysisPositive and nega-tive symptom scaleNegative symptoms
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