目的 对瑜伽干预2型糖尿病有效性的系统评价/Meta分析进行再评价,以指导临床相关科学研究,为医务人员提供决策依据.方法 计算机检索CNKI、WanFang Data、VIP、CBM、PubMed、Cochrane Library、Embase、Web of Science、JBI和CINAHL数据库,搜集瑜伽干预2型糖尿病的系统评价/Meta分析,检索时限均从建库至2023年11月6日.由2名研究者独立进行文献筛选、资料提取,采用AMSTAR对纳入研究评价方法学质量,采用GRADE分级标准评估证据确信度,并对结局指标进行统计分析.结果 最终纳入14项系统评价/Meta分析.AMSTAR评价结果显示7项研究为高质量和7项研究为中质量.GRADE评价结果显示证据2项为高确信度,26项为中确信度,其余31项为低或极低确信度.研究结果显示:瑜伽能较好地降低空腹血糖(中等确信度)、糖化血红蛋白(中等确信度)和餐后血糖水平(中等确信度),且在高密度胆固醇(中等确信度)、低密度胆固醇(中等确信度)、甘油三脂(中等确信度)、总胆固醇(中等确信度)、收缩压和舒张压(中等确信度)、肌肉力量(高等确信度)、心肺健康(中等确信度)和体重水平(中等确信度)等方面也优于其他干预.结论 现有证据表明瑜伽具有较好的血糖控制效果,且在血脂参数和人体测量指标方面也存在一定的疗效,但当前研究证据质量和确信度较低,今后的研究者应规范研究设计,为2型糖尿病的预后治疗提供更多高质量证据.
Efficacy of yoga on type 2 diabetes mellitus patients with glycemia,lipid profile and anthropometric measure:an overview of systematic reviews
Objective To overview the systematic reviews/meta-analysis(SR/MA)for the effectiveness of yoga on patients with type 2 diabetes mellitus.Methods The CNKI,WanFang Data,VIP,CBM,PubMed,Cochrane Library,Embase,Web of Science,JBI and CINAHL databases were electronically searched to collect SR/MA on the intervention of yoga in diabetes mellitus from inception to November 6th,2023.Two researchers independently screened the literature and extracted data.AMSTAR was used to evaluate the quality of methodology,and GRADE was used to evaluate the certainty of evidence,and the outcome indicators were statistically analyzed.Results A total of 14 SR/MA were included.The evaluation results of AMSTAR showed that 7 articles were of high quality and 7 articles were of moderate quality.The result of GRADE showed that there were 2 items of high-level evidence,26 items of intermediate evidence,and the remaining 31 items were low-level or very low-level evidence.The results showed that yoga could significantly reduce fasting blood glucose(FBG)(moderate confidence),glycosylated hemoglobin(HA1C)(moderate confidence)and postprandial blood glucose(PPBG)levels(moderate confidence),and was also superior to other interventions in high-density cholesterol(HDL)(moderate confidence),low-density cholesterol(LDL)(moderate confidence),triglyceride(TG)(moderate confidence),total cholesterol(TC)(moderate confidence),systolic blood pressure(SBP)and diastolic blood pressure(DBP)(moderate confidence),muscle strength(high confidence),cardiorespiratory fitness(moderate confidence)and weight(moderate confidence).Conclusion The existing evidence shows that yoga has a good effect on blood glucose control(moderate confidence)and also has a certain effect on lipid parameters(moderate confidence)and anthropometric indicators(moderate confidence),but the quality and confidence of the current research evidence are low.Future researchers should standardize the research design to provide more high-quality evidence for the prognosis and treatment of type 2 diabetes mellitus.
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