我国关于肿瘤化疗患者预期性恶心呕吐干预性研究文献方法学质量评价

目的分析我国肿瘤化疗患者预期性恶心呕吐干预性研究的现状,为今后的研究提供依据和方向。方法以"预期性恶心呕吐"、"胃肠道反应"、"化疗"为主题词,对中国期刊全文数据库(CNKI)、万方数据库、维普数据库(VIP)及中国生物医学数据库(CBM)关于肿瘤化疗患者预期性恶心呕吐研究的护理文献检索;采用EndNote X3软件查重,对符合纳入排除标准的文献采用改良后的Jadad量表进行方法学质量评价,采用CONSORT声明2010版本对文献报告质量进行综合评价。结果共检索出10篇有关预期性恶心呕吐的干预性研究,干预方法涉及中医护理、心理干预及音乐疗法等。本次纳入的文献方法学质量极低,Jadad评分均低于2分,只有1项研究使用随机数字表进行随机分配,其他文献均只提及"随机"字样;无1篇采用分配隐藏、盲法及失访与退出的报道。纳入研究报告书写欠规范,主要体现在忽视随机方法的阐述、缺乏盲法、分配隐藏的使用、样本量无具体的估算方法、缺乏依从性、病例脱落及失访情况的分析及忽视不良反应的报告等。结论国内有关肿瘤化疗患者预期性恶心呕吐干预性研究较少;文献方法学质量较差,报告书写欠规范,因此,应加强预期性恶心呕吐干预性研究的方法学研究,注重报告的书写规范,以提高科研质量,满足循证需求。     

有氧运动结合抗阻运动对化疗期肿瘤患者癌因性疲乏及生活质量干预效果的Meta分析

目的 系统评价有氧运动结合抗阻运动对化疗期肿瘤患者癌因性疲乏及生活质量的干预效果。方法 计算机检索中国知网、万方、维普、中国生物医学文献服务系统、PubMed、Web of Science、Embase、Cochrane Library数据库中关于有氧运动结合抗阻运动对化疗期肿瘤患者癌因性疲乏及生活质量干预效果的随机对照试验，检索时限为建库至2022年4月1日。由2名研究者独立对纳入文献进行质量评价和资料提取，采用RevMan 5.3软件进行Meta分析。结果 共纳入11篇文献，共涵盖957例化疗期肿瘤患者。Meta分析结果显示：有氧运动结合抗阻运动能改善化疗期肿瘤患者的癌因性疲乏症状及生活质量[SMD=-0.88,95%CI(-1.31,-0.45),P<0.0001;SMD=0.70,95%CI(0.24,1.16),P=0.003];提高峰值摄氧量、6 min步行距离[SMD=0.45,95%CI(0.14,0.76),P=0.005;WMD=28.04,95%CI(8.32,47.75),P=0.005];降低焦虑/抑郁情绪[WMD=-2.58,95%CI(-4.50,-...     

不同运动疗法对癌症患者癌因性疲乏干预效果的网状Meta分析

目的采用网状Meta分析评价不同运动疗法对癌症患者癌因性疲乏(cancer related fatigue, CRF)的应用效果。方法计算机检索PubMed、Cochrane Library、Embase、CNKI、维普和万方数据库,检索有关运动疗法干预癌因性疲乏的随机对照实验,检索时限均为建库至2020年4月。采用Cochrane质量评价手册对纳入的文献进行质量评价,并由2位研究者独立进行数据的提取及分析,采用Stata1 6.0软件对数据进行网状Meta分析。结果共纳入22篇文献:7种运动疗法,共1600例患者。网状Meta分析结果显示,在缓解癌症患者CRF上,7种运动疗法的效果由高到低分别为,抗阻联合有氧运动、瑜伽、气功、抗阻运动、肌肉放松训练、有氧运动、太极。结论抗阻联合有氧运动对癌症患者CRF干预效果最佳,但本结论还需高质量、多中心、大样本的RCT进一步验证。     

癌症患者癌因性疲乏真实体验质性研究的Meta整合

目的系统总结癌症患者癌因性疲乏的真实体验,为更好地开展癌症患者癌因性疲乏管理提供参考。方法计算机检索中国知网、维普、万方数据库、CBM、PubMed、The Cochrane Library、EMbase、Web of Science、PsycINFO数据库检索所有关于癌症患者癌因性疲乏的质性研究,检索时限均为建库时间至2020年5月。使用英国牛津大学循证医学中心文献质量评价项目评价纳入文献的质量,使用定性系统评价证据分级工具评价整合结果的可信度。结果共纳入9篇文献,总结37个研究结果,归纳为10个类属,整合成4个结果:癌因性疲乏的多维度表现;癌因性疲乏对患者的消极影响;癌因性疲乏患者的健康需求;癌因性疲乏患者的应对策略。结论癌因性疲乏给癌症患者的生活造成了一系列的消极影响,医护人员应关注患者癌因性疲乏的真实体验和健康需求,给予足够的支持和帮助,鼓励患者积极应对,以缓解癌因性疲乏症状及程度,改善生活质量。     

系统性护理干预对乳腺癌化疗患者癌因性疲乏作用的系统评价

目的：分析系统性护理干预与常规护理干预两种护理方式在缓解乳腺癌化疗患者癌因性疲乏应用的差别。方法全面检索万方期刊数据库、中国期刊全文数据库、维普期刊全文数据库,收集关于系统性护理干预与常规护理干预在乳腺癌化疗患者癌因性疲乏作用对比的研究,采用Jadad量表对所有纳入的文献进行证据质量评价,运用统计学软件Stata和SAS,对癌因性疲乏和生活质量的观察指标进行Meta分析。结果共纳入13项研究,1322例患者,其中系统性护理组662例,常规护理组660例。系统性护理组缓解癌因性疲乏的作用优于常规护理组[OR（95％CI）＝3．497（2．838～4．310）,P ＜0．01];在提高生活质量方面也优于常规护理组（ SMD＞0,P＜0．05）。结论系统性护理干预在缓解乳腺癌化疗患者癌因性疲乏和提高患者生活质量方面明显优于常规护理干预,值得临床推广应用。     

基于CiteSpace的国内癌因性疲乏护理相关文献的可视化分析

目的:对我国近20年癌因性疲乏护理研究相关文献进行计量学分析,探究癌因性疲乏护理研究的现状及发展方向,为我国癌因性疲乏相关的护理工作及研究提供思路.方法:在中国知网(CNKI)近20年收录的文献中,以"癌因性疲乏护理"为主题词进行检索,确定发文量、作者、机构、关键词4个方面,用CiteSpace 5.5.R2软件进行分析.结果:纳入文献1128篇,运用CiteSpace 5.5.R2软件绘制知识图谱对文献进行分析,呈现出4个特征:国内有关癌因性疲乏的护理文献逐年增涨,2016年至今为繁荣时期;国内针对不同癌症导致的癌因性疲乏,有不同方向的护理科研合作团队;国内高校与其附属医院对于癌因性疲乏的护理研究合作较为紧密;"睡眠质量""心理弹性""有氧运动"是国内近年癌因性疲乏护理研究的热点.结论:癌因性疲乏护理日益受到护理研究人员的关注,但需继续提高年发文量,进一步加强机构、作者之间的合作关系,并对癌因性疲乏护理研究热点进一步探讨,促进癌因性疲乏护理研究的发展,为癌症病人提供更全面的护理.     

微波治疗宫颈糜烂随机对照试验的质量评价

目的评价微波治疗宫颈糜烂随机对照试验的方法学质量和报告质量。方法通过计算机检索、手工检索,全面收集与微波治疗宫颈糜烂有关的随机对照试验,按照Cochrane协作网推荐的评价方法对纳入研究进行方法学质量评价,按照CONSORT清单项目进行研究报告质量评价。结果最终纳入文献11篇,其中随机对照试验3篇,半随机对照试验8篇。评价结果显示,纳入文献方法学质量和报告质量普遍较低,其中C级为10篇, CONSORT评分最高仅17分。结论以往的微波治疗宫颈糜烂随机对照试验研究存在不同程度的方法学质量缺陷,故其结论存在发生选择性偏倚、实施性偏倚、测量性偏倚以及减员性偏倚的高度可能性。而低的研究报告质量又会严重影响读者对研究结果真实性、重要性及实用性的正确理解和评价。因此期待设计严密、实施科学、报告完整的随机对照研究出现。     

血液肿瘤患者癌因性疲乏干预效果的网状Meta分析

目的 采用网状Meta分析评价不同干预方法改善血液肿瘤患者癌因性疲乏(CRF)的效果。方法 检索Cochrane Library、PubMed、Web of science、中国生物医学文献数据库(CBM)、中国科技期刊全文数据库(CNKI)、万方数据库、维普数据库，检索时间设为建库至2018年3月，纳入不同干预方法降低血液肿瘤患者CRF的随机对照试验。使用JBI 2015年RCT真实性评价标准进行文献质量评价，主要结局指标为CRF，次要结局指标为生活质量(QoL)。通过Stata13.0绘制网状图，采用ADDIS1.16.6软件进行网状Meta分析。结果 共纳入21篇文献，7种干预方法。网状Meta分析结果显示：有氧运动、联合运动、正念减压疗法、放松训练对比常规护理，在降低CRF方面差异具有统计学意义；有氧运动、联合运动对比常规护理，在提高QoL方面差异具有统计学意义。排序概率图结果表明，放松训练对降低CRF的效果最佳，其后依次为正念减压疗法、联合运动、有氧运动、抗阻运动、音乐疗法、常规护理；有氧运动对提高QoL的效果最佳，其后依次为联合运动、抗阻运动、常规护理。结论 不同干预方法降低血液肿瘤患者CRF的效果中，以放松训练最佳。在以后研究中可关注不同方法干预效果的直接比较，同时建议将放松训练结合其时间、频率等因素进一步研究，开展临床循证实践，为降低CRF提供更多的证据支持。     

癌因性疲乏患者瑜伽运动管理的最佳证据总结

目的 系统检索、提取、汇总和分析癌因性疲乏患者瑜伽运动管理的最佳证据，为临床制订基于证据的癌因性疲乏患者瑜伽运动决策和干预提供循证依据。方法 计算机检索BMJ最佳临床实践、UpToDate、英国国家卫生与临床优化研究所指南网、加拿大安大略注册护士协会指南网、苏格兰学院间指南网、美国国家综合癌症网络、指南国际网络、医脉通、澳大利亚乔安娜布里格斯研究所循证卫生保健中心图书馆、Cochrane图书馆、PubMed、Web of Science、CINAHL、万方数据库、中国知网、中国生物医学文献数据库、美国癌症研究学会网站和美国肿瘤护理学会网站中关于癌因性疲乏患者瑜伽运动的所有证据，包括临床实践指南、证据总结、临床决策、专家共识、系统评价等，检索时间为建库至2021年12月。由2名研究人员独立进行文献筛选和质量评价，根据主题进行证据提取、归纳和汇总。结果 最终共纳入7篇文献，包括1篇指南和6篇系统评价。通过2名研究人员共同讨论，提取归纳癌因性疲乏患者瑜伽运动管理相关证据共22条，汇总9个主题，分别为运动认知、运动效果、瑜伽类型、运动评估、运动指导与监督、运动对象、制订原则、运动参数、评价工具...     

正念减压法对癌因性疲乏干预效果的系统评价

目的：系统评价正念减压法干预癌因性疲乏的有效性。方法计算机检索PubM ed、M edline、EM base、Web of Science、Cochrane Central Register of Controlled T rials、CBM和万方数据库,查找关于正念减压法干预癌因性疲乏的相关研究文献,检索时限均从建库至2014年12月。由2位评价员按纳入与排除标准独立筛选文献、提取资料并评价质量后,采用RevMan 5．1软件进行Meta分析。结果共纳入3篇RCT ,381例患者。Meta分析结果显示：接受正念减压疗法组患者干预前后疲乏降低的程度与对照组患者相比,差异有统计学意义[SMD＝－0．36,95％ CI（－0．53,－0．20）,P＜0．0001]。结论现有证据表明,正念减压法训练能缓解癌因性疲乏。鉴于纳入研究数量有限,上述结论尚需开展更多研究予以验证。     

A systematic review of physical therapy interventions for patients with anorexia and bulemia nervosa

Abstract

Purpose: The purpose of this systematic review was to summarise the evidence from randomised controlled trials examining the effectiveness of physical therapy compared with care as usual or a wait-list condition on eating pathology and on physiological and psychological parameters in patients with anorexia and bulimia nervosa. Method: EMBASE, PsycINFO, PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database and The Cochrane Library were searched from their inception until February, 2013. Articles were eligible if they utilised a randomised controlled trial design, compared physical therapy with a placebo condition, control intervention, or standard care and included patients with anorexia and bulimia nervosa. The methodological quality was assessed with the Jadad scale. Results: Eight randomised controlled trials involving 213 patients (age range: 16–36 years) met all selection criteria. Three of the 8 included studies were of strong methodological quality (Jadad score≥3). Major methodological weaknesses were attrition and selection bias. The main results demonstrate that aerobic and resistance training result in significantly increased muscle strength, body mass index and body fat percentage in anorexia patients. In addition, aerobic exercise, yoga, massage and basic body awareness therapy significantly lowered scores of eating pathology and depressive symptoms in both anorexia and bulimia nervosa patients. No adverse effects were reported. Conclusions: The paucity and heterogeneity of available studies limits overall conclusions and highlights the need for further research.

• Implications for Rehabilitation

• Supervised physical therapy might increase weight in anorexia nervosa patients.

• Aerobic exercise, massage, basic body awareness therapy and yoga might reduce eating pathology in patients with anorexia and bulimia nervosa.

• Aerobic exercise, yoga and basic body awareness therapy might improve mental and physical quality of life in patients with an eating disorder.

     

早期有氧锻炼对乳腺癌术后化疗患者疲乏的影响

目的探讨早期有氧锻炼对乳腺癌术后化疗患者癌因性疲乏的影响。方法将60例乳腺癌患者按床号单、双号分为观察组和对照组,观察组在术后化疗前1周开始有氧锻炼,对照组在化疗开始后进行有氧锻炼。应用简易疲乏量表对两组在化疗前1周和化疗后2周的癌因性疲乏进行评估。结果两组在化疗前1周疲乏程度无明显差异,化疗后2周观察组疲乏程度明显低于对照组,资料经秩和检验-H检验法,Hc=4.301,P<0.05,有统计学意义。结论早期有氧锻炼可减轻乳腺癌术后化疗患者的癌因性疲乏。     

Efficacy of Exercise Interventions in Patients With Advanced Cancer: A Systematic Review

Objective

To critically analyze the literature surrounding the efficacy of exercise interventions in patients with advanced cancer.

The use of aerobic exercise training in improving aerobic capacity in individuals with stroke: a meta-analysis

OBJECTIVE: To determine whether aerobic exercise improves aerobic capacity in individuals with stroke. DESIGN: A systematic review of randomized controlled trials. DATABASES SEARCHED: MEDLINE, CINAHL, EMBASE, Cochrane Database of Systematic Reviews and Physiotherapy Evidence Database were searched. INCLUSION CRITERIA: Design: randomized controlled trials (RCTs). Participants: individuals with stroke. Interventions: aerobic exercise training aimed at improving aerobic capacity. OUTCOMES: Primary outcomes: aerobic capacity (peak oxygen consumption (VO2), peak workload). Secondary outcomes: walking velocity, walking endurance. DATA ANALYSIS: The methodological quality was assessed by the PEDro scale. Meta-analyses were performed for all primary and secondary outcomes. RESULTS: Nine articles (seven RCTs) were identified. The exercise intensity ranged from 50% to 80% heart rate reserve. Exercise duration was 20-40 min for 3-5 days a week. The total number of subjects included in the studies was 480. All studies reported positive effects on aerobic capacity, regardless of the stage of stroke recovery. Meta-analysis revealed a significant homogeneous standardized effect size (SES) in favour of aerobic exercise to improve peak VO2 (SES 0.42; 95% confidence interval (CI) 0.15-0.69; P=0.001) and peak workload (SES 0.50; 95% CI 0.26-0.73; P<0.001). There was also a significant homogeneous SES in favour of aerobic training to improve walking velocity (SES 0.26; 95% CI 0.05-0.48; P= 0.008) and walking endurance (SES 0.30; 95% CI 0.06-0.55; P= 0.008). CONCLUSIONS: There is good evidence that aerobic exercise is beneficial for improving aerobic capacity in people with mild and moderate stroke. Aerobic exercise should be an important component of stroke rehabilitation.     

A review of the benefits of whole body exercise during and after treatment for breast cancer

Aim. A current critical review of the literature was deemed necessary to evaluate the strength of evidence to inform clinical practice. Background. Recently, there has been a noticeable increase in empirical literature surrounding the benefits of exercise for breast cancer patients. Methods. A systematic search strategy was used to identify relevant literature. Twenty‐nine articles were retained for critical review, appraised for quality and synthesized. Results. Many early studies had limited internal and external validity. Recent studies were considerably more rigorous and robust. Consistent support for all types of aerobic exercise was most evident in studies of patients during adjuvant cancer treatments (chemotherapy and radiotherapy), compared with post‐treatment studies. The evidence which suggested that aerobic exercise limits cancer‐related fatigue was particularly strong. For other patient concerns, the empirical support was less robust, however, the potential for beneficial and measurable patient outcomes was indicated for cardiopulmonary function, overall quality of life, global health, strength, sleep, self‐esteem and reduced weight gain, depression, anxiety and tiredness. Conclusions. Additional studies with higher methodological quality are required in this clinically relevant area to substantiate current indications particularly for patient subgroups (e.g. older people, those with advanced cancer and the disadvantaged). Relevance to clinical practice. It is important for all healthcare professionals involved in the care of individuals affected by breast cancer to be aware of the evidence surrounding the benefits of exercise and to encourage patients to increase physical activity and improve their overall health and well‐being.     

延长睡眠时间与中风风险的荟萃分析

目的：分析延长睡眠时间与中风风险,对睡眠时间延长是否增加中风风险做出循证医学分析。方法检索 MEDLINE、PUBMED、EMBASE、WOS 1997~2015年相关文献,Jadad 评分评估所涉及研究的质量,剔除评分小于4分的研究,取得每项研究的睡眠时间与中风风险的相对风险度(RR )值及95%可信区间(95% CI ),STATA 11.0合并分析睡眠时间延长与中风风险的 RR 及 P 值,并通过分层(按性别、短暂延长睡眠时间、长时延长睡眠时间)进一步分析睡眠时间延长与中风的风险。结果延长睡眠时间(>8小时)中风总风险增高(RR =1.28,95% CI =1.22~1.35,P =0.00);短暂延长睡眠时间(8~10小时)中风风险增高(RR =1.15,95% CI =1.07~1.24,P =0.00);其中未分性别研究中风风险度增高(RR =1.12,95% CI =1.00~1.24,P =0.052);男性中风风险增高(RR =1.11,95% CI =0.95~1.29,P =0.198);女性中风风险增高(RR =1.24,95% CI =1.09~1.43,P =0.002)。长时间延长睡眠时间(≥10小时)中风风险增高(RR =1.41,95% CI =1.32~1.52,P =0.00);其中未分性别中风风险增高(RR =1.30,95% CI =1.17~1.45,P =0.00);男性中风风险增高(RR =1.46,95% CI =1.29~1.66,P =0.00);女性中风风险增高(RR =1.56,95% CI =1.36~1.78,P =0.00)。结论延长睡眠眠时间(>8小时)中风风险发生率明显增加。     

Upper limb function evaluation scales for individuals with cerebral palsy: a systematic review

[Purpose] The aim of the present study was to perform a systematic review of the literature on the scales and methods most often used for the evaluation of upper limb function in individuals with cerebral palsy. [Materials and Methods] Searches were conducted in the Medline, PEDro, Lilacs, Scielo, and PubMed databases. The following inclusion criteria were used for the selection of articles: randomized controlled study, evaluation of upper limb function in individuals with cerebral palsy, and publication between 2006 and 2014. The methodological quality of the articles was evaluated using the PEDro evidence scale. [Results] Five articles met the inclusion criteria and achieved 6 points or higher on the PEDro scale of methodological quality. [Conclusion] The studies analyzed used different evaluation scales, but no consensus has been reached thus far on which scale is the most appropriate. Thus, further studies are needed to establish an adequate method for the evaluation of upper limb function in individuals with cerebral palsy.Key words: Cerebral palsy, Scale function, Upper limbs     

运动处方在癌因性疲乏中的应用研究

综述了运动减轻癌因性疲乏的理论基础、运动改善癌因性疲乏的机制、癌因性疲乏的运动干预方式及运动处方在癌因性疲乏中的应用现状，提出基于运动强度和方式的运动处方模型的研究缺乏。