Physical activity for secondary prevention of disease. Systematic reviews of randomised clinical trials.
Physical activity for secondary prevention of disease. Systematic reviews of randomised clinical trials.
复制标题
身体活动对疾病的二级预防。
作者：
Katrine Karmisholt;P. Gøtzsche
背景
体力活动被推荐用于几种疾病的二级预防，但证据的可靠性并不总是很清楚。
方法
我们在MEDLINE和Cochrane图书馆中检索1998-2004年发表的随机临床试验的系统评价。
结果
我们确定了30篇符合条件的系统性综述，排除了13篇包含在较大综述中的试验或比同一主题的其他综述更早的试验。体力活动降低了冠心病患者的全因死亡率，优势比为0.73(95%可信区间为0.54至0.98)，间歇性跛行患者的最大步行时间增加了6.5分钟(4.4至8.7)，膝关节骨关节炎患者的疼痛减轻，标准化平均差异为0.34(0.24至0.44)。在心力衰竭、慢性阻塞性肺疾病、2型糖尿病和纤维肌痛方面也有积极的效果，但它们需要在高质量的试验中得到证实。运动在几种情况下改善了生活质量，通常还会导致身体表现的改善。在中风、哮喘、类风湿性关节炎、急性或慢性下腰痛、慢性疲劳综合征、抑郁症、囊性纤维化或艾滋病毒/艾滋病方面没有显示出效果。伤害的发生一般没有报道。
结论
作为疾病的二级预防，体育活动可能具有重要的、甚至是挽救生命的效果，但需要更多和更好的试验来充分评估其益处和危害，特别是将运动与药物进行比较的试验。
BACKGROUND
Physical activity is recommended for secondary prevention of several diseases but it is not always clear how reliable the evidence is.
METHODS
We searched MEDLINE and The Cochrane Library for systematic reviews of randomised clinical trials published 1998-2004.
RESULTS
We identified 30 eligible systematic reviews and excluded 13 that contained trials covered in larger reviews or were older than other reviews on the same subject. Physical activity decreased all-cause mortality in patients with coronary heart disease, odds ratio 0.73 (95% confidence interval 0.54 to 0.98), increased maximum walking time in patients with intermittent claudication by 6.5 min (4.4 to 8.7), and decreased pain in patients with osteoarthritis of the knee, standardised mean difference 0.34 (0.24 to 0.44). There were positive effects also in heart failure, chronic obstructive lung disease, type 2 diabetes and fibromyalgia, but they need confirmation in high-quality trials. Exercise improved quality of life in several conditions and generally led to improved physical performance. An effect was not shown in stroke, asthma, rheumatoid arthritis, acute or chronic low back pain, chronic fatigue syndrome, depression, cystic fibrosis or HIV/AIDS. The occurrence of harms was generally not reported.
CONCLUSION
Physical activity can have important, and even life-saving, effects as secondary prevention of disease, but more and better trials are needed to fully assess its benefits and harms, in particular trials that compare exercise with drugs.