中老年高血压、糖尿病患者社区运动干预策略分析

Research on Community-Based Exercise Intervention Strategy for Middle-Aged and Older Patients with Hypertension and Diabetes

DOI：10.12064/ssr.20210505

中文关键词:慢性病社区运动干预策略

英文关键词:chronic diseases community exercise intervention strategy

基金项目:江苏省体育局重大体育科研课题(ST192101)；江苏省研究生科研创新计划(KYCX21_2909)

作者	单位
陆阿明	苏州大学体育学院,江苏苏州 215021 。
任园园	苏州大学体育学院,江苏苏州 215021 。
王岑依	苏州大学体育学院,江苏苏州 215021 。
陈一言	苏州大学体育学院,江苏苏州 215021 。

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中文摘要:

目的：通过对2015年后符合随机对照实验要求的高血压、糖尿病患者社区运动干预的效果和技术应用的文献进行分析，为我国体医融合的慢性病社区运动干预实施提供借鉴。方法：采用Meta分析的文献检索、筛选、质量评估方法，最终纳入分析中老年高血压患者社区运动干预文献33篇，糖尿病患者社区运动干预文献28篇，提取相关数据进行分析。结果：(1)运动干预后高血压患者的收缩压(SBP)、舒张压(DBP)显著下降(P＜0.001)，糖尿病患者糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2 h血糖(2 h FBG)显著下降(P＜0.001)；(2)运动干预的组织方面，表现为采用个性化运动处方的比例较低，多以步行等患者习惯的运动方式自主实施；(3)运动干预形式以有氧运动为主，且干预效果明显，抗阻运动仅在高血压患者SBP下降的过程中作用明显，而联合运动较少采用，且未见明显效果；(4)运动干预主要以小强度为主，但中高强度的运动干预效果明显；(5)常采用30~60 min，每周3次及以上的运动干预，且干预效果较好，糖尿病患者每天保持60 min以上的运动有更好的效果。结论：(1)社区运动干预是高血压、糖尿病患者控制病情的有效手段，运动干预策略遵循运动处方与健身指导的一般理论；(2)社区运动干预实施中组织发动慢性病患者参与运动至关重要，干预策略应着眼于患者体质健康水平的提升。

英文摘要:

Objectives: To provide reference for the implementation of community-based exercise intervention for chronic diseases in China through analyses of literature on the effect and technology of community-based exercise intervention for patients with hypertension and diabetes who meet the requirements of randomized controlled trials (RCTs) since 2015. Methods: Meta-analysis literature retrieval, screening and quality assessment methods were adopted to include 33 literatures on community-based exercise intervention in middle-aged and older patients with hypertension and 28 literatures on patients with diabetes, and relevant data were extracted for analysis. Results: (1) SBP and DBP of hypertensive patients decreased significantly after exercise intervention (P＜0.001), and HbA1c, FBG, and 2hFBG of diabetic patients decreased significantly (P＜0.001); (2) In terms of the organization of exercise intervention, the proportion of personalized exercise prescriptions was relatively low, and the exercises that patients were accustomed to such as walking are the main ones; (3) Aerobic exercise was the main form of exercise intervention, and the intervention effect was obvious. Resistance exercise only played a significant role in the decline of SBP in patients with hypertension, while combined exercise was rarely used, and no significant effect was found; (4) Exercise intervention was mainly at low intensity, but the effect of medium to high intensity exercise intervention was distinct; (5) Exercise intervention time was 30 ~ 60 minutes at most, more than 3 times a week intervention effect was better. Diabetic patients who exercised for more than 60 minutes a day had a better effect. Conclusion: (1) Community-based exercise intervention is an effective means to control the condition of patients with hypertension and diabetes. The exercise intervention strategy follows the general theory of exercise prescription and fitness guidance.(2)It is very important to organize and motivate patients with chronic diseases to participate in exercise. The primary goal of community-based exercise intervention should focus on the improvement of patients' physical health.

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