针对血管舒缩性更年期症状的锻炼

Exercise for vasomotor menopausal symptoms.

作者信息

Daley A, MacArthur C, Mutrie N, Stokes-Lampard H

机构信息

Primary Care and General Practice, University of Birmingham, Edgbaston, Birmingham, UK.

出版信息

Cochrane Database Syst Rev. 2007 Oct 17(4):CD006108. doi: 10.1002/14651858.CD006108.pub2.

Abstract

BACKGROUND

Evidence suggests that a high proportion of perimenopausal and early postmenopausal women will experience some menopause symptoms, hot flushes being the most common. The effects caused by falling levels of estrogen may be alleviated by hormone replacement therapy (HRT) but there has been a marked global decline in the prescription and use of HRT due to concerns about the risks and benefits of HRT; consequently many women are now seeking alternatives. As large numbers of women are choosing not to take HRT, it is increasingly important to identify evidence based lifestyle modifications, which can have a positive effect on menopausal symptoms.

OBJECTIVES

To examine the effectiveness of any type of exercise intervention in the management of vasomotor menopausal symptoms (hot flushes and night sweats) in perimenopausal and postmenopausal women.

SEARCH STRATEGY

Searches of the following electronic bibliographic databases were performed to identify randomised controlled trials: The Cochrane Library (CENTRAL) (Wiley Internet interface) 2006 Issue 2, MEDLINE (Ovid) 1966-May week 4 2006, EMBASE (Ovid) 1980-week 21 2006, PsycINFO (Ovid) 1967-May week 5 2006, Science Citation Index and Social Science Citation Index (Web of Science) 1900-June 2006 and 1956-June 2006 respectively, CINAHL (Ovid) 1982-May week 4 2006, SPORT Discus (ERL WebSPIRS) 1830-2006/04.

SELECTION CRITERIA

Randomised controlled trials (RCTs) in which any type of exercise intervention was compared to other treatments or no treatment in the management of menopausal vasomotor symptoms in symptomatic perimenopausal and postmenopausal women.

DATA COLLECTION AND ANALYSIS

Nineteen reports were deemed potentially eligible, but of these only one met the inclusion criteria and three authors independently extracted data from this trial.

MAIN RESULTS

Only one very small trial, which compared exercise with HRT, was available for inclusion in this review. Based on within-group analyses the study authors concluded that both interventions were effective in reducing vasomotor symptoms. Between-group trial analyses conducted by reviewers showed that the HRT group experienced significantly fewer hot flushes compared to the exercise group at follow-up.

AUTHORS' CONCLUSIONS: Only one very small trial involving symptomatic women has assessed the effectiveness of exercise in the management of vasomotor menopausal symptoms. Exercise was not as effective as HRT in this trial. We found no evidence from randomised controlled trials on whether exercise is an effective treatment relative to other interventions or no intervention in reducing hot flushes and or night sweats in symptomatic women. No conclusions regarding the effectiveness of exercise as a treatment for vasomotor menopausal symptoms could be made due to a lack of trials.

摘要

背景

有证据表明,很大比例的围绝经期和绝经后早期女性会出现一些更年期症状,潮热是最常见的症状。雌激素水平下降所引起的影响或许可通过激素替代疗法(HRT)得到缓解,但由于对HRT的风险和益处存在担忧,全球范围内HRT的处方量和使用量已显著下降;因此,许多女性现在正在寻求替代方法。由于大量女性选择不接受HRT,确定基于证据的生活方式改变变得越来越重要,这些改变可能对更年期症状产生积极影响。

目的

探讨任何类型的运动干预对围绝经期和绝经后女性血管舒缩性更年期症状(潮热和盗汗)的管理效果。

检索策略

检索了以下电子文献数据库以识别随机对照试验:考克兰图书馆(CENTRAL)(Wiley互联网接口)2006年第2期、医学索引数据库(MEDLINE)(Ovid)1966年至2006年5月第4周、荷兰医学文摘数据库(EMBASE)(Ovid)1980年至2006年第21周、心理学文摘数据库(PsycINFO)(Ovid)1967年至2006年5月第5周、科学引文索引和社会科学引文索引(科学网)分别为1900年至2006年6月以及1956年至2006年6月、护理学与健康照护数据库(CINAHL)(Ovid)1982年至2006年5月第4周、体育文献数据库(SPORT Discus)(ERL WebSPIRS)1830年至2006年4月。

选择标准

将任何类型的运动干预与其他治疗方法或不进行治疗相比较,以管理有症状的围绝经期和绝经后女性更年期血管舒缩症状的随机对照试验(RCTs)。

数据收集与分析

19份报告被认为可能符合条件,但其中只有一份符合纳入标准,三位作者独立从该试验中提取数据。

主要结果

本综述仅纳入了一项将运动与HRT进行比较的非常小的试验。基于组内分析,研究作者得出结论,两种干预措施在减轻血管舒缩症状方面均有效。综述作者进行的组间试验分析表明,在随访时,HRT组经历的潮热明显少于运动组。

作者结论

仅有一项涉及有症状女性的非常小的试验评估了运动对更年期血管舒缩症状的管理效果。在该试验中,运动不如HRT有效。我们没有从随机对照试验中找到证据,以证明相对于其他干预措施或不进行干预,运动在减轻有症状女性的潮热和/或盗汗方面是否有效。由于缺乏试验,无法就运动作为治疗更年期血管舒缩症状的有效性得出结论。

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