Daley Amanda, Stokes-Lampard Helen, Macarthur Christine
Primary Care Clinical Sciences, College of Medicine and Dentistry, Learning Centre Building, Universitiy of Birmingham, Birmingham, England, UK, B15 2TT.
Cochrane Database Syst Rev. 2011 May 11(5):CD006108. doi: 10.1002/14651858.CD006108.pub3.
Evidence suggests that many perimenopausal and early postmenopausal women will experience menopause symptoms, hot flushes being the most common. Symptoms caused by fluctuating levels of oestrogen may be alleviated by HRT but there has been a marked global decline in its use 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 modification interventions that have potential to reduce vasomotor menopausal symptoms.
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.
Searches of the following electronic bibliographic databases were performed to identify randomised controlled trials (RCTs): Cochrane Menstrual Disorders and Subfertility Group Specialised trials register; Cochrane Library (CENTRAL) (Wiley Internet interface), MEDLINE (Ovid), EMBASE (Ovid), PsycINFO (Ovid), Science Citation Index and Social Science Citation Index (Web of Science), CINAHL (Ovid) and SPORT Discus. Searches included dates up until 16-24 March 2010.
RCTs in which any type of exercise intervention were compared no treatment/control or other treatments in the management of menopausal vasomotor symptoms in symptomatic perimenopausal/postmenopausal women.
Six studies were deemed eligible for inclusion. Three authors independently extracted data from eligible studies. Three meta-analyses according to comparator the group were performed.
In the comparison of exercise versus no treatment/control (three studies), the non-significant effect size Standardised Mean Difference (SMD) for vasomotor symptoms was -0.14 (95% CI: -0.54 to 0.26); SMD was -0.04, -0.25, -0.38. For the analysis of exercise versus HRT (three studies), the non-significant SMD was 0.49 (95% CI: -0.27 to 1.26); SMD across studies was 0.13, 0.19 and 1.52, with all studies favouring HRT. In the comparison of exercise versus yoga (two studies), the non-significant SMD was -0.09 (95%CI:-0.64 to 0.45); SMD was -0.37 and 0.19. All comparisons were based on small samples. One small study reported data that could not be included in the meta-analysis; in this study hot flush scores were significantly lower in the exercise plus soy milk group (83%) than soy milk only group (72%).
AUTHORS' CONCLUSIONS: The existing studies provided insufficient evidence to determine the effectiveness of exercise as a treatment for vasomotor menopausal symptoms, or whether exercise is more effective than HRT or yoga.
有证据表明，许多围绝经期和绝经后早期女性会经历绝经症状，潮热是最常见的症状。雌激素水平波动引起的症状可能通过激素替代疗法（HRT）得到缓解，但由于对HRT风险和益处的担忧，其在全球范围内的使用显著下降；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，识别基于证据的有可能减轻血管舒缩性绝经症状的生活方式改变干预措施变得越来越重要。
研究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绝经症状（潮热和盗汗）管理的有效性。
对以下电子文献数据库进行检索以识别随机对照试验（RCT）：Cochrane月经紊乱与生育力低下小组专业试验注册库；Cochrane图书馆（CENTRAL）（Wiley网络界面）、医学期刊数据库（MEDLINE）（Ovid）、荷兰医学文摘数据库（EMBASE）（Ovid）、心理学文摘数据库（PsycINFO）（Ovid）、科学引文索引和社会科学引文索引（Web of Science）、护理学与健康领域数据库（CINAHL）（Ovid）和体育与运动科学数据库（SPORT Discus）。检索日期截至2010年3月16日至24日。
有症状的围绝经期/绝经后女性在血管舒缩性绝经症状管理中，将任何类型运动干预与不治疗/对照或其他治疗进行比较的RCT。
六项研究被认为符合纳入标准。三位作者独立从符合条件的研究中提取数据。根据比较组进行了三项荟萃分析。
在运动与不治疗/对照的比较中（三项研究），血管舒缩性症状的效应量标准化均数差（SMD）无显著差异，为-0.14（95%置信区间：-0.54至0.26）；SMD分别为-0.04、-0.25、-0.38。在运动与HRT的比较分析中（三项研究），无显著差异的SMD为0.49（95%置信区间：-0.27至1.26）；各研究的SMD分别为0.13、0.19和1.52，所有研究均支持HRT。在运动与瑜伽的比较中（两项研究），无显著差异的SMD为-0.09（95%置信区间：-0.64至0.45）；SMD分别为-0.37和0.19。所有比较均基于小样本。一项小型研究报告的数据无法纳入荟萃分析；在该研究中，运动加豆浆组的潮热评分（83%）显著低于仅饮用豆浆组（72%）。
现有研究提供的证据不足，无法确定运动作为血管舒缩性绝经症状治疗方法的有效性，也无法确定运动是否比HRT或瑜伽更有效。
