del Pino-Sedeño Tasmania, Trujillo-Martín María M, Ruiz-Irastorza Guillermo, Cuellar-Pompa Leticia, de Pascual-Medina Ana M, Serrano-Aguilar Pedro
Canary Foundation of Health Research (FUNCANIS), Canary Islands, Spain.
Canary Foundation of Health Research (FUNCANIS) and Center for Biomedical Research of the Canary Islands (CIBICAN), Canary Islands, Spain, and Spanish Network of Health Services Research for Chronic Diseases (REDISSEC), Madrid, Spain.
Arthritis Care Res (Hoboken). 2016 Jan;68(1):141-8. doi: 10.1002/acr.22675.
Survival of patients with systemic lupus erythematosus (SLE) has significantly improved over the past decades. As SLE patients live longer they inevitably experience a range of clinical manifestations and somatic symptoms. Quality of life may also be impacted through a range of subjective indicators. Among these parameters, fatigue is the most prevalent complaint. Nonpharmacologic strategies seem regularly utilized for fatigue management in SLE; however, their real effects are not known.
A systematic review was conducted to analyze the effectiveness of nonpharmacologic interventions to reduce fatigue in SLE patients. Medline/PreMedline, Embase, PsycINFO, SCI-EXPANDED, Social Sciences Citation Index, and the Cochrane Library were searched (June 2014). Studies were included and assessed for quality if they fulfilled prespecified criteria.
A total of 12 studies were finally included (n = 549): 7 randomized trials, 1 nonrandomized trial, and 4 prospective observational studies. They assessed 5 main intervention categories: exercise, behavioral and psychological approaches, diets, acupuncture, and phototherapy. All interventions produced reductions in fatigue, as measured using at least 1 instrument. Aerobic exercise was found to be effective and suitable for reducing fatigue, but results were not always consistent across instruments used. The diversity of psychological interventions limits the significance of the results; however, data point to a positive impact on fatigue. There are still few data on the effect of acupuncture, diets, and ultraviolet A radiation.
Studies are few and heterogeneous; however, nonpharmacologic interventions applied to SLE patients can be effective in reducing fatigue.
在过去几十年中，系统性红斑狼疮（SLE）患者的生存率有了显著提高。随着SLE患者寿命的延长，他们不可避免地会出现一系列临床表现和躯体症状。生活质量也可能会受到一系列主观指标的影响。在这些参数中，疲劳是最常见的主诉。非药物策略似乎经常用于SLE患者的疲劳管理；然而，它们的实际效果尚不清楚。
进行了一项系统评价，以分析非药物干预对降低SLE患者疲劳的有效性。检索了Medline/PreMedline、Embase、PsycINFO、SCI-EXPANDED、社会科学引文索引和Cochrane图书馆（2014年6月）。如果研究符合预先设定的标准，则纳入并评估其质量。
最终共纳入12项研究（n = 549）：7项随机试验、1项非随机试验和4项前瞻性观察性研究。它们评估了5种主要干预类别：运动、行为和心理方法、饮食、针灸和光疗。所有干预措施都使疲劳程度降低，这是使用至少一种工具测量得出的结果。有氧运动被发现对减轻疲劳有效且适用，但不同测量工具得出的结果并不总是一致。心理干预的多样性限制了结果的显著性；然而，数据表明其对疲劳有积极影响。关于针灸、饮食和紫外线A辐射效果的数据仍然很少。
研究数量少且异质性大；然而，应用于SLE患者的非药物干预措施在减轻疲劳方面可能是有效的。
