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传统中医运动对经皮冠状动脉介入治疗后心脏康复的影响:随机对照试验网络荟萃分析的研究方案。

Effects of traditional Chinese exercise on cardiac rehabilitation after percutaneous coronary intervention: study protocol for network meta-analysis of randomised controlled trials.

机构信息

Department of Cardiovascular Disease, First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China.

Guangzhou University of Chinese Medicine, Guangzhou, China.

出版信息

BMJ Open. 2019 Feb 19;9(2):e023096. doi: 10.1136/bmjopen-2018-023096.

Abstract

INTRODUCTION

Coronary heart disease (CHD) is the most common cause of death worldwide. Percutaneous coronary intervention (PCI) has been shown to reduce mortality in patients with CHD. However, there are still recurrences of cardiovascular events after PCI. Cardiac rehabilitation (CR) in patients with established CHD is associated with reductions in cardiovascular mortality and hospital admissions, as well as improved quality of life. More and more clinical trials suggest that traditional Chinese exercise (TCE) plays a positive role in patients post-PCI. The primary purposes of the current study are to conduct a network meta-analysis of randomised trials to determine the effects of TCE in patients after PCI, and to separately compare the effects of tai chi, baduanjin and yijinjing on CR after PCI.

METHODS AND ANALYSIS

Studies will be retrieved from the following databases: PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, Wanfang Data, Chinese BioMedical Database and Chinese Science and Technology Periodicals Database, from inception to December 2018. We will include randomised controlled trials that are related to the effects of TCE therapies in patients after PCI. The primary outcomes will be all-cause mortality, revascularisations, health-related quality of life and hospitalisations. Two reviewers will independently select eligible articles. For each included article, two reviewers will independently extract the data and assess the risk of bias by using the Cochrane risk of bias tool. Bayesian network meta-analyses will be conducted to pool all treatment effects. The ranking probabilities for the optimal intervention of various treatments (tai chi, baduanjin or yijinjing) will be estimated by the mean ranks and surface under the cumulative ranking curve. The Grading of Recommendations Assessment, Development and Evaluation System will be used to assess the quality of evidence.

ETHICS AND DISSEMINATION

The results will be disseminated through peer-reviewed publications. They will provide consolidated evidence to inform clinicians on the potential functions of TCE in CR, and to provide reliable evidence for the application of TCE.

TRIAL REGISTRATION NUMBER

CRD42018088415.

摘要

简介

冠心病(CHD)是全球最常见的死亡原因。经皮冠状动脉介入治疗(PCI)已被证明可降低 CHD 患者的死亡率。然而,PCI 后仍会发生心血管事件复发。在已确诊 CHD 的患者中进行心脏康复(CR)可降低心血管死亡率和住院率,并提高生活质量。越来越多的临床试验表明,传统中医运动(TCE)对 PCI 后患者有积极作用。本研究的主要目的是对随机试验进行网络荟萃分析,以确定 TCE 在 PCI 后患者中的作用,并分别比较太极拳、八段锦和易筋经对 PCI 后 CR 的影响。

方法与分析

研究将从以下数据库中检索:PubMed、Embase、Cochrane 图书馆、中国国家知识基础设施、万方数据、中国生物医学文献数据库和中国科技期刊数据库,从建库到 2018 年 12 月。我们将纳入与 PCI 后 TCE 治疗效果相关的随机对照试验。主要结局为全因死亡率、血运重建、健康相关生活质量和住院。两位评审员将独立选择合格文章。对于每一篇纳入的文章,两位评审员将独立提取数据,并使用 Cochrane 偏倚风险工具评估偏倚风险。将进行贝叶斯网络荟萃分析以汇总所有治疗效果。通过平均秩和累积排序曲线下面积来估计各种治疗方法(太极拳、八段锦或易筋经)的最佳干预措施的排序概率。将使用推荐评估、制定与评估系统对证据质量进行评估。

伦理与传播

研究结果将通过同行评审出版物进行传播。它们将提供综合证据,为临床医生提供 TCE 在 CR 中的潜在作用,并为 TCE 的应用提供可靠的证据。

注册号

CRD42018088415。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dca1/6398736/83e1265817b3/bmjopen-2018-023096f01.jpg

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