School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China.
Medicine (Baltimore). 2023 Jan 20;102(3):e32517. doi: 10.1097/MD.0000000000032517.
Alzheimer's disease (AD) is a progressive neurodegenerative disorder with an insidious onset, usually characterized by memory impairment, visual-spatial skill impairment, executive dysfunction and personality behavioral changes. Studies have confirmed that vascular dysfunction may precede AD pathological changes and can present as vascular malformations, atherosclerosis, and impaired self-regulation, and can affect oxidative stress and amyloidosis. Therefore, it is important to improve or prevent vascular dysfunction in AD patients. Regular exercise can effectively inhibit the production of reactive oxygen species during the occurrence of AD and can improve the reduction of cerebral blood flow due to AD. Previous studies have shown that exercise can achieve superior clinical results in improving vascular function in AD patients. Therefore, we hypothesize that traditional Chinese exercises (TCEs) may have a good clinical effect in improving vascular function in patients with AD.
We will search "PubMed," "the Cochrane Library," "Embase," "Web of Science," "CINAHL," "ProQuest Dissertations and Theses," and "ProQuest-Health & Medical Collection," "CNKI," "SinoMed," "VIP," and "Wanfang Data" to find randomized controlled trials of the effects of TCEs on AD vascular function from the creation of the database to the present, including at least 1 indicator in carotid intima-media thickness (cIMT), middle cerebral artery mean flow velocity (MFV), blood indicators [Heme Oxidase-1 (HO-1), angiopoietin I (Ang I), vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor, matrix metalloproteinase-9 (MMP-9)], and arterial stiffness [(Ankle Brachial Index (ABI), pulse wave velocity (PWV)]. For the included literature, Excel 2019 will be used for data extraction and collection. For the indicators that can be netted for network meta-analysis, Surface Under the Cumulative Ranking for each exercise modality will be calculated with the help of Stata 16.0 and rank, where the higher the SUCRA score, the higher the ranking. For the indicators that cannot be netted, Review Manager 5.4 will be used for meta-analysis will be performed to evaluate the improvement effect of TCEs on AD patients.
This meta-analysis will further determine the efficacy and safety of TCEs on vascular function in AD patients.
In this study, randomized controlled trials of the effects of TCEs on vascular function in AD patients will be selected to provide evidence-based medical evidence for promoting the application of TCEs by observing the order of advantages and disadvantages of various exercise modalities through network meta-analysis.
阿尔茨海默病（AD）是一种进行性神经退行性疾病，发病隐匿，通常表现为记忆障碍、视觉空间技能障碍、执行功能障碍和个性行为改变。研究证实，血管功能障碍可能先于 AD 病理变化出现，并可表现为血管畸形、动脉粥样硬化和自我调节受损，可影响氧化应激和淀粉样蛋白。因此，改善 AD 患者的血管功能非常重要。有规律的运动可以有效抑制 AD 发生过程中活性氧的产生，改善 AD 引起的脑血流减少。先前的研究表明，运动可以在改善 AD 患者的血管功能方面取得优异的临床效果。因此，我们假设传统的中国运动（TCEs）可能对改善 AD 患者的血管功能有很好的临床效果。
我们将检索“PubMed”、“Cochrane 图书馆”、“Embase”、“Web of Science”、“CINAHL”、“ProQuest 论文和学位”、“ProQuest-Health & Medical Collection”、“CNKI”、“SinoMed”、“VIP”和“Wanfang Data”，从数据库创建到现在，查找 TCEs 对 AD 血管功能影响的随机对照试验，包括颈动脉内中膜厚度（cIMT）、大脑中动脉平均血流速度（MFV）至少 1 个指标、血液指标[血红素加氧酶-1（HO-1）、血管生成素 I（Ang I）、血管内皮生长因子（VEGF）、脑源性神经营养因子、基质金属蛋白酶-9（MMP-9）]和动脉僵硬度[踝臂指数（ABI）、脉搏波速度（PWV）]。对于纳入的文献，将使用 Excel 2019 进行数据提取和收集。对于可以进行网络荟萃分析的指标，将在 Stata 16.0 的帮助下计算每种运动方式的累积排序表面下面积（SUCRA），SUCRA 得分越高，排名越高。对于不能进行网络荟萃分析的指标，将使用 Review Manager 5.4 进行荟萃分析，以评估 TCEs 对 AD 患者的改善效果。
这项荟萃分析将进一步确定 TCEs 对 AD 患者血管功能的疗效和安全性。
在这项研究中，将选择 TCEs 对 AD 患者血管功能影响的随机对照试验，通过网络荟萃分析观察各种运动方式的优缺点顺序，为促进 TCEs 的应用提供循证医学证据。
