按摩联合生活方式干预与单纯生活方式干预对单纯性肥胖的比较效果：一项系统评价和荟萃分析。
Comparative effectiveness of massage combined with lifestyle intervention and lifestyle intervention alone for simple obesity: A systematic review and meta-analysis.
作者信息
Wang Gaofeng, Ju Hongyu, Zhang Zepeng, Wu Xingquan, Niu Heli, Zhang Lili, Chen Lili, Lou Huijuan, Yang Yonggang
机构信息
Department of Traditional Chinese Medicine, Baicheng Medical College, Baicheng, Jilin Province, China.
Department of Traditional Chinese Medicine, the Affiliated Hospital of Baicheng Medical College, Baicheng, Jilin Province, China.
出版信息
Medicine (Baltimore). 2025 Jan 10;104(2):e41074. doi: 10.1097/MD.0000000000041074.
BACKGROUND
This study aimed to assess the comparative effectiveness of massage combined with lifestyle intervention and lifestyle intervention alone in patients with simple obesity.
METHODS
The PubMed, Embase, Cochrane Library, CNKI, VIP Database, and Wanfang Data were searched. Meta-analysis was conducted in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Primary outcomes were body weight (BW) and body mass index (BMI). Secondary outcomes were waist circumference (WC), hip circumference (HC), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting insulin (FINS), and homeostasis model assessment-insulin resistance (HOMA-IR) and adverse events.
RESULTS
Thirteen randomized controlled trials were included. The meta-analysis showed that massage combined with lifestyle intervention significantly decreased BW (mean difference [MD]: -4.85; 95% confidence interval [CI]: -8.25 to -1.46; P = .005), BMI (MD: -2.65; 95% CI: -4.05 to -1.24; P = .0002), WC (MD: -3.63; 95% CI: -6.28 to -0.98; P = .007), TC (MD: -0.52; 95% CI: -0.84 to -0.20; P = .001), TG (MD: -0.23; 95% CI: -0.45 to -0.02; P = .003), LDL-C (MD: -0.48; 95% CI: -0.54 to -0.42; P < .00001), HDL-C (MD: -0.11; 95% CI: -0.17 to -0.05; P = .0004), FINS (MD: -1.64; 95% CI: -3.16 to -0.12; P = .03), and HOMA-IR (MD: -0.42; 95% CI: -0.65 to -0.18; P = .0005) compared with lifestyle intervention alone. In subgroup analyses, more obvious reduction in BMI (P = .02, I2 = 80.3%) for the children and adolescents subgroup, more obvious reduction in HC (P = .04, I2 = 76.1%) for the adults subgroup, more significant reduction in TC (P < .00001, I2 = 98.3%), LDL-C (P < .00001, I2 = 95.6%), and HDL-C (P < .0001, I2 = 94.1%) for intermittent treatment subgroup and more significant reduction in TC (P < .00001, I2 = 95.9%) and HDL-C (P < .0001, I2 = 94.1%) for treatment times ≤30 subgroup were detected.
CONCLUSIONS
Compared with lifestyle intervention alone, massage combined with lifestyle intervention significantly decreased BW, BMI, WC, TC, TG, LDL-C, FINS, and HOMA-IR, but produced less effect in increasing HDL-C. And different ages, treatment intervals, and treatment times can all affect treatment outcomes.
背景
本研究旨在评估按摩联合生活方式干预与单纯生活方式干预对单纯性肥胖患者的相对疗效。
方法
检索了PubMed、Embase、Cochrane图书馆、中国知网、维普数据库和万方数据。按照2020年系统评价和Meta分析的首选报告项目指南进行Meta分析。主要结局指标为体重（BW）和体重指数（BMI）。次要结局指标为腰围（WC）、臀围（HC）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、空腹胰岛素（FINS）、稳态模型评估胰岛素抵抗（HOMA-IR）和不良事件。
结果
纳入13项随机对照试验。Meta分析显示，与单纯生活方式干预相比，按摩联合生活方式干预显著降低了BW（平均差[MD]：-4.85；95%置信区间[CI]：-8.25至-1.46；P = .005）、BMI（MD：-2.65；95%CI：-4.05至-1.24；P = .0002）、WC（MD：-3.63；95%CI：-6.28至-0.98；P = .007）、TC（MD：-0.52；95%CI：-0.84至-0.20；P = .001）、TG（MD：-0.23；95%CI：-0.45至-0.02；P = .003）、LDL-C（MD：-0.48；95%CI：-0.54至-0.42；P < .00001）、HDL-C（MD：-0.11；95%CI：-0.17至-0.05；P = .0004）、FINS（MD：-1.64；95%CI：-3.16至-0.12；P = .03）和HOMA-IR（MD：-0.42；95%CI：-0.65至-0.18；P = .0005）。亚组分析中，儿童和青少年亚组BMI降低更明显（P = .02，I² = 80.3%），成人亚组HC降低更明显（P = .04，I² = 76.1%），间歇治疗亚组TC（P < .00001，I² = 98.3%）、LDL-C（P < .00001，I² = 95.6%）和HDL-C（P < .0001，I² = 94.1%）降低更显著，治疗次数≤30次亚组TC（P < .00001，I² = 95.9%）和HDL-C（P < .0001，I² = 94.1%）降低更显著。
结论
与单纯生活方式干预相比，按摩联合生活方式干预显著降低了BW、BMI、WC、TC、TG、LDL-C、FINS和HOMA-IR，但在升高HDL-C方面效果较差。不同年龄、治疗间隔和治疗次数均会影响治疗效果。
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