高强度运动对抑郁症患者的影响：一项随机对照试验的系统评价和荟萃分析
The impact of high-intensity exercise on patients with depression: a systematic review and meta-analysis of randomized controlled trials.
作者信息
Zeng Junru, Wang Hong
机构信息
Department of Martial Art, Wuhan Sports University, Wuhan, China.
出版信息
Front Public Health. 2025 Aug 13;13:1616925. doi: 10.3389/fpubh.2025.1616925. eCollection 2025.
OBJECTIVE
This study systematically evaluated the effectiveness of high-intensity exercise as an intervention for patients with depression through meta-analysis.
METHODS
Relevant studies were retrieved from PubMed, Embase, Cochrane, and Web of Science up to June 30, 2025. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. Sensitivity and subgroup analyses were conducted to assess robustness and explore heterogeneity. Data analysis was performed using Review Manager 5.4.1 and Stata 15.1.
RESULTS
Nine randomized controlled trials (RCTs) with 514 participants were included (193 in the intervention group and 321 in the control group). Compared to controls, the intervention group showed greater improvement in depression severity, based on the Hamilton Rating Scale for Depression (HRSD) (SMD: -0.44; 95% CI: -0.69, -0.18; = 0.0008) and overall depression scores (SMD: -0.23; 95% CI: -0.39, -0.07; = 0.006). However, results from the Hamilton Depression Rating Scale (HAMD) (SMD: -0.17; 95% CI: -0.39, 0.06; = 0.14) and Beck Depression Inventory (BDI-II) (SMD: 0.12; 95% CI: -0.10, 0.34; = 0.28) were not significant. Similar outcomes were observed with Montgomery-Asberg Depression Rating Scale (MADRS), Patient Health Questionnaire Depression Scale (PHQ-9), and Geriatric Depression Scale (GDS) (SMD: -0.35; 95% CI: -0.70, 0.01; = 0.06). No significant difference was found in Maximal Oxygen Uptake (VO2max) (SMD: 0.29; 95% CI: -0.22, 0.80; = 0.27). Subgroup analysis revealed that long-term high-intensity exercise interventions were more effective than short-term ones. In patients with depression, those aged 60 years or older benefited more from high-intensity exercise compared to younger individuals aged 30-60 years. Among different exercise modalities, high-intensity aerobic exercise showed the greatest efficacy, followed by high-intensity resistance training, while high-intensity interval training was comparatively less effective.
CONCLUSION
Compared to the control group, high-intensity exercise modestly improves depressive symptoms in patients with depression. However, due to limitations such as small sample sizes, potential heterogeneity, and result instability, further validation through large-scale, multi-centre, randomized, double-blind clinical trials is warranted.
目的
本研究通过荟萃分析系统评估高强度运动作为抑郁症患者干预措施的有效性。
方法
截至2025年6月30日，从PubMed、Embase、Cochrane和Web of Science检索相关研究。计算标准化均数差（SMD）及95%置信区间（CI）。进行敏感性和亚组分析以评估稳健性并探索异质性。使用Review Manager 5.4.1和Stata 15.1进行数据分析。
结果
纳入9项随机对照试验（RCT），共514名参与者（干预组193名，对照组321名）。与对照组相比，基于汉密尔顿抑郁量表（HRSD），干预组在抑郁严重程度上有更大改善（SMD：-0.44；95%CI：-0.69，-0.18；P = 0.0008），总体抑郁评分也有改善（SMD：-0.23；95%CI：-0.39，-0.07；P = 0.006）。然而，汉密尔顿抑郁评定量表（HAMD）（SMD：-0.17；95%CI：-0.39，0.06；P = 0.14）和贝克抑郁量表（BDI-II）（SMD：0.12；95%CI：-0.10，0.34；P = 0.28）的结果不显著。蒙哥马利-艾森伯格抑郁评定量表（MADRS）、患者健康问卷抑郁量表（PHQ-9）和老年抑郁量表（GDS）也观察到类似结果（SMD：-0.35；95%CI：-0.70，0.01；P = 0.06）。最大摄氧量（VO2max）无显著差异（SMD：0.29；95%CI：-0.22，0.80；P = 0.27）。亚组分析显示，长期高强度运动干预比短期干预更有效。在抑郁症患者中，60岁及以上的患者比30至60岁的年轻患者从高强度运动中获益更多。在不同运动方式中，高强度有氧运动显示出最大疗效，其次是高强度抗阻训练，而高强度间歇训练相对效果较差。
结论
与对照组相比，高强度运动适度改善了抑郁症患者的抑郁症状。然而，由于样本量小、潜在异质性和结果不稳定性等局限性，有必要通过大规模、多中心、随机、双盲临床试验进行进一步验证。
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