身心锻炼干预抑郁症有效性的Meta分析

doi:10.3969/j.issn.1006-9771.2019.11.004

《中国康复理论与实践》 ›› 2019, Vol. 25 ›› Issue (11): 1260-1271.doi: 10.3969/j.issn.1006-9771.2019.11.004

身心锻炼干预抑郁症有效性的Meta分析

杨剑^1,2, 梁艳^1,2, 邱卓英^3,4,5, 吴铭^1,2, 李安巧^4,5,6

1.华东师范大学体育与健康学院，上海市 200241
2.华东师范大学“青少年健康评价与运动干预”教育部重点实验室，上海市 200241
3.中国康复研究中心/中国康复科学所康复信息研究所，北京市 100068
4.世界卫生组织国际分类家族中国合作中心，北京市 100068
5.中国ICF研究院，山东潍坊市 261000
6.中国智力和发展性残疾分级、评估与康复（运动）重点实验室，郑州大学，河南郑州市 450001

收稿日期:2019-10-21 修回日期:2019-10-24 出版日期:2019-11-25 发布日期:2019-11-21
通讯作者: 梁艳，E-mail： njnu219@163.com E-mail:njnu219@163.com
作者简介:杨剑(1970-)，男，江苏徐州市人，博士，教授，博士研究生导师，主要研究方向：体育运动心理。
基金资助:
1.教育部人文社会科学研究规划基金项目(No. 19YJA890030)；2.中央级公益性科研院所基本科研业务费专项资金项目(重大科学研究引导基金项目) (No. 2017CZ-7; No. 2018CZ-4)

Effects of Mind-body Exercise on Depression: A Meta-analysis

YANG Jian^1,2, LIANG Yan^1,2, QIU Zhuo-ying^3,4,5, WU Ming^1,2, LI An-qiao^4,5,6

1.School of Physical Education and Health, East China Normal University, Shanghai 200241, China
2.Key Laboratory of Adolescent Health Assessment and Exercise Intervention of Ministory of Education, Shanghai 200241, China
3.Research Institute of Rehabilitation Information, China Rehabilitation Research Centre/China Rehabilitation Science Institute, Beijing 100068, China
4.WHO Family of International Classifications Collaborating Center in China, Beijing 100068, China
5.China Academy of ICF, Weifang, Shandong 261053, China
6.China Key Laboratory of Classification, Evaluation and Rehabilitation Sport of Intellectual and Development Disability, Zhengzhou University, Zhengzhou, Henan 450001, China

Received:2019-10-21 Revised:2019-10-24 Published:2019-11-25 Online:2019-11-21
Contact: LIANG Yan, E-mail: njnu219@163.com E-mail:njnu219@163.com
Supported by:
Supported by Ministory of Education Humanities and Social Sciences Research Fund (No. 19YJA890030) and National Special Fund Projects of Basic Research of Public Benefits for Institutes at Central Governmental Level (Leading Project of Major Scientific Research) (No. 2017CZ-7; No. 2018CZ-4)

摘要/Abstract

摘要： 目的检验瑜伽、太极拳和气功三项身心锻炼作为补充性和替代性疗法干预抑郁症的有效性。方法检索Web of Science、PubMed、EMbase、Cochrane Library、PaycINFO、SPORTDiscu、中国生物医学(CBM)和中国知网(CNKI)数据库有关于瑜伽、太极和气功干预抑郁症的随机对照试验(RCTs)，对纳入文献进行方法学质量评价，采用Revman 5.3软件进行Meta分析。结果共纳入29项RCTs，共1379例受试者。单独身心锻炼干预抑郁症有效(SMD = -0.73, 95%CI -1.00~-0.47, P < 0.01)，但存在异质性和发表偏倚。身心锻炼联合药物干预抑郁症有效(SMD = -0.54, 95%CI -0.71~-0.36, P < 0.01)，不存在异质性和发表偏倚。结论身心锻炼可作为药物治疗抑郁症的补充性疗法，优化药物治疗的效果；单独身心锻炼对于抑郁症的干预效应不稳定，未来还需更多长周期、高质量的研究以检验其干预抑郁症的实际有效性。

关键词: 抑郁症, 瑜伽, 太极拳, 气功, Meta分析

Abstract: Objective To determine the effectiveness of mind-body exercise, named Yoga, Taijiquan and Qigong, as a complementary and alternative therapy, on depression. Methods Randomized controlled trials (RCTs) about Yoga, Taijiquan and Qigong for depression were searched from Web of Science, PubMed, EMbase, Cochrane Library, PaycINFO, SPORTDiscu, CBM and CNKI. They were assessed methodological quality, and analyzed with Revman 5.3. Results A total of 29 RCTs involving 1379 subjects were included. Mind-body exercise alone was an effective intervention on depression (SMD = -0.73, 95%CI -1.00 to -0.47, P < 0.01), with significant heterogeneity and publication bias. Mind-body exercise combined with medicine was also effective on depression (SMD = -0.54, 95%CI-0.71 to -0.36, P < 0.01), without significant heterogeneity and publication bias. Conclusion Mind-body exercise can be a complement of medicine for depression. Single mind-body exercise is not stable for depression intervention. More long-term and high-quality researches are needed to determine the actual effectiveness on depression in the future.

Key words: depression, Yoga, Taijiquan, Qigong, meta-analysis

中图分类号:

R749.4

杨剑, 梁艳, 邱卓英, 吴铭, 李安巧. 身心锻炼干预抑郁症有效性的Meta分析[J]. 《中国康复理论与实践》, 2019, 25(11): 1260-1271.

YANG Jian, LIANG Yan, QIU Zhuo-ying, WU Ming, LI An-qiao. Effects of Mind-body Exercise on Depression: A Meta-analysis[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(11): 1260-1271.

参考文献

1 BranchiI, SchmidtM V. In search of the biological basis of mood disorders: Exploring out of the mainstream [J]. Psychoneuroendocrinology, 2011, 36(3): 305-307.
2 FerrariA J, CharlsonF J, NormanR E, et al. Burden of depressive disorders by country, sex, age, and year: findings from the global burden of disease study 2010 [J]. PLoS Med, 2013, 10(11): e1001547.
3 LeichsenringF, SteinertC, HoyerJ. Psychotherapy versus pharmacotherapy of depression: what’s the evidence? [J]. Z Psychosom Med Psyc, 2016, 62(2): 190-195.
4 RiefW, NestoriucY, WeissS, et al. Meta-analysis of the placebo response in antidepressant trials [J]. J Affect Disord, 2009, 118(1-3): 1-8.
5 ChenK W, TurnerF D. A case study of simultaneous recovery from multiple physical symptoms with medical Qigong therapy [J]. J Altern Complement Med, 2004, 10(1): 159-162.
6 KlaraL, DanaK, JanP. Perspectives on perceived stigma and self-stigma in adult male patients with depression [J]. Neuropsych Dis Treat, 2014: 1399-1405.
7 王杰龙. 补充和替代医学现状及其在运动医学的应用[J]. 浙江体育科学, 2006(3): 88-91.
8 张群策,陈业孟,李蕙,等. 另类医学在北美医疗保健体系中的崛起及思考[J]. 北京中医药大学学报, 2009, 16(5): 38-41.
9 JinP. Efficacy of Tai Chi, brisk walking, meditation, and reading in reducing mental and emotional stress [J]. J Psychosom Res, 1992, 36(4): 361-370.
10 YuX, LimingL, XiankunC, et al. Does Tai Chi relieve fatigue? A systematic review and meta-analysis of randomized controlled trials [J]. PLoS One, 2017, 12(4): e0174872.
11 ChanJ S, HoR T, ChungK F, et al. Qigong exercise alleviates fatigue, anxiety, and depressive symptoms, improves seep quality, and shortens sleep latency in persons with chronic fatigue syndrome-like illness [J]. Evid Based Compl Alt, 2014, 2014: 106048.
12 WangF, LeeE K O, WuT, et al. The effects of Tai Chi on depression, anxiety, and psychological well-being: a systematic review and meta-analysis [J]. Int J Behav Med, 2014, 21(4): 605-617.
13 FieldT, DiegoM, Hernandez-ReifM, et al. Yoga and massage therapy reduce prenatal depression and prematurity [J]. J Bodyw Mov Ther, 2012, 16(2): 204-209.
14 FieldT, DiegoM, DelgadoJ, et al. Yoga and social support reduce prenatal depression, anxiety and cortisol [J]. J Bodyw Mov Ther, 2013, 17(4): 397-403.
15 ShahidiM, MojtahedA, ModabberniaA, et al. Laughter Yoga versus group exercise program in elderly depressed women: a randomized controlled trial [J]. Int J Geriatr Psychiatry, 2011, 26(3): 322-327.
16 MelissaM, RebeccaL, MichaelW, et al. Efficacy of Yoga for depressed postpartum women: a randomized controlled trial [J]. Complement Ther Clin, 2015, 21(2): 94-100.
17 周涛. 健身气功八段锦对25例糖尿病抑郁患者血糖、心理干预作用观察[J]. 内蒙古中医药, 2014, 33(24): 70.
18 MeisterK, JuckelG. A systematic review of mechanisms of change in body-oriented yoga in major depressive disorders [J]. Pharmacopsychiatry, 2017, 51(3): 73-81.
19 CramerH, LaucheR, LanghorstJ, et al. Yoga for depression: a systematic review and meta-analysis [J]. Depress Anxiety, 2013, 30: 1068-1083.
20 TsangH W H, TsangW W N, JonesA Y M, et al. Psycho-physical and neurophysiological effects of Qigong on depressed elders with chronic illness [J]. Aging Ment Health, 2013, 17(3): 336-348.
21 ZhangJ, YangK H, TianJ H, et al. Effects of Yoga on psychologic function and quality of life in women with breast cancer: a meta-analysis of randomized controlled trials [J]. J Altern Complem Med, 2012, 18(11): 994-1002.
22 DavenportM H, MccurdyA P, MottolaM F, et al. Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: a systematic review and meta-analysis [J]. Brit J Sport Med, 2018, 52(21): 1376-1385.
23 LiuX, ClarkJ, SiskindD, et al. A systematic review and meta-analysis of the effects of Qigong and Tai Chi for depressive symptoms [J]. Complement Ther Med, 2015, 23(4): 516-534.
24 ShusterJ J. Review: Cochrane Handbook for Systematic Reviews for Interventions, Version 5.1.0, published 3/2011. Julian P.T. Higgins and Sally Green, Editors [J]. Res Synth Methods, 2011, 2(2): 126-130.
25 TsangH W H, FungK M T, ChanA S M, et al. Effect of a Qigong exercise programme on elderly with depression [J]. Int J Geriatr Psychiatry, 2006, 21(9): 890-897.
26 GongH, NiC, ShenX, et al. Yoga for prenatal depression: a systematic review and meta-analysis [J]. BMC Psychiatry, 2015, 15(1): 14-22.
27 RethorstC D, WipfliB M, LandersD M. The antidepressive effects of exercise: a meta-analysis of randomized trials [J]. Sports Med, 2009, 39(6): 491-511.
28 WangC, BannuruR, RamelJ, et al. Tai Chi on psychological well-being: systematic review and meta-analysis [J]. BMC Complem Altern M, 2010, 10(1): 23-39.
29 杨声坪,闫先侠,刘建强,等. 随机对照试验质量评价标准的比较分析[J]. 循证医学, 2010, 10(6): 369-373.
30 TarsillaM. Cochrane Handbook for Systematic Reviews of Interventions [M]. Cochrane, 2008.
31 JanakiramaiahN, GangadharB N, MurthyP J N V, et al. Antidepressant efficacy of Sudarshan Kriya Yoga (SKY) in melancholia: a randomized comparison with electroconvulsive therapy (ECT) and imipramine [J]. J Affect Disord, 2000, 57(1-3): 255-259.
32 ChouK L, PeterL, EdwinY, et al. Effect of Tai Chi on depressive symptoms amongst Chinese older patients with depressive disorders: a randomized clinical trial [J]. Int J Geriatr Psychiatry, 2004, 19(11): 1105-1107.
33 SharmaV K, DasS, MondalS, et al. Effect of Sahaj Yoga on depressive disorders [J]. Indian J Physiol Pharmacol, 2005, 49(4): 462-468.
34 ButlerL D, WaeldeL C, HastingsT A, et al. Meditation with Yoga, group therapy with hypnosis, and psychoeducation for long-term depressed mood: a randomized pilot trial [J]. J Clin Psychol, 2008, 64(7): 806-820.
35 林以环,王俊清,张华娜. 瑜伽放松训练对抑郁症患者负性情绪和自我效能的影响[J]. 护士进修杂志, 2010, 25(23): 2125-2127.
36 LavretskyH, AlsteinL L, OlmsteadR E, et al. Complementary use of Tai Chi chih augments escitalopram treatment of geriatric depression: a randomized controlled trial [J]. Am J Geriatr Psychiatry, 2011, 19(10): 839-850.
37 邱添莹. 健身气功·五禽戏结合药物治疗轻中度抑郁症的研究[D]. 南京:南京中医药大学, 2011.
38 KinserP A, BourguignonC, WhaleyD, et al. Feasibility, acceptability, and effects of gentle hatha yoga for women with major depression: findings from a randomized controlled mixed-methods study [J]. Arch Psychiat Nurs, 2013, 27(3): 137-147.
39 GangadharB, NaveenG, RaoM, et al. Positive antidepressant effects of generic Yoga in depressive out-patients: a comparative study [J]. Indian J Psychiat, 2013, 55(7): 369-373.
40 杨云秀,杨清珍,吴清培. 运动处方在中老年抑郁症患者中的运用效果评价[J]. 临床和实验医学杂志, 2013, 12(16): 1334-1335.
41 KinserP A, ElswickR K, KornsteinS. Potential long-term effects of a mind-body intervention for women with major depressive disorder: sustained mental health improvements with a pilot Yoga intervention [J]. Arch Psychiat Nurs, 2014, 28(6): 377-383.
42 王俊清,林以环,张华娜. 瑜伽放松训练改善抑郁症患者情绪和睡眠的研究[J]. 汕头大学医学院学报, 2014, 27(3): 150-152.
43 UebelackerL A, BattleC L, SuttonK A, et al. A pilot randomized controlled trial comparing prenatal Yoga to perinatal health education for antenatal depression [J]. Arch Womens Ment Health, 2016, 19(3): 543-547.
44 赵桂增,程瑞换,介崇崇,等. 太极拳运动对中老年人轻度抑郁症影响的研究[J]. 中国疗养医学, 2015, 24(5): 452-454.
45 王冬梅,秦启忠. 健身气功.五禽戏干预大学生轻度抑郁症的效果评价[J]. 当代体育科技, 2015, 5(23): 29-30.
46 程香,王冬梅,陈欣,等. 健身气功·五禽戏改善轻度抑郁大学生前额叶和海马氢质子磁共振波谱[J]. 南方医科大学学报, 2016, 36(11): 1468-1476.
47 FalsafiN. A randomized controlled trial of mindfulness versus Yoga: effects on depression and/or anxiety in college students [J]. J Am Psychiat Nurses, 2016, 22(6): 483-497.
48 SudhaP, ReneeR, AshlyC, et al. Treating major depression with Yoga: a prospective, randomized, controlled pilot trial [J]. PLoS One, 2017, 12(3): e173869.
49 SchuverK J, LewisB A. Mindfulness-based Yoga intervention for women with depression [J]. Complement Ther Med, 2016, 26: 85-91.
50 袁礼洪,张洪兵,周方,等. 太极拳对老年慢性充血性心力衰竭伴抑郁状态患者抑郁状态、睡眠质量和生活质量的改善作用[J]. 广西医学, 2016, 38(11): 1547-1550.
51 侯辰. 八段锦对改善轻中度抑郁障碍患者抑郁情绪和睡眠质量的临床疗效研究[D]. 太原:山西医科大学, 2017.
52 YeungA S, FengR, KimD J H, et al. A pilot, randomized controlled study of Tai Chi with passive and active controls in the treatment of depressed Chinese Americans [J]. J Clin Psychiatry, 2017, 78(5): 522-528.
53 张峰,林正华,张莉莉,等. 帕罗西汀配合八段锦运动疗法对抑郁症患者的临床效果观察[J]. 中国现代药物应用, 2017, 11(11): 109-111.
54 RimerJ, DwanK, LawlorD A, et al. Exercise for depression[J]. Cochrane Database Syst Rev, 20127): CD004366.
55 CooneyG M, DwanK, GreigC A, et al. Exercise for depression [J]. Cochrane Database Syst Rev, 20139): CD004366.
56 WilburJ, BuchholzS W. Adding facilitated physical activity to standard GP care for depression does not improve symptoms [J]. Evid Base Ment Health, 2012, 15(4): 93.
57 ChiI, JordanmarshM, GuoM, et al. Tai Chi and reduction of depressive symptoms for older adults: a meta-analysis of randomized trials [J]. Geriatr Gerontol Int, 2013, 13(1): 3-12.
58 王从江. 体育锻炼对我国普通大学生抑郁症影响的Meta分析[J]. 成都体育学院学报, 2014, 40(3): 75-79.
59 LarunL, NordheimL V, EkelandE, et al. Exercise in prevention and treatment of anxiety and depression among children and young people [J]. Cochrane Database Syst Rev, 20063): CD004691.
60 BuddeH, WegnerM. The Exercise Effect on Mental Health: Neurobiological Mechanisms [M]. Boca Raton: CRC Press, 2018.

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身心锻炼干预抑郁症有效性的Meta分析

Effects of Mind-body Exercise on Depression: A Meta-analysis

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