家庭干预对儿童肥胖治疗效果的Meta分析

    Family-Based Interventions to Treat Obese Children: A Meta Analysis of Randomized Controlled Trials

    • 摘要: 目的 评价家庭干预对儿童肥胖的治疗效果。 方法 计算机检索PubMed、EMBASE、SCI、Cochrane Library、中国生物医学文献数据库、中文科技期刊全文数据库、中国期刊全文数据库及中华医学会数字化期刊数据库,收集家庭干预治疗儿童肥胖症的随机对照试验,检索时间截至2010年10月。由3名评价员采用Cochrane系统评价员手册文献质量评价标准评价纳入研究质量,评价指标为体重指数、体重、收缩压、舒张压、体脂肪百分比值、超重百分比及体重指数标准差评分等,用RevMan 5.0软件进行Meta分析。 结果 共检索到1 106篇文献,选择其中符合纳入标准的7篇随机对照研究文献进行Meta分析,Meta分析结果显示: ①家庭干预组与不干预组治疗儿童肥胖在体重指数降低值均数差-1.41,95%可信区间(-2.69,-0.14)、体重降低值均数差 -3.48, 95%可信区间(-6.15,-0.81)、收缩压降低值均数差-4.63,95%可信区间(-6.09,-3.16)、舒压降低值均数差-2.82,95%可信区间(-3.24,-2.41)及体脂肪百分比降低值均数差-1.58,95%可信区间(-1.72,-1.44)方面的差异有统计学意义,两组的超重百分比降低值均数差-7.36,95%可信区间(-18.36,3.64)差异无统计学意义;②家庭干预组与只干预儿童组在体重指数降低值均数差-1.98,95%可信区间(-4.48,0.53)、体重降低值均数差-6.04,95%可信区间(-15.45,3.37)和体重指数标准差评分降低值均数差-0.04,95%可信区间(-0.23,0.15)等方面的差异均无统计学意义。 结论 当前研究显示: 在治疗儿童肥胖的行为干预措施中,相较于不干预组,家庭干预组具有一定疗效,而只干预儿童组与家庭干预组之间的疗效并无明显差异,以上结论尚需进一步高质量的研究予以明确。

       

      Abstract: Objective The aim of this meta-analysis was to evaluate the effectiveness of family-based interventions on the treatment of childhood obesity. Methods The information of this literature was retrieved from the following several databases: PubMed, EMBASE, SCI, The Cochrane Library, Chinese Biomedical Literature Database, China Journal Full Text Database and Chinese Medical Association Journals, and the references of the included studies were retrieved up to October 2010. The quality of the included studies was evaluated according to Handbook recommended standard by three reviewers. The trials were analyzed using body mass index (BMI, kg/m2), body weight, systolic blood pressure (SBP), diastolic blood pressure (DBP), body fat percentage, percent overweight and body mass index standard deviation score (BMI-SDS) as evaluation indexes to make a comprehensive assessment. The data were analyzed by RevMan 5.0 from the Cochrane Collaboration. Results Seven RCTs(n=479) were included, and the research sites were distributed in China, the United States, Israel, Finland and Turkey. Meta-analysis based on included studies showed: ①Body mass index (BMI) decrease MD=-1.41,95%CI(-2.69, -0.14), body weight loss MD=-3.48, 95%CI(-6.15, -0.81), systolic blood pressure (SBP) decrease MD=-4.63, 95%CI(-6.09, -3.16), diastolic blood pressure (DBP) reduction MD=-2.82, 95%CI(-3.24, -2.41)and body fat percentage change MD=-1.58,95%CI(-1.72, -1.44) had statistical significance in family-based intervention groups compared with non-intervention groups, while percent overweight change MD=-7.36,95%CI(-18.36, 3.64) showed no statistical significance; ②Body mass index (BMI) decrease MD=-1.98, 95%CI(-4.48, 0.53), body weight loss MD=-6.04, 95%CI(-15.45, 3.37), and body mass index standard deviation score (BMI-SDS) change MD=-0.04, 95%CI(-0.23, 0.15) had no statistical significance in family-based intervention groups compared with child-based intervention groups. Conclusion The current studies showed that: Among the treatments of behavioral interventions for childhood obesity, family-based intervention has its certain effectiveness when compared with non-intervention groups; however there is no significant difference between child-based intervention with it. Still, this conclusion needs more high-quality researches to support.

       

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