Volume 4,Issue 9
克罗恩病患者运动康复与自我管理研究进展综述
克罗恩病是终身波动的慢性炎症性疾病，除腹痛、腹泻、体重变化外，还会伴疲劳、骨量减少、肌力下降和生活质量受损。本文使用了目的性文献综述法，整理2019—2024年10篇主要研究。结果表明，缓解期或轻度活动期患者进行每次30—60分钟、每周3次以上、8—26周的有氧联合抗阻训练，可以改善心肺功能、肌肉力量和部分骨密度指标，
并且有助于心理状态改善；疾病活动度有下降，但炎症标志物变化不稳定。自我管理干预是涵盖症状监测、用药依从、压力调节、目标制定和远程随访，可提升依从性、心理健康和生活质量。目前的研究仍存在样本小、异质性大、活动期证据不足等问题，未来应该探索分层运动处方与数字化行为支持结合的复合干预模式。
[1]Jones K, Kimble R, Baker K, et al. Effects of structured exercise programmes on physiological and psychological outcomes in adults with inflammatory bowel disease (IBD): a systematic review and meta-analysis[J]. PLOS ONE, 2022, 17(12): e0278480.
[2]Neal W N, Jones C D, Pekmezi D, et al. Physical activity in adults with crohn’s disease: a scoping review[J]. Crohn’s & Colitis 360, 2022, 4(2): otac022.
[3]Iizawa M, Hirose L, Nunotani M, et al. A systematic review of self-management interventions for patients with inflammatory bowel disease[J]. Inflammatory Intestinal Diseases, 2023, 8(1): 1-12.
[4]Bauer N, Löffler C, Oeznur O, et al. Evaluation of a multimodal stress management and comprehensive lifestyle modification program on quality of life and gastrointestinal symptoms in patients with crohn’s disease: a randomized controlled pilot trial with 9-month follow-up[J]. Digestion, 2024, 105(3): 201-212.
[5]Tew G A, Leighton D, Carpenter R, et al. High-intensity interval training and moderate-intensity continuous training in adults with crohn’s disease: a pilot randomised controlled trial[J]. BMC Gastroenterology, 2019, 19(1): 19-29.
[6]Jones K, Baker K, Speight R A, et al. Randomised clinical trial: combined impact and resistance training in adults with stable Crohn’s disease[J]. Alimentary Pharmacology & Therapeutics, 2020, 52(6): 964-975.
[7]Hommel K A, Noser A E, Plevinsky J, et al. Pilot and feasibility of the SMART IBD mobile app to improve self-management in pediatric inflammatory bowel disease[J]. Journal of Pediatric Gastroenterology and Nutrition, 2024, 78(6): 1273-1278.
[8] 朱杨帆. 炎症性肠病青少年自我管理干预的证据总结[J]. 中国护理管理, 2024, 24(12): 1898.
[9] 程海琪, 周薇, 李萍, 等. 炎症性肠病患者运动锻炼的证据总结[J]. 广州医药, 2024, 55(12): 1397-1406.
[10]Baker K A, Miller T D, Marino F E, et al. The exercise-induced inflammatory response in inflammatory bowel disease: a systematic review and meta-analysis[J]. PLOS ONE, 2022, 17(2): e0262534.