我国心脏康复研究现状及问题的文献计量学评价
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摘要
背景近年来我国心脏康复研究备受临床关注,心脏康复研究论文刊登数量明显增多,但心脏康复方案各异、缺乏统一的评价标准,文献计量学研究缺失。目的采用文献计量学方法评价国内心脏康复相关文献,分析我国心脏康复研究现状、明确存在的问题。方法计算机检索中国知网(CNKI)、万方数据知识服务平台、中国生物医学文献数据库(CBM),筛选有关心脏康复的文献,检索时间为建库至2018年11月。分析心脏康复研究论文刊载期刊、刊登数量、研究类型、统计学方法、研究主题及内容等。结果 (1)最终纳入1 127篇文献,其中24种护理学专业期刊刊载137篇(占12.2%);2012年以后心脏康复研究论文刊登数量呈现明显增多趋势。(2)涉及研究类型9种,其中随机对照研究(RCT)及准随机对照研究(CCT)443篇(占39.3%)。(3)651篇(占57.8%)采用描述性分析,465篇(占41.3%)未采用统计学方法。(4)研究主题及内容主要包括心脏康复模式、心脏康复措施、结局指标、心脏康复效果及评价指标,其中涉及运动康复文献393篇(占34.9%)、心理护理文献160篇(占14.2%)、中医适宜技术文献152篇(占13.5%)、信息技术应用文献107篇(占9.5%);涉及的病种主要包括冠心病、心肌梗死、心力衰竭、急性冠脉综合征、心脏瓣膜疾病及多种心脏病术后;涉及的心脏运动康复方式主要包括心肺运动试验、有氧运动、抗阻运动。结论基于文献计量学评价结果,我国心脏康复研究近年来备受关注、重视,运动康复及心理护理等是主要的研究热点,但与国外相比,我国尚未形成完善的心脏康复模式且干预性研究质量良莠不齐。
Background Researches on cardiac rehabilitation attracted much clinical attention and number of published papers significantly increased in recent years in China,but the cardiac rehabilitation programmes are various,without unified evaluation criteria and bibliometric study. Objective To evaluate domestic pertinent literatures about cardiac rehabilitation by bibliometric method,to analyze the research status and problems of cardiac rehabilitation in China. Methods Computer was used to search CNKI,Wanfang Data,and CBM from establishing database to November 2018,to screen pertinent literatures about cardiac rehabilitation. Journals publishing papers about cardiac rehabilitation,number of published papers,study types,statistical method,research topics and contents were analyzed. Results(1)A total of 1 127 literatures were enrolled eventually,thereinto 137 literatures(accounting for 12.2%)were published in 24 nursing journals;number of published papers about cardiac rehabilitation significantly increased from 2012.(2)A total of 9 study types were involved,thereinto 443 literatures(accounting for 39.3%)were randomized controlled trial(RCT)and quasi-randomized controlled trail(CCT).(3)A total of 651 literatures(accounting for 57.8%)used descriptive analysis,465 literatures(accounting for 41.3%)did not use any statistical method.(4)Research topics and contents mainly included cardiac rehabilitation model,cardiac rehabilitation measures,outcome indicators,cardiac rehabilitation effect and evaluation indicators,thereinto 393 literatures(accounting for 34.9%)were about exercise rehabilitation,160 literatures(accounting for 14.2%)about psychological problems and care,152 literatures(accounting for 13.5%)about appropriate health technology of traditional Chinese medicine,107 literatures(accounting for 9.5%)about information technology application;coronary heart disease,myocardial infarction,heart failure,acute coronary syndrome,heart valve disease and multiple postoperative heart disease were involved;referred cardiac exercise rehabilitation mainly included cardiopulmonary exercise testing,aerobic exercise and resistance exercise. Conclusion Based on Bibliometric evaluation results,researches on cardiac rehabilitation attracted much clinical attention in recent years in China,exercise rehabilitation and psychological care are the major research hotspots,but compared with that at abroad,systematic cardiac rehabilitation model is not yet formed and interventional researches are of varying qualities at home.
Background Researches on cardiac rehabilitation attracted much clinical attention and number of published papers significantly increased in recent years in China,but the cardiac rehabilitation programmes are various,without unified evaluation criteria and bibliometric study. Objective To evaluate domestic pertinent literatures about cardiac rehabilitation by bibliometric method,to analyze the research status and problems of cardiac rehabilitation in China. Methods Computer was used to search CNKI,Wanfang Data,and CBM from establishing database to November 2018,to screen pertinent literatures about cardiac rehabilitation. Journals publishing papers about cardiac rehabilitation,number of published papers,study types,statistical method,research topics and contents were analyzed. Results(1)A total of 1 127 literatures were enrolled eventually,thereinto 137 literatures(accounting for 12.2%)were published in 24 nursing journals;number of published papers about cardiac rehabilitation significantly increased from 2012.(2)A total of 9 study types were involved,thereinto 443 literatures(accounting for 39.3%)were randomized controlled trial(RCT)and quasi-randomized controlled trail(CCT).(3)A total of 651 literatures(accounting for 57.8%)used descriptive analysis,465 literatures(accounting for 41.3%)did not use any statistical method.(4)Research topics and contents mainly included cardiac rehabilitation model,cardiac rehabilitation measures,outcome indicators,cardiac rehabilitation effect and evaluation indicators,thereinto 393 literatures(accounting for 34.9%)were about exercise rehabilitation,160 literatures(accounting for 14.2%)about psychological problems and care,152 literatures(accounting for 13.5%)about appropriate health technology of traditional Chinese medicine,107 literatures(accounting for 9.5%)about information technology application;coronary heart disease,myocardial infarction,heart failure,acute coronary syndrome,heart valve disease and multiple postoperative heart disease were involved;referred cardiac exercise rehabilitation mainly included cardiopulmonary exercise testing,aerobic exercise and resistance exercise. Conclusion Based on Bibliometric evaluation results,researches on cardiac rehabilitation attracted much clinical attention in recent years in China,exercise rehabilitation and psychological care are the major research hotspots,but compared with that at abroad,systematic cardiac rehabilitation model is not yet formed and interventional researches are of varying qualities at home.
引文
[1]丁荣晶.《冠心病心脏康复/二级预防中国专家共识》解读[J].岭南心血管病杂志,2013,19(2):123-126.
[2]OLDRIDGE N.Exercise-based cardiac rehabilitation in patients with coronary heart disease:meta-analysis outcomes revisited[J].Future Cardiol,2012,8(5):729-751.DOI:10.2217/fca.12.34.
[3]LAWLER P R,FILION K B,EISENBERG M J.Efficacy of exercise-based cardiac rehabilitation post-myocardial infarction:a systematic review and meta-analysis of randomized controlled trials[J].Am Heart J,2011,162(4):571-584,e2.
[4]郝云霞,周政,刘庆荣,等.从心血管专科发展看护理在心脏康复中的作用[J].中华护理杂志,2015,50(6):645-649.DOI:10.3761/j.issn.0254-1769.2015.06.001.
[5]董媛,金海.心脏康复理念、心脏康复患者及心脏康复模式的综述[J].吉林医学,2018,39(2):358-361.DOI:10.3969/j.issn.1004-0412.2018.02.075.
[6]MADDISON R,RAWSTORN J C,STEWART R A H,et al.Effects and costs of real-time cardiac telerehabilitation:randomised controlled non-inferiority trial[J].Heart,2018.pii:heartjnl-2018-313189.DOI:10.1136/heartjnl-2018-313189.
[7]KINSARA A J.Do We Need Cardiac Rehabilitation in Heart Failure[J].J Coll Physicians Surg Pak,2018,28(1):61-62.DOI:10.29271/jcpsp.2018.01.61.
[8]张进,丁立群,范洁,等.运动康复治疗对慢性稳定性心力衰竭患者运动耐力、心肺功能及生活质量的影响[J].中国循环杂志,2017,32(11):1099-1103.DOI:10.3969/j.issn.1000-3614.2017.11.013.
[9]叶磊,王秋莉,周意,等.运动康复护理模式对慢性心力衰竭患者心功能的影响[J].中华现代护理杂志,2016,22(33):4830-4833.DOI:10.3760/cma.j.issn.1674-2907.2016.33.025.
[10]丁荣晶.心肺运动试验:风险及防控[J].临床心电学杂志,2017,26(5):321-323.DOI:10.3969/j.issn.1005-0272.2017.05.001.
[11]李翔,杨旭.6分钟步行试验在心脏康复中的作用[J].中国临床医生杂志,2018,46(5):507-510.DOI:10.3969/j.issn.2095-8552.2018.05.002.
[12]PRADO D M,ROCCO E A,SILVA A G,et al.Effects of continuous vs interval exercise training on oxygen uptake efficiency slope in patients with coronary artery disease[J].Braz J Med Biol Res,2016,49(2):e4890.DOI:10.1590/1414-431X20154890.
[13]WISE F M,PATRICK J M.Resistance exercise in cardiac rehabilitation[J].Clin Rehabil,2011,25(12):1059-1065.DOI:10.1177/0269215511423408.
[14]李广鹤,车琳.冠心病患者抗阻运动康复进展[J].实用老年医学,2013,27(3):184-188.
[15]苏媛媛,张伟宏,张振香,等.弹力带强心复健操对社区冠状动脉粥样硬化性心脏病患者躯体功能的影响[J].重庆医学,2018,47(27):3593-3596.DOI:10.3969/j.issn.1671-8348.2018.27.031.
[16]HANSEN D,STEVENS A,EIJNDE B O,et al.Endurance exercise intensity determination in the rehabilitation of coronary artery disease patients:a critical re-appraisal of current evidence[J].Sports Med,2012,42(1):11-30.
[17]周友根,宋平,邓晓剑,等.认知行为疗法对冠心病患者心理及运动处方依从性的影响[J].心血管康复医学杂志,2018,27(4):369-372.DOI:10.3969/j.issn.1008-0074.2018.04.01.
[18]姜红梅,刘传浩,贾曦,等.心理干预对老年慢性心衰患者康复治疗依从性的影响[J].泰山医学院学报,2014,35(10):1021-1024.DOI:10.3969/j.issn.1004-7115.2014.10.016.
[19]颜羽,杨奕,农湫雯,等.基于微信平台的延续护理在冠心病介入治疗患者心脏康复管理中的应用研究[J].临床护理杂志,2017,16(2):2-4.DOI:10.3969/j.issn.1671-8933.2017.02.001.
[20]刘华玲,黄雪嘉,赵惠芬,等.电话随访联合家庭督导对冠心病PCI术后患者康复的效果研究[J].中外医学研究,2017,15(33):152-154.DOI:10.14033/j.cnki.cfmr.2017.33.075.
[21]牛琳琳,于瑞.中医情志疗法在心脏康复中的应用探析[J].中医临床研究,2018,10(22):43-45.DOI:10.3969/j.issn.1674-7860.2018.22.017.
[22]郑秀琴,胡军.传统功法在慢性心功能不全早期心脏康复中的运用[J].上海中医药大学学报,2018,32(5):92-96.
[23]王家美,梁春,王蓓,等.“坐式八段锦”对急性心肌梗死病人介入治疗术后心脏康复的影响[J].中西医结合心脑血管病杂志,2018,16(8):1082-1085.DOI:10.12102/j.issn.1672-1349.2018.08.027.
[24]成青莲,崔竞宇,杜廷海.中医五音疗法在心脏康复中的应用[J].中国中医药现代远程教育,2017,15(12):135-136.DOI:10.3969/j.issn.1672-2779.2017.12.061.
[25]陈静薇,余小玲,林小丽,等.中医经络操结合康复训练用于心脏搭桥术后患者的效果观察[J].中华现代护理杂志,2016,22(4):540-543.DOI:10.3760/cma.j.issn.1674-2907.2016.04.025.
[26]刘晗,徐志华,黄丹,等.信息技术在心脏康复应用中的研究进展[J].中国实验诊断学,2018,22(6):1103-1106.
[2]OLDRIDGE N.Exercise-based cardiac rehabilitation in patients with coronary heart disease:meta-analysis outcomes revisited[J].Future Cardiol,2012,8(5):729-751.DOI:10.2217/fca.12.34.
[3]LAWLER P R,FILION K B,EISENBERG M J.Efficacy of exercise-based cardiac rehabilitation post-myocardial infarction:a systematic review and meta-analysis of randomized controlled trials[J].Am Heart J,2011,162(4):571-584,e2.
[4]郝云霞,周政,刘庆荣,等.从心血管专科发展看护理在心脏康复中的作用[J].中华护理杂志,2015,50(6):645-649.DOI:10.3761/j.issn.0254-1769.2015.06.001.
[5]董媛,金海.心脏康复理念、心脏康复患者及心脏康复模式的综述[J].吉林医学,2018,39(2):358-361.DOI:10.3969/j.issn.1004-0412.2018.02.075.
[6]MADDISON R,RAWSTORN J C,STEWART R A H,et al.Effects and costs of real-time cardiac telerehabilitation:randomised controlled non-inferiority trial[J].Heart,2018.pii:heartjnl-2018-313189.DOI:10.1136/heartjnl-2018-313189.
[7]KINSARA A J.Do We Need Cardiac Rehabilitation in Heart Failure[J].J Coll Physicians Surg Pak,2018,28(1):61-62.DOI:10.29271/jcpsp.2018.01.61.
[8]张进,丁立群,范洁,等.运动康复治疗对慢性稳定性心力衰竭患者运动耐力、心肺功能及生活质量的影响[J].中国循环杂志,2017,32(11):1099-1103.DOI:10.3969/j.issn.1000-3614.2017.11.013.
[9]叶磊,王秋莉,周意,等.运动康复护理模式对慢性心力衰竭患者心功能的影响[J].中华现代护理杂志,2016,22(33):4830-4833.DOI:10.3760/cma.j.issn.1674-2907.2016.33.025.
[10]丁荣晶.心肺运动试验:风险及防控[J].临床心电学杂志,2017,26(5):321-323.DOI:10.3969/j.issn.1005-0272.2017.05.001.
[11]李翔,杨旭.6分钟步行试验在心脏康复中的作用[J].中国临床医生杂志,2018,46(5):507-510.DOI:10.3969/j.issn.2095-8552.2018.05.002.
[12]PRADO D M,ROCCO E A,SILVA A G,et al.Effects of continuous vs interval exercise training on oxygen uptake efficiency slope in patients with coronary artery disease[J].Braz J Med Biol Res,2016,49(2):e4890.DOI:10.1590/1414-431X20154890.
[13]WISE F M,PATRICK J M.Resistance exercise in cardiac rehabilitation[J].Clin Rehabil,2011,25(12):1059-1065.DOI:10.1177/0269215511423408.
[14]李广鹤,车琳.冠心病患者抗阻运动康复进展[J].实用老年医学,2013,27(3):184-188.
[15]苏媛媛,张伟宏,张振香,等.弹力带强心复健操对社区冠状动脉粥样硬化性心脏病患者躯体功能的影响[J].重庆医学,2018,47(27):3593-3596.DOI:10.3969/j.issn.1671-8348.2018.27.031.
[16]HANSEN D,STEVENS A,EIJNDE B O,et al.Endurance exercise intensity determination in the rehabilitation of coronary artery disease patients:a critical re-appraisal of current evidence[J].Sports Med,2012,42(1):11-30.
[17]周友根,宋平,邓晓剑,等.认知行为疗法对冠心病患者心理及运动处方依从性的影响[J].心血管康复医学杂志,2018,27(4):369-372.DOI:10.3969/j.issn.1008-0074.2018.04.01.
[18]姜红梅,刘传浩,贾曦,等.心理干预对老年慢性心衰患者康复治疗依从性的影响[J].泰山医学院学报,2014,35(10):1021-1024.DOI:10.3969/j.issn.1004-7115.2014.10.016.
[19]颜羽,杨奕,农湫雯,等.基于微信平台的延续护理在冠心病介入治疗患者心脏康复管理中的应用研究[J].临床护理杂志,2017,16(2):2-4.DOI:10.3969/j.issn.1671-8933.2017.02.001.
[20]刘华玲,黄雪嘉,赵惠芬,等.电话随访联合家庭督导对冠心病PCI术后患者康复的效果研究[J].中外医学研究,2017,15(33):152-154.DOI:10.14033/j.cnki.cfmr.2017.33.075.
[21]牛琳琳,于瑞.中医情志疗法在心脏康复中的应用探析[J].中医临床研究,2018,10(22):43-45.DOI:10.3969/j.issn.1674-7860.2018.22.017.
[22]郑秀琴,胡军.传统功法在慢性心功能不全早期心脏康复中的运用[J].上海中医药大学学报,2018,32(5):92-96.
[23]王家美,梁春,王蓓,等.“坐式八段锦”对急性心肌梗死病人介入治疗术后心脏康复的影响[J].中西医结合心脑血管病杂志,2018,16(8):1082-1085.DOI:10.12102/j.issn.1672-1349.2018.08.027.
[24]成青莲,崔竞宇,杜廷海.中医五音疗法在心脏康复中的应用[J].中国中医药现代远程教育,2017,15(12):135-136.DOI:10.3969/j.issn.1672-2779.2017.12.061.
[25]陈静薇,余小玲,林小丽,等.中医经络操结合康复训练用于心脏搭桥术后患者的效果观察[J].中华现代护理杂志,2016,22(4):540-543.DOI:10.3760/cma.j.issn.1674-2907.2016.04.025.
[26]刘晗,徐志华,黄丹,等.信息技术在心脏康复应用中的研究进展[J].中国实验诊断学,2018,22(6):1103-1106.