素食降低血壓之成效：系統性文獻回顧與統合分析隨機臨床試驗

Effects of Vegetarian Diets on Blood Pressure: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

廖美菊(Mei-Chu Liao)

指導教授 ： 蔡佩珊

臺北醫學大學/護理學院/護理學研究所/碩士(2013年)

https://doi.org/10.6831/TMU.2013.00150

摘要

回顧方法：樣本收納條件為：1.中文或英文文獻2.隨機控制試驗的臨床實驗文獻3.以素食為介入措施，結果指標為血壓值變化之研究4.研究對象成年人。排除條件：1.重複文獻。兩位收案人員獨立擷取每篇臨床試驗的資料與數據。成效指標包括收縮壓及舒張壓。使用標準的統合成效方法，以Review Manager 5.1統計軟體分析素食相對於其他飲食對成年人樣本的收縮壓及舒張壓的影響。並將樣本分為有、無高血壓危險因子族群，分析素食對收縮壓的影響。使用異質性檢驗分析收納樣本間之同質性。
研究結果：最終共有8篇英文文獻，共364人納入統合分析。結果顯示舒張壓的成效值為-1.13mmHg（p<0.0001）有統計意義，而舒張壓在敏感性分析後成效值為-0.46mmHg（p=0.56）；在收縮壓部分成效值為-2.07mmHg　（p=0.15），經由敏感分析結果顯示收縮壓成效值為-2.28mmHg（p=0.11）。因收縮壓在樣本間具有異質性，故進行次群體分析，依照樣本的特性分成沒有高血壓危險因子及有高血壓危險因子2組。結果顯示沒有高血壓危險因子樣本收縮壓統合成效值為-2.40 mmHg（p=0.45），而有高血壓危險因子樣本間具有高同質性且收縮壓顯著下降，統合成效值為 -3.68mmHg（p<0.0001）。
結論：本研究經由統合分析後發現素食的降血壓成效極微小，推論可能原因為1.所納入文獻控制組的飲食內容不一致，影響統合分析結果2.介入時間不長平均為6-12週（除了2篇的時間大於1年），難以看出素食長期對血壓的影響。另外本研究次群體分析有高血壓危險因子的成效值有統計意義。推論有高血壓危險因子的族群其血壓值較易受到飲食影響。

關鍵字

統合分析 ； 系統性文獻回顧 ； 素食 血壓

並列摘要

Objective To assess the effects of vegetarian diets compared with other diets on blood pressure in adult persons.
Design Systematic review and meta-analysis of randomized controlled trials.
Data sources Literature databases searched up to the end of December 2011.
Review methods Randomized controlled trials comparing vegetarian diets with other diets in adult subjects were eligible. Two data assessors independently abstracted data from each trial. Outcome measures were systolic blood pressure (SBP) and diastolic blood pressure (DBP). Standard meta-analysis methods (Review Manager 5.1) were used to assess the effects of vegetarian diets on blood pressure compared with other diets. Tests for heterogeneity were used to assess for differences in treatment effect across different vegetarian diet.
Results In total, 8 trials of 364 participants met the inclusion criteria and were included in the meta-analyses. The results showed that the effect size for the reduction of SBP and DBP was -2.07mmHg (p = 0.15) and -1.13mmHg (p <0.0001), respectively. Because the sample was highly heterogeneous for SBP, subgroup analyses were performed. The sample was divided into two groups according to whether the trial included participants with and without risk factors of hypertension. For the group without risk factors, the effect size for SBP reduction was -2.40 mmHg (p = 0.45) whereas for the group with risk factors the effect size was -3.68mmHg (p <0.0001). Conclusions Vegetarian diets have minimal effects on blood pressure. Large, well designed, randomized controlled trials with improved methodology and reporting are needed to assess the efficacy of vegetarian diets for improving blood pressure.

並列關鍵字

Meta-Analysis ； Systematic Review ； bloodpressure,vegetarian diet

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