癌症相关肌少性肥胖是一种以进行性骨骼肌流失与体脂异常蓄积并存的代谢综合征,在癌症患者中常见。该综合征不仅显著削弱患者的躯体功能,还会加剧放化疗不良反应,影响治疗耐受性,导致不良预后,已成为影响癌症患者生存质量与长期结局的关键临床问题。运动干预作为非药物治疗的核心策略,通过改善身体成分、调控糖脂代谢通路及抑制慢性炎症等多重机制发挥积极作用,对癌症相关肌少性肥胖患者具有重要意义。本文系统性综述了有氧运动、抗阻运动、高强度间歇运动及多模式联合运动在癌症相关肌少性肥胖患者中的应用效果、作用机制及实施方案,归纳总结不同运动模式的剂量-效应关系及安全执行参数。同时,本文还探讨了当前临床实践中面临的运动处方标准化不足、患者长期依从性欠佳及个体化方案欠缺等关键挑战,并对未来研究重点提出展望,旨在为癌症相关肌少性肥胖者提供运动康复方案指导。
Abstract
Cancer-related sarcopenic obesity is a metabolic syndrome characterized by progressive loss of skeletal muscle mass and abnormal fat accumulation, with high prevalence among cancer patients, particularly in the digestive system. This syndrome not only significantly impairs physical function but also exacerbates adverse effects of radiotherapy and chemotherapy, reduces treatment tolerance, and leads to poor prognosis, becoming a critical clinical issue affecting the quality of life and long-term outcomes for cancer patients. Exercise intervention, as a core non-pharmacological treatment strategy, plays a positive role through multiple mechanisms including improving body composition, regulating glucose-lipid metabolic pathways, and inhibiting chronic inflammation, making it particularly significant for patients with cancer-related sarcopenic obesity. This systematic review examines the application effects, mechanisms, and implementation plans of aerobic exercise, resistance training, high-intensity interval training, and multimodal combined exercise in patients with cancer-related sarcopenic obesity. It summarizes dose-response relationships and safety parameters for different exercise modalities. Additionally, the study addresses key challenges in current clinical practice, such as insufficient standardization of exercise prescriptions, poor long-term patient adherence, and lack of individualized protocols. Future research priorities are proposed to guide exercise rehabilitation strategies for patients with cancer-related sarcopenic obesity.
关键词
癌症 /
肌少症 /
肌少性肥胖 /
运动疗法 /
抗阻运动 /
有氧运动 /
身体成分 /
康复
Key words
Cancer /
Sarcopenia /
Sarcopenic obesity /
Exercise therapy /
Resistance training /
Aerobic exercise /
Body composition /
Rehabilitation
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