摘要
背景:当前针对患者骨健康/骨密度相关疾患结局指标的影响,传统太极功法干预仍然存在较大的争议,亟待作进一步探讨。目的:系统评价传统太极功法干预对改善骨密度流失的临床疗效与安全性。方法:通过计算机对中国知网CNKI、万方、维普VIP和中国生物医学文献数据库、以及国外数据库PubMed、MEDLINE、EMbase、CochraneLibrary等进行全面检索;配合对大学图书馆的馆藏期刊进行手工检索,检索时间截于2019年1月;系统搜集传统太极功法(包括太极拳、太极推手、太极柔力球等)干预对骨健康/骨密度相关疾患结局指标影响的随机对照研究(RCT)文献。参考Cochrane系统评价方法进行文献筛选、资料提取以及方法学质量评价;并采用Rev Man 5.3软件进行Meta分析。结果与结论:共纳入14篇文献(16个RCT研究),Meta分析结果表明:接受传统太极功法干预后,脊柱腰椎L2-4骨密度(SMD=0.40,95%CI[0.16,0.65],P=0.001)、以及股骨颈骨密度(SMD=0.75,95%CI [0.27,1.24],P=0.002)改善方面均优于对照组;然而在Ward’s三角骨密度(SMD=0.50,95%CI[-0.10,1.10],P=0.10)、股骨干骨密度(SMD=0.16,95%CI[-0.11,0.44],P=0.25)、股骨近端转子骨密度(SMD=0.54,95%CI[-0.01,1.09],P=0.05)、以及桡骨远端1/3处骨密度(SMD=0.20,95%CI[-0.26,0.66],P=0.040)与对照组比较,组间差异无统计学意义;且传统太极功法干预尚未发现严重不良事件。当前证据发现,传统太极功法干预在特定人群(例如老年人、骨质疏松人群、围绝经期与绝经后妇女)脊柱腰椎、股骨颈等部位的骨密度流失改善方面疗效明确,不良反应较少。鉴于纳入文献数量偏少以及研究本身局限性,有待开展高质量的、设计严谨的临床试验予以进一步验证。
BACKGROUND: There is no consensus on the effectiveness and safety of Tai Chi of traditional body refreshment for patients concerning bone mineral density loss, which needs further investigation.OBJECTIVE: To assess the effectiveness and safety of Tai Chi of traditional body refreshment for improving bone mineral density loss.METHODS: Databases including CNKI, WanFang, VIP, CBM, PubMed, MEDLINE, EMbase and Cochrane Library were searched by computer for randomized controlled trials involving Tai Chi of traditional body refreshment(including Tai Ji Quan, Tai Chi push hand, Tai Chi softball, et al.) on the effect of bone health/bone mineral density published before January 2019. The related periodicals were also manually retrieved. Literature screening, data extraction and methodological quality were conducted based on the Cochrane methods. Meta-analysis was performed on RevMan 5.3 software.RESULTS AND CONCLUSION: Fourteen articles including 16 randomized controlled trials were included. Meta-analyses results found that:Tai Chi of traditional body refreshment was superior to the control group in improving bone mineral density of L2-4(SMD=0.40, 95%CI[0.16,0.65], P=0.001), and femoral neck(SMD=0.75, 95%CI [0.27, 1.24], P=0.002). Furthermore, no significant differences were observed between groups in bone mineral density of Ward’s triangle(SMD=0.50, 95%CI[-0.10, 1.10], P=0.10), femoral shaft(SMD=0.16, 95%CI [-0.11, 0.44],P=0.25), proximal femoral trochanter(SMD=0.54, 95%CI [-0.01, 1.09], P=0.05), and 1/3 distal radius(SMD=0.20, 95%CI [-0.26, 0.66],P=0.040). No seriously adverse events were reported. Current evidence suggest that Tai Chi of traditional body refreshment shows additive benefits for the improvement of bone mineral density loss of lumbar spine and femoral neck in specific populations(such as elderly,osteoporosis groups, perimenopausal and postmenopausal women). In view of the study of small number and itself limitations, further clinical trials with high quality and rigorous design are needed for further v
作者
曾令烽
杨伟毅
梁桂洪
陈红云
郭达
罗明辉
潘建科
赵第
赵金龙
黄和涛
韩燕鸿
林炯同
侯森荣
吴明
李嘉晖
梁伟雄
欧爱华
刘军
Zeng Lingfeng;Yang Weiyi;Liang Guihong;Chen Hongyun;Guo Da;Luo Minghui;Pan Jianke;Zhao Di;Zhao Jinlong;Huang Hetao;Han Yanhong;Lin Jiongtong;Hou Senrong;Wu Ming;Li Jiahui;Liang Weixiong;Ou Aihua;Liu Jun(the Second Affiliated Hospital of Guangzhou University of Chinese Medicine (Guangdong Provincial Hospital of Chinese Medicine), Guangzhou 510120, Guangdong Province, China;the Second Clinical Medical College of Guangzhou University of Chinese Medicine/Post-Doctoral Research Station, Guangzhou 510405, Guangdong Province, China;Bone and Joint Research Team of Degeneration and Injury, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou 510120, Guangdong Province, China)
出处
《中国组织工程研究》
CAS
北大核心
2019年第27期4420-4428,共9页
Chinese Journal of Tissue Engineering Research
基金
中国博士后科学基金资助项目(2018M633036):膝骨关节炎临床防治指南及中医慢病管理研究,项目负责人:曾令烽
广东省财政厅项目([2014]157号):中老年退行性膝骨关节炎中医药防治管理体系,项目负责人:刘军
广东省财政厅项目([2018]8号):中医骨伤科传统特色疗法传承创新研究,项目负责人:刘军
广东省中医院中医药科学技术研究专项(YK2013B2N19):岭南伤科名家临证经验传承研究,项目负责人:刘军
广东省中医院中医药科学技术研究专项(YN2015MS15):中医药治疗骨关节炎临床研究的系统评价及其GRADE证据质量评价研究,项目负责人:刘军
广东省医学科学技术研究基金(B2019091):全膝关节置换TKA术前及术后测定量表N-KSS 2.0的引进与考核,项目负责人:曾令烽~~
关键词
太极
传统功法
骨密度流失
太极拳
太极推手
太极柔力球
系统评价
META分析
随机对照设计
Tai Chi
traditional body refreshment
bone mineral density loss
Tai Ji Quan
Tai Chi push hand
Tai Chi softball
systematic review
meta-analysis
randomized controlled design
