摘要
Objective To systematically evaluate the effects of different forms of traditional Chinese health-preservation exercises on osteoporosis(OP)using network meta-analysis.Methods A systematic search on Excerpta Medica Database(EMBASE),Springer Link,Allied and Complementary Medicine Database(AMED),PubMed,Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Academic Journal Full-text Database(Wanfang)and Chongqing VIP Database(CQVIP)targeted the randomized controlled trials(RCTs)studying traditional Chinese exercises for OP published up to January 2020.Cochrane handbook was adopted to estimate the publication bias in the included studies,and statistical analysis was performed using Stata 14.0 and GeMTC 0.14.3 when data were extracted.Results Fifty RCTs were included in the network meta-analysis,comprising a total of 4505 OP patients.The network meta-analysis showed that in terms of visual analog scale(VAS)for pain,Tai Ji Quan(Tai Chi)was the most efficacious,followed by Yi Jin Jing(Sinew-transforming Qigong Exercises),Ba Duan Jin(Eight-sectioned Exercise),Wu Qin Xi(Five-animal Exercises),sports training,drug and blank control;in terms of bone mineral density(BMD)of femoral neck,Yi Jin Jing was the most efficacious,followed by Wu Qin Xi,Ba Duan Jin,Tai Ji Quan,sports training,blank control and drug;regarding the lumbar BMD,it was Yi Jin Jing,Tai Ji Quan,Ba Duan Jin,Wu Qin Xi,sports training,blank control and drug in the descending order of efficacy;in terms of serum alkaline phosphatase,it was Yi Jin Jing,Tai Ji Quan,sports training,Wu Qin Xi,Ba Duan Jin,drug and blank control in the descending order of efficacy.Conclusion The evidence to date suggests that the first choice for OP amongst the traditional Chinese exercises should be Yi Jin Jing,which can not only reduce the subjective pain,but also promote bone formation and increase BMD,though this conclusion requires more high-quality large-scale RCTs for further proof.
目的:通过网状Meta分析系统评价不同中国传统养生功法对骨质疏松症(OP)的影响.方法:系统检索荷兰医学文摘(EMBASE)、Springer Link、联合补充医学数据库(AMED)、PubMed、Cochrane Library、中国知网(CNKI)、万方学术期刊全文数据库(Wanfang)及重庆维普数据库(CQVIP)中关于中国传统功法治疗OP的随机对照试验(RCTs),检索的时间范围是从建库至2020年1月.根据Cochrane手册对纳入文献进行风险偏倚评价,并在数据提取后使用Stata14.0以及GeMTC 0.14.3进行统计分析.结果:共50项RCTs被纳入网状Meta分析,总计4505例OP患者.网状Meta分析等级概率排序显示,在疼痛的视觉模拟量表(VAS)评分方面,按疗效从高到低排列,干预方法依次为太极拳、易筋经、八段锦、五禽戏、运动训练、药物和空白对照;在股骨颈骨密度(BMD)方面,按疗效从高到低排列,干预方法依次为易筋经、五禽戏、八段锦、太极拳、运动训练、空白对照和药物;在腰椎BMD方面,按疗效从高到低排列,干预方法依次为易筋经、太极拳、八段锦、五禽戏、运动训练、空白对照和药物;在血清碱性磷酸酶(ALP)方面,按疗效从高到低排列,干预方法依次为易筋经、太极拳、运动训练、五禽戏、八段锦、药物和空白对照.结论:基于当前证据,建议在采用中国传统功法治疗OP时首选易筋经,能缓解患者主观疼痛,促进骨形成,增加BMD.上述结论仍需更多高质量、大样本的RCTs进一步证实.
作者
Li Yong-jie
Niu Xin-rui
Hu Sheng
李永杰;牛芯蕊;扈盛(Wuhan Sports University,Wuhan 430079,China;Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)
