Lee Myeong Soo, Pittler Max H, Guo Ruoling, Ernst Edzard
Complementary Medicine, Peninsula Medical School, Universities of Exeter and Plymouth, Exeter, UK.
J Hypertens. 2007 Aug;25(8):1525-32. doi: 10.1097/HJH.0b013e328092ee18.
To assess systematically the clinical evidence of qigong for hypertension.
Databases were searched up to August 2006. All randomized clinical trials (RCTs) testing qigong in patients with hypertension of any origin and assessing clinically relevant outcomes were considered. Trials using any type of control intervention were included. The selection of studies, data extraction and quality assessment were performed independently by at least two reviewers. Methodological quality was evaluated using the Jadad score.
A total of 121 potentially relevant articles were identified and 12 RCTs were included. Seven RCTs tested qigong in combination with antihypertensive drugs compared with antihypertensive drugs alone. The meta-analysis of two trials reporting adequate data suggested beneficial effects in favour of qigong [weighted mean difference, systolic blood pressure (SBP) -12.1 mmHg, 95% confidence interval (CI) -17.1 to -7.0; diastolic blood pressure -8.5 mmHg, 95% CI -12.6 to -4.4]. Qigong was compared with waiting list control in two RCTs and was found to reduce SBP significantly (weighted mean difference -18.5 mmHg, 95% CI -23.1 to -13.9). In three further RCTs the comparisons made were: qigong combined with conventional therapy versus muscle relaxation combined with conventional therapy; qigong as a sole treatment versus exercise. All reported positive results in at least some of the relevant outcome measures. The methodological quality of the studies was low.
There is some encouraging evidence of qigong for lowering SBP, but the conclusiveness of these findings is limited. Rigorously designed trials are warranted to confirm these results.
系统评估气功治疗高血压的临床证据。
检索数据库至2006年8月。纳入所有对任何病因的高血压患者进行气功测试并评估临床相关结局的随机临床试验(RCT)。纳入使用任何类型对照干预的试验。研究的选择、数据提取和质量评估由至少两名审阅者独立进行。使用Jadad评分评估方法学质量。
共识别出121篇潜在相关文章,纳入12项RCT。7项RCT将气功与降压药联合使用与单独使用降压药进行比较。两项报告了充分数据的试验的荟萃分析表明,气功有有益效果[加权平均差,收缩压(SBP)-12.1 mmHg,95%置信区间(CI)-17.1至-7.0;舒张压-8.5 mmHg,95%CI -12.6至-4.4]。在两项RCT中,将气功与等待名单对照进行比较,发现气功可显著降低SBP(加权平均差-18.5 mmHg,95%CI -23.1至-13.9)。在另外三项RCT中,进行的比较为:气功联合传统疗法与肌肉放松联合传统疗法;气功作为单一疗法与运动。所有研究至少在一些相关结局指标上报告了阳性结果。研究的方法学质量较低。
有一些令人鼓舞的证据表明气功可降低收缩压,但这些发现的确定性有限。需要进行严格设计的试验来证实这些结果。