Lee Myeong Soo, Pittler Max H, Ernst Edzard
Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, UK.
Clin Rheumatol. 2008 Feb;27(2):211-8. doi: 10.1007/s10067-007-0700-4. Epub 2007 Sep 14.
The aim of this study was to evaluate data from controlled clinical trials testing the effectiveness of tai chi for treating osteoarthritis. Systematic searches were conducted on MEDLINE, AMED, British Nursing Index, CINAHL, EMBASE, PsycInfo, The Cochrane Library 2007, Issue 2, the UK National Research Register and ClinicalTrials.gov, Korean medical databases, the Qigong and Energy database and Chinese medical databases (until June 2007). Hand searches included conference proceedings and our own files. There were no restrictions regarding the language of publication. All controlled trials of tai chi for patients with osteoarthritis were considered for inclusion. Methodological quality was assessed using the Jadad score. Five randomised clinical trials (RCTs) and seven non-randomised controlled clinical trials (CCTs) met all inclusion criteria. Five RCTs assessed the effectiveness of tai chi on pain of osteoarthritis (OA). Two RCTs suggested significant pain reduction on visual analog scale or Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) compared to routine treatment and an attention control program in knee OA. Three RCTs did not report significant pain reduction on multiple sites pain. Four RCTs tested tai chi for physical functions. Two of these RCTs suggested improvement of physical function on activity of daily living or WOMAC compared to routine treatment or wait-list control, whilst two other RCTs failed to do so. In conclusion, there is some encouraging evidence suggesting that tai chi may be effective for pain control in patients with knee OA. However, the evidence is not convincing for pain reduction or improvement of physical function. Future RCTs should assess larger patient samples for longer treatment periods and use appropriate controls.
本研究旨在评估太极拳治疗骨关节炎有效性的对照临床试验数据。对MEDLINE、AMED、英国护理索引、CINAHL、EMBASE、PsycInfo、2007年第2期《Cochrane图书馆》、英国国家研究注册库和ClinicalTrials.gov、韩国医学数据库、气功与能量数据库以及中国医学数据库（截至2007年6月）进行了系统检索。手工检索包括会议论文集和我们自己的文献库。对出版物语言没有限制。纳入所有针对骨关节炎患者的太极拳对照试验。采用Jadad评分评估方法学质量。五项随机临床试验（RCT）和七项非随机对照临床试验（CCT）符合所有纳入标准。五项RCT评估了太极拳对骨关节炎（OA）疼痛的疗效。两项RCT表明，与常规治疗和膝关节OA的注意力控制方案相比，视觉模拟量表或西安大略和麦克马斯特大学骨关节炎指数（WOMAC）上的疼痛显著减轻。三项RCT未报告多部位疼痛有显著减轻。四项RCT测试了太极拳对身体功能的影响。其中两项RCT表明，与常规治疗或等待名单对照相比，日常生活活动或WOMAC上的身体功能有所改善，而另外两项RCT则未发现这种情况。总之，有一些令人鼓舞的证据表明，太极拳可能对膝关节OA患者的疼痛控制有效。然而，关于疼痛减轻或身体功能改善的证据并不令人信服。未来的RCT应评估更大的患者样本，进行更长疗程的治疗，并使用适当的对照。
