State Key Laboratory of Respiratory Disease, First Affiliated Hospital, Guangzhou Medical College, 151 Yanjiang Road, Guangzhou 510120, PR China.
Eur J Heart Fail. 2013 Mar;15(3):316-23. doi: 10.1093/eurjhf/hfs170. Epub 2012 Oct 25.
Whether Tai Chi (TC) is effective in the cardiac rehabilitation of patients with chronic heart failure (CHF) remains controversial. We performed a meta-analysis to examine the effects of TC on exercise capacity and quality of life (QoL) in CHF patients.
PubMed and EMBASE databases were searched (up to May 2012) for relevant studies. Studies including participants with reduced left ventricular systolic function (ejection fraction ≤ 45%) were selected. Interventions considered were TC with or without comparisons (education or usual care). Weighted mean differences (WMDs) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using the I(2) test. Four randomized controlled trials (RCTs) (n = 242) met the inclusion criteria. TC significantly improved QoL (WMD -14.54 points; 95% CI -23.45 to -5.63). TC was not associated with a significant reduction in N-terminal pro brain natriuretic peptide (WMD -61.16 pg/mL; 95% CI -179.27 to 56.95), systolic blood pressure (WMD -1.06 mmHg; 95% CI -13.76 to 11.63), diastolic blood pressure (WMD -0.08 mmHg; 95% CI -3.88 to 3.73), improved 6 min walking distance (WMD 46.73 m; 95% CI -1.62 to 95.09), or peak oxygen uptake (WMD 0.19 mL/kg/min; 95% CI -0.74 to 1.13).
TC may improve QoL in patients with CHF and could be considered for inclusion in cardiac rehabilitation programmes. However, there is currently a lack of evidence to support TC altering other important clinical outcomes. Further larger RCTs are urgently needed to investigate the effects of TC.
太极拳（TC）是否对慢性心力衰竭（CHF）患者的心脏康复有效仍存在争议。我们进行了一项荟萃分析，以检验 TC 对 CHF 患者运动能力和生活质量（QoL）的影响。
检索了 PubMed 和 EMBASE 数据库（截至 2012 年 5 月）以获取相关研究。选择包括左心室收缩功能降低（射血分数≤45%）患者的研究。考虑的干预措施包括 TC 加或不加对照（教育或常规护理）。计算了加权均数差值（WMD）和 95%置信区间（CI），并使用 I(2)检验评估异质性。四项随机对照试验（RCT）（n=242）符合纳入标准。TC 显著改善了 QoL（WMD-14.54 分；95%CI-23.45 至-5.63）。TC 与 N 端脑利钠肽前体（WMD-61.16pg/ml；95%CI-179.27 至 56.95）、收缩压（WMD-1.06mmHg；95%CI-13.76 至 11.63）、舒张压（WMD-0.08mmHg；95%CI-3.88 至 3.73）、6 分钟步行距离（WMD 46.73m；95%CI-1.62 至 95.09）或峰值摄氧量（WMD 0.19ml/kg/min；95%CI-0.74 至 1.13）的改善均无显著相关性。
TC 可能改善 CHF 患者的 QoL，可以考虑将其纳入心脏康复计划。然而，目前缺乏证据支持 TC 改变其他重要临床结局。迫切需要进一步的大型 RCT 来研究 TC 的影响。
