Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Germany.
Complement Ther Med. 2013 Aug;21(4):396-406. doi: 10.1016/j.ctim.2013.06.001. Epub 2013 Jul 1.
This paper aimed to systematically review and meta-analyze the effectiveness of Tai Chi for osteoarthritis of the knee.
MEDLINE, the Cochrane Library, EMBASE, Scopus, PsycInfo and CAMBASE were screened through April 2013. Randomized controlled trials (RCTs) comparing Tai Chi to control conditions were included. Two authors independently assessed risk of bias using the risk of bias tool recommended by the Cochrane Back Review Group. Outcome measures included pain, physical functional, joint stiffness, quality of life, and safety. For each outcome, standardized mean differences and 95% confidence intervals were calculated.
5 RCTs with a total of 252 patients were included. Four studies had a low risk of bias. Analysis showed moderate overall evidence for short-term effectiveness for pain, physical function, and stiffness. Strong evidence was found for short-term improvement of the physical component of quality of life. No long-term effects were observed. Tai Chi therapy was not associated with serious adverse events.
This systematic review found moderate evidence for short-term improvement of pain, physical function and stiffness in patients with osteoarthritis of the knee practicing Tai Chi. Assuming that Tai Chi is at least short-term effective and safe it might be preliminarily recommended as an adjuvant treatment for patients with osteoarthritis of the knee. More high quality RCTs are urgently needed to confirm these results.
本文旨在系统地回顾和荟萃分析太极拳治疗膝骨关节炎的疗效。
通过 2013 年 4 月对 MEDLINE、Cochrane 图书馆、EMBASE、Scopus、PsycInfo 和 CAMBASE 进行筛选，纳入了太极拳与对照条件比较的随机对照试验（RCT）。两位作者使用 Cochrane 背部评价组推荐的风险偏倚工具独立评估风险偏倚。结局指标包括疼痛、身体功能、关节僵硬、生活质量和安全性。对于每个结局，计算了标准化均数差和 95%置信区间。
纳入了 5 项 RCT，共有 252 名患者。四项研究的偏倚风险较低。分析显示，在短期疼痛、身体功能和僵硬方面具有中等程度的总体证据。对于生活质量的身体成分的短期改善，有强有力的证据。没有观察到长期效果。太极拳治疗与严重不良事件无关。
本系统评价发现，对于膝骨关节炎患者练习太极拳，在短期疼痛、身体功能和僵硬方面有中度改善的证据。假设太极拳至少在短期有效且安全，因此可以初步推荐其作为膝骨关节炎患者的辅助治疗方法。需要更多高质量的 RCT 来证实这些结果。
