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太极拳对慢性病患者健康相关生活质量的影响:随机对照试验的系统评价

Effects of Tai Chi on health related quality of life in patients with chronic conditions: a systematic review of randomized controlled trials.

作者信息

Li Guichen, Yuan Hua, Zhang Wei

机构信息

School of Nursing, Jilin University, PR China.

School of Nursing, Jilin University, PR China.

出版信息

Complement Ther Med. 2014 Aug;22(4):743-55. doi: 10.1016/j.ctim.2014.06.003. Epub 2014 Jun 28.

Abstract

OBJECTIVES

To determine the effects of Tai Chi practice on health related quality of life in patients with various chronic medical conditions.

BACKGROUND

One of the characters of chronic illness is life-long condition with the deterioration in health related quality of life. Tai Chi has become a popular mind-body exercise and self-management strategy for patients with chronic conditions regarding its various physical and psychological effects.

METHODS

Eight databases (the Cochrane Library, PubMed, Medline, EBSCO, Web of science and three Chinese databases: CNKI, Wanfang data and VIP) were searched (up to December 2013) for relevant studies. Studies including participants with chronic conditions were selected. All studies were randomized controlled trials reporting the effects of Tai Chi on health related quality of life. Two independent reviewers extracted trial data and assessed risk of bias using the risk of bias tool recommended by the Cochrane Back Review Group.

RESULTS

Of the 2021 papers which were screened, 21 studies including 1200 patients met the eligibility criteria. Most studies (18 of 21 studies) found significant improvements on health related quality of life for participants with chronic conditions in Tai Chi group. No evidence was observed to suggest that Tai Chi was more effective than other types of exercise. And objective measures were not always consistent with self-reported quality of life measures.

CONCLUSIONS

Tai Chi appears to be safe and has positive effects on health related quality of life in patients with chronic conditions, especially for patients with disorders in Cardio-cerebrovascular and respiratory systems, and musculoskeletal system. However, as the delivery mood of Tai Chi provides multiply benefits, which part of the group provides the most benefit in improving quality of life is unclear. Due to the design limitations of previous studies, more larger and well-designed RCTs are needed to confirm the effects. And qualitative researches are warranted to explore how Tai Chi may work exactly from patients' own perspectives.

摘要

目的

确定太极拳练习对患有各种慢性疾病患者健康相关生活质量的影响。

背景

慢性病的特点之一是终身患病且健康相关生活质量下降。太极拳因其各种生理和心理效应,已成为慢性病患者流行的身心锻炼和自我管理策略。

方法

检索了八个数据库(考克兰图书馆、PubMed、Medline、EBSCO、科学网以及三个中文数据库:中国知网、万方数据和维普)(截至2013年12月)以查找相关研究。纳入了包括慢性病患者的研究。所有研究均为随机对照试验,报告了太极拳对健康相关生活质量的影响。两名独立评审员提取试验数据,并使用考克兰回顾组推荐的偏倚风险工具评估偏倚风险。

结果

在筛选的2021篇论文中,21项研究(包括1200名患者)符合纳入标准。大多数研究(21项研究中的18项)发现,太极拳组慢性病患者的健康相关生活质量有显著改善。没有证据表明太极拳比其他类型的运动更有效。客观测量结果并不总是与自我报告的生活质量测量结果一致。

结论

太极拳似乎是安全的,对慢性病患者的健康相关生活质量有积极影响,尤其是对心血管和呼吸系统以及肌肉骨骼系统疾病患者。然而,由于太极拳的练习方式具有多种益处,尚不清楚哪一部分人群在改善生活质量方面获益最大。由于既往研究的设计局限性,需要更多更大规模且设计良好的随机对照试验来证实其效果。并且有必要进行定性研究,从患者自身角度探索太极拳究竟是如何起作用的。

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