Yang Yan, Qiu Wei Qing, Hao Yan Lei, Lv Zhan Yun, Jiao Shu Ji, Teng Jun Feng
Department of Neurology, Affiliated Hospital of Jining Medical University, Jining, Shandong, China.
Department of Neurology, Laizhou People's Hospital of Shangdong, Laizhou, Shandong, China; Binzhou Medical University Hospital, Binzhou, Shandong, China.
PLoS One. 2015 Apr 1;10(4):e0122469. doi: 10.1371/journal.pone.0122469. eCollection 2015.
Several studies assessed the efficacy of traditional Chinese medical exercise in the management of Parkinson's disease (PD), but its role remained controversial. Therefore, the purpose of this systematic review is to evaluate the evidence on the effect of traditional Chinese medical exercise for PD.
Seven English and Chinese electronic databases, up to October 2014, were searched to identify relevant studies. The PEDro scale was employed to assess the methodological quality of eligible studies. Meta-analysis was performed by RevMan 5.1 software.
Fifteen trials were included in the review. Tai Chi and Qigong were used as assisting pharmacological treatments of PD in the previous studies. Tai Chi plus medication showed greater improvements in motor function (standardized mean difference, SMD, -0.57; 95% confidence intervals, CI, -1.11 to -0.04), Berg balance scale (BBS, SMD, -1.22; 95% CI -1.65 to -0.80), and time up and go test (SMD, -1.06; 95% CI -1.44 to -0.68). Compared with other therapy plus medication, Tai Chi plus medication also showed greater gains in motor function (SMD, -0.78; 95% CI -1.46 to -0.10), BBS (SMD, -0.99; 95% CI -1.44 to -0.54), and functional reach test (SMD, -0.77; 95% CI -1.51 to -0.03). However, Tai Chi plus medication did not showed better improvements in gait or quality of life. There was not sufficient evidence to support or refute the effect of Qigong plus medication for PD.
In the previous studies, Tai Chi and Qigong were used as assisting pharmacological treatments of PD. The current systematic review showed positive evidence of Tai Chi plus medication for PD of mild-to-moderate severity. So Tai Chi plus medication should be recommended for PD management, especially in improving motor function and balance. Qigong plus medication also showed potential gains in the management of PD. However, more high quality studies with long follow-up are warrant to confirm the current findings.
多项研究评估了中医运动疗法对帕金森病（PD）的疗效，但其作用仍存在争议。因此，本系统评价的目的是评估中医运动疗法对PD疗效的证据。
检索截至2014年10月的7个英文和中文电子数据库，以识别相关研究。采用PEDro量表评估纳入研究的方法学质量。使用RevMan 5.1软件进行荟萃分析。
本评价纳入了15项试验。太极拳和气功在既往研究中被用作PD的辅助药物治疗。太极拳联合药物治疗在运动功能（标准化均数差，SMD，-0.57；95%置信区间，CI，-1.11至-0.04）、伯格平衡量表（BBS，SMD，-1.22；95%CI -1.65至-0.80）以及计时起立行走测试（SMD，-1.06；95%CI -1.44至-0.68）方面显示出更大改善。与其他疗法联合药物治疗相比，太极拳联合药物治疗在运动功能（SMD，-0.78；95%CI -1.46至-0.10）、BBS（SMD，-0.99；95%CI -1.44至-0.54）以及功能性伸展测试（SMD，-0.77；95%CI -1.51至-0.03）方面也显示出更大改善。然而，太极拳联合药物治疗在步态或生活质量方面未显示出更好的改善。没有足够的证据支持或反驳气功联合药物治疗对PD的疗效。
在既往研究中，太极拳和气功被用作PD的辅助药物治疗。当前的系统评价显示了太极拳联合药物治疗对轻度至中度PD的积极证据。因此，应推荐太极拳联合药物治疗用于PD管理，尤其是在改善运动功能和平衡方面。气功联合药物治疗在PD管理中也显示出潜在益处。然而，需要更多高质量、长期随访的研究来证实当前的研究结果。
