Shepherd-Banigan M, Goldstein K M, Coeytaux R R, McDuffie J R, Goode A P, Kosinski A S, Van Noord M G, Befus D, Adam S, Masilamani V, Nagi A, Williams J W
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA.
Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, 508 Fulton Street, Durham, NC, 27705, USA; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center 6301 Herndon Road, Durham, NC, USA.
Complement Ther Med. 2017 Oct;34:156-164. doi: 10.1016/j.ctim.2017.08.011. Epub 2017 Aug 24.
Vasomotor symptoms (VMS), commonly reported during menopausal transition, negatively affect psychological health and health-related quality of life (HRQoL). While hormone therapy is an effective treatment, its use is limited by concerns about possible harms. Thus, many women with VMS seek nonhormonal, nonpharmacologic treatment options. However, evidence to guide clinical recommendations is inconclusive. This study reviewed the effectiveness of yoga, tai chi and qigong on vasomotor, psychological symptoms, and HRQoL in peri- or post-menopausal women.
MEDLINE, Cochrane Database of Systematic Reviews, EMBASE, CINAHL and the Allied and Complementary Medicine Database were searched. Researchers identified systematic reviews (SR) or RCTs that evaluated yoga, tai chi, or qigong for vasomotor, psychological symptoms, and health-related quality of life (HRQoL) in peri- or post-menopausal women. Data were abstracted on study design, participants, interventions and outcomes. Risk of bias (ROB) was assessed and updated meta-analyses were performed.
We identified one high-quality SR (5 RCTs, 582 participants) and 3 new RCTs (345 participants) published after the SR evaluating yoga for vasomotor, psychological symptoms, and HRQoL; no studies evaluated tai chi or qigong. Updated meta-analyses indicate that, compared to controls, yoga reduced VMS (5 trials, standardized mean difference (SMD) -0.27, 95% CI -0.49 to -0.05) and psychological symptoms (6 trials, SDM -0.32; 95% CI -0.47 to -0.17). Effects on quality of life were reported infrequently. Key limitations are that adverse effects were rarely reported and outcome measures lacked standardization.
Results from this meta-analysis suggest that yoga may be a useful therapy to manage bothersome vasomotor and psychological symptoms.
血管舒缩症状(VMS)在绝经过渡期间普遍存在,会对心理健康和健康相关生活质量(HRQoL)产生负面影响。虽然激素疗法是一种有效的治疗方法,但其使用因对潜在危害的担忧而受到限制。因此,许多有VMS的女性寻求非激素、非药物的治疗选择。然而,指导临床建议的证据并不确凿。本研究回顾了瑜伽、太极拳和气功对围绝经期或绝经后女性血管舒缩症状、心理症状和HRQoL的有效性。
检索了MEDLINE、Cochrane系统评价数据库、EMBASE、CINAHL以及综合与补充医学数据库。研究人员确定了评估瑜伽、太极拳或气功对围绝经期或绝经后女性血管舒缩症状、心理症状和健康相关生活质量(HRQoL)影响的系统评价(SR)或随机对照试验(RCT)。提取了关于研究设计、参与者、干预措施和结果的数据。评估了偏倚风险(ROB)并进行了更新的荟萃分析。
我们确定了一项高质量的SR(5项RCT,582名参与者)以及SR发表后新发表的3项RCT(345名参与者),这些研究评估了瑜伽对血管舒缩症状、心理症状和HRQoL的影响;没有研究评估太极拳或气功。更新的荟萃分析表明,与对照组相比,瑜伽可减轻VMS(5项试验,标准化均差(SMD)-0.27,95%CI-0.49至-0.05)和心理症状(6项试验,SMD-0.32;95%CI-0.47至-0.17)。对生活质量的影响报道较少。主要局限性在于很少报告不良反应且结局测量缺乏标准化。
该荟萃分析的结果表明,瑜伽可能是管理令人烦恼的血管舒缩症状和心理症状的一种有用疗法。