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太极拳和气功预防中风及中风风险因素的疗效:一项系统评价与荟萃分析

Efficacy of Tai Chi and qigong for the prevention of stroke and stroke risk factors: A systematic review with meta-analysis.

作者信息

Lauche Romy, Peng Wenbo, Ferguson Caleb, Cramer Holger, Frawley Jane, Adams Jon, Sibbritt David

机构信息

Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM) Faculty of Health, Centre for Cardiovascular and Chronic Care, University of Technology Sydney, Sydney, NSW, Australia Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany.

出版信息

Medicine (Baltimore). 2017 Nov;96(45):e8517. doi: 10.1097/MD.0000000000008517.

Abstract

BACKGROUND

This review aims to summarize the evidence of Tai Chi and qigong interventions for the primary prevention of stroke, including the effects on populations with major stroke risk factors.

METHODS

A systematic literature search was conducted on January 16, 2017 using the PubMed, Scopus, Cochrane Library, and CINAHL databases. Randomized controlled trials examining the efficacy of Tai Chi or qigong for stroke prevention and stroke risk factors were included. Risk of bias was assessed using the Cochrane Risk of Bias tool.

RESULTS

Twenty-one trials with n = 1604 patients with hypertension, hyperlipidaemia, diabetes, overweight or obesity, or metabolic syndrome were included. No trials were found that examined the effects of Tai Chi/qigong on stroke incidence. Meta-analyses revealed significant, but not robust, benefits of Tai Chi/qigong over no interventions for hypertension (systolic blood pressure: -15.55 mm Hg (95% CI: -21.16; -9.95); diastolic blood pressure: -10.66 mm Hg (95% CI: -14.90, -6.43); the homeostatic model assessment (HOMA) index (-2.86%; 95% CI: -5.35, -0.38) and fasting blood glucose (-9.6 mg/dL; 95% CI: -17.28, -1.91), and for the body mass index compared with exercise controls (-1.65 kg/m; 95% CI: -3.11, -0.20). Risk of bias was unclear or high for the majority of trials and domains, and heterogeneity between trials was high. Only 6 trials adequately reported safety. No recommendation for the use of Tai Chi/qigong for the prevention of stroke can be given.

CONCLUSION

Although Tai Chi and qigong show some potential more robust studies are required to provide conclusive evidence on the efficacy and safety of Tai Chi and qigong for reducing major stroke risk factors.

摘要

背景

本综述旨在总结太极拳和气功干预对中风一级预防的证据,包括对具有主要中风风险因素人群的影响。

方法

于2017年1月16日使用PubMed、Scopus、Cochrane图书馆和CINAHL数据库进行了系统的文献检索。纳入了检验太极拳或气功对中风预防及中风风险因素疗效的随机对照试验。使用Cochrane偏倚风险工具评估偏倚风险。

结果

纳入了21项试验,涉及n = 1604例患有高血压、高脂血症、糖尿病、超重或肥胖或代谢综合征的患者。未发现有试验研究太极拳/气功对中风发病率的影响。荟萃分析显示,与无干预措施相比,太极拳/气功对高血压(收缩压:-15.55 mmHg(95%置信区间:-21.16;-9.95);舒张压:-10.66 mmHg(95%置信区间:-14.90,-6.43))、稳态模型评估(HOMA)指数(-2.86%;95%置信区间:-5.35,-0.38)和空腹血糖(-9.6 mg/dL;95%置信区间:-17.28,-1.91)有显著但不稳固的益处,与运动对照组相比,对体重指数也有显著但不稳固的益处(-1.65 kg/m;95%置信区间:-3.11,-0.20)。大多数试验和领域的偏倚风险不明确或较高,试验之间的异质性也较高。只有6项试验充分报告了安全性。无法给出使用太极拳/气功预防中风的建议。

结论

尽管太极拳和气功显示出一些潜力,但需要更有力可靠的研究来提供关于太极拳和气功降低主要中风风险因素的疗效和安全性的确凿证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0ac3/5690748/6282c5345361/medi-96-e8517-g002.jpg

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