Department of Tuina, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China; Laboratory for Biological Effects of Tuina, State Administration of Traditional Chinese Medicine, Tianjin 300193, China.
Department of Tuina, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300193, China; Laboratory for Biological Effects of Tuina, State Administration of Traditional Chinese Medicine, Tianjin 300193, China.
Complement Ther Med. 2019 Apr;43:109-116. doi: 10.1016/j.ctim.2019.01.021. Epub 2019 Jan 23.
Low back pain (LBP) is one of the most common public health concerns worldwide. Baduanjin is very popular and widely practiced for the management of LBP. This study aims to systematically investigate the efficacy and safety of Baduanjin exercise for patients with LBP.
The PubMed, EMBASE, CENTRAL, Web of Science Core Collection, CBM, CNKI, WANFANG and VIP databases were searched from inception to August 2018 to identify potentially eligible studies. Risk of bias was assessed with the Cochrane collaboration's tool. All statistical analyses were conducted with the RevMan 5.3 software.
Nine studies involving 519 patients were included in this systematic review. Our meta-analysis showed that Baduanjin was associated with a small improvement in pain relief compared with general exercise (MD= -0.50, 95% CI: -0.86 to -0.15, P = 0.005). One trial indicated that Baduanjin was superior to routine drug (ibuprofen) in alleviating pain, and the effect was moderate (MD= -1.04, 95% CI: -1.52 to -0.56, P < 0.0001). A descriptive analysis showed that Baduanjin plus other active treatments (such as massage, suspension, or routine drug plus general exercise) had small to moderate effects on low back pain relief compared with active treatments alone. One trial reported that Baduanjin decreased the Oswestry Disability Index (ODI) score compared with routine drug (MD= -4.92, 95% CI= -7.81 to -2.03, P = 0.0009). Another trial found the combination of Baduanjin and electrotherapy offered better improvement than electrotherapy on back-specific function (MD= -6.03, 95% CI= -8.45 to -3.61, P < 0.00001). Three trials suggested that Baduanjin alone or in combination with other treatments achieved greater effects on the Japanese Orthopaedic Association (JOA) score improvement than other treatments. No adverse event was identified in the only study reporting on safety data.
The present study indicated that Baduanjin is effective for LBP. However, evidence supporting the finding is limited due to the small sample size, potential methodological flaws and significant heterogeneity. More large-scale, well-designed RCTs are warranted.
腰痛（LBP）是全球最常见的公共健康问题之一。八段锦非常流行，被广泛用于治疗腰痛。本研究旨在系统评估八段锦锻炼治疗腰痛的疗效和安全性。
从建库至 2018 年 8 月，检索 PubMed、EMBASE、CENTRAL、Web of Science 核心合集、CBM、CNKI、WANFANG 和 VIP 数据库，以识别可能符合条件的研究。使用 Cochrane 协作偏倚风险评估工具评估偏倚风险。所有统计分析均采用 RevMan 5.3 软件进行。
本系统评价纳入了 9 项研究，共 519 名患者。我们的荟萃分析表明，与一般运动相比，八段锦可略微减轻疼痛（MD=-0.50，95%CI：-0.86 至 -0.15，P=0.005）。一项试验表明，八段锦在缓解疼痛方面优于常规药物（布洛芬），且疗效为中度（MD=-1.04，95%CI：-1.52 至 -0.56，P<0.0001）。描述性分析表明，与单独采用活性治疗相比，八段锦加其他活性治疗（如按摩、悬吊或常规药物加一般运动）对缓解腰痛有小到中度效果。一项试验报告称，与常规药物相比，八段锦降低了 Oswestry 残疾指数（ODI）评分（MD=-4.92，95%CI=-7.81 至 -2.03，P=0.0009）。另一项试验发现，与电疗相比，八段锦联合电疗在改善腰背功能方面效果更好（MD=-6.03，95%CI=-8.45 至 -3.61，P<0.00001）。三项试验表明，与其他治疗相比，单独使用八段锦或联合其他治疗对日本骨科协会（JOA）评分改善的效果更大。唯一报告安全性数据的研究未发现不良事件。
本研究表明，八段锦对腰痛有效。然而，由于样本量小、潜在方法学缺陷和高度异质性，支持这一发现的证据有限。需要更多大规模、设计良好的 RCT 来验证。
