Department of Epidemiology and Biostatistics, Sichuan University West China School of Public Health, 610041 Chengdu, China.
J Rehabil Med. 2019 Jun 18;51(6):405-417. doi: 10.2340/16501977-2555.
To systematically synthesize and critically evaluate evidence on the effects of tai chi for patients with type 2 diabetes mellitus.
Seven electronic databases (Wan Fang, SinoMed, China National Knowledge Infrastructure, VIP, PubMed, Embase, and Cochrane Library) were systematically searched from their inception to March 2018.
Randomized controlled trials investigating the effects of tai chi on individuals with type 2 diabetes mellitus were eligible.
Biomedical outcomes (fasting plasma glucose, glycosylated haemoglobin (HbA1c), fasting insulin, insulin resistance, body mass index, total cholesterol, blood pressure) as well as balance and quality of life-related outcomes were extracted independently by 2 reviewers. Stata 12.0 software was used to synthesize data if there was no or moderate heterogeneity across studies. Otherwise, narrative summaries were performed.
A total of 23 studies (25 articles) involving 1,235 patients were included in this meta-analysis. Significant changes in tai chi-related effects were observed in lowering fasting plasma glucose (standardized mean difference; SMD -0.67; 95% confidence interval (95% CI) -0.87 to -0.47; p <0.001), HbA1c (mean difference; MD-0.88%; 95% CI -1.45% to -0.31%; p =0.002) and insulin resistance (MD -0.41; 95% CI -0.78 to -0.04; p = 0.029). Beneficial effects of tai chi were also found in decreasing body mass index (MD -0.82 kg/m2; 95% CI -1.28 to -0.37 kg/m2; p < 0.001) and total cholesterol (SMD -0.59; 95% CI -0.90 to -0.27; p < 0.001). In addition, tai chi reduced blood pressure (systolic blood pressure (MD -10.03 mmHg; 95% CI -15.78 to -4.29 mmHg; p = 0.001), diastolic blood pressure (MD -4.85 mmHg; 95% CI -8.23 to -1.47 mmHg; p = 0.005)) and improved quality of life-related outcomes (physical function (MD 7.07; 95% CI 0.79-13.35; p = 0.027), bodily pain (MD 4.30; 95% CI 0.83-7.77; p = 0.015) and social function (MD 13.84; 95% CI 6.22-21.47; p < 0.001)). However, no impact was exerted on fasting insulin (SMD -0.32; 95% CI -0.71 to 0.07; p = 0.110) or balance (MD 2.71 s; 95% CI -3.29 to 8.71 s; p = 0.376).
Tai chi is effective in controlling biomedical outcomes and improving quality of life-related outcomes in individuals with type 2 diabetes mellitus, although no effects were observed on balance and fasting insulin. Further high-quality research is needed to elucidate the effects of different types of tai chi, the long-term effects of tai chi, the impact on respiratory function, and the association between tai chi and the risk of developing type 2 diabetes mellitus in healthy individuals.
系统综合和批判性评价太极拳对 2 型糖尿病患者的影响的证据。
从建库到 2018 年 3 月，系统检索了 7 个电子数据库（万方、中国生物医学文献服务系统、中国知网、维普、PubMed、Embase 和 Cochrane Library）。
符合条件的随机对照试验研究了太极拳对 2 型糖尿病患者的影响。
由 2 名评审员独立提取生物医学结局（空腹血糖、糖化血红蛋白（HbA1c）、空腹胰岛素、胰岛素抵抗、体重指数、总胆固醇、血压）以及平衡和生活质量相关结局。如果研究之间没有或仅有中度异质性，则使用 Stata 12.0 软件综合数据。否则，进行叙述性总结。
共有 23 项研究（25 篇文章）纳入了 1235 名患者，包括在这项荟萃分析中。太极拳相关效应观察到显著变化，可降低空腹血糖（标准化均数差；SMD -0.67；95%置信区间（95%CI）-0.87 至 -0.47；p <0.001）、糖化血红蛋白（MD -0.88%；95%CI -1.45%至 -0.31%；p = 0.002）和胰岛素抵抗（MD -0.41；95%CI -0.78 至 -0.04；p = 0.029）。还发现太极拳对降低体重指数（MD -0.82 kg/m2；95%CI -1.28 至 -0.37 kg/m2；p <0.001）和总胆固醇（SMD -0.59；95%CI -0.90 至 -0.27；p <0.001）也有有益的作用。此外，太极拳降低血压（收缩压（MD -10.03 mmHg；95%CI -15.78 至 -4.29 mmHg；p = 0.001），舒张压（MD -4.85 mmHg；95%CI -8.23 至 -1.47 mmHg；p = 0.005）和改善生活质量相关结局（身体功能（MD 7.07；95%CI 0.79-13.35；p = 0.027），身体疼痛（MD 4.30；95%CI 0.83-7.77；p = 0.015）和社会功能（MD 13.84；95%CI 6.22-21.47；p <0.001））。然而，空腹胰岛素（SMD -0.32；95%CI -0.71 至 0.07；p = 0.110）或平衡（MD 2.71 s；95%CI -3.29 至 8.71 s；p = 0.376）没有影响。
太极拳在控制 2 型糖尿病患者的生物医学结局和改善生活质量相关结局方面是有效的，尽管对平衡和空腹胰岛素没有影响。需要进一步的高质量研究来阐明不同类型的太极拳、太极拳的长期效果、对呼吸功能的影响以及太极拳与健康个体发生 2 型糖尿病风险之间的关系。
