Hangzhou Normal University, No. 2318,Yuhangtang Rd, Cangqian, Yuhang District, 311121, Hangzhou, Zhejiang Province, People's Republic of China.
Queensland University of Technology, Kelvin Grove, Brisbane, QLD, 4059, Australia.
Support Care Cancer. 2019 Oct;27(10):3701-3716. doi: 10.1007/s00520-019-04911-0. Epub 2019 Jun 24.
PURPOSES: To assess the effects of Tai Chi on quality of life (QOL) of cancer survivors. METHODS: The following databases were searched: PubMed, Cochrane CENTRAL, EBSCO (including MEDLINE, CINAHL, and other databases), ScienceDirect, CNKI, Wangfang Data, and CQVIP until April 25, 2018. Randomized controlled trials (RCTs) published in English or Chinese examining the effects of Tai Chi intervention for cancer survivors were included. The primary outcome was QOL; the secondary outcomes were limb function/muscular strength, immune function indicators, cancer-related fatigue (CRF), and sleep disturbance. Methodological quality was assessed using the Cochrane Risk of Bias tool. Results of RCTs were pooled with mean difference (MD) or standardized mean difference (SMD) with 95% confidence intervals (CI). Quality of evidence for each outcome was assessed with the GRADE system. RESULTS: Twenty-two RCTs were included in this review. Tai Chi improved the physical (SMD 0.34, 95%CI 0.09, 0.59) and mental health (SMD 0.60, 95%CI 0.12, 1.08) domains of quality of life. The intervention improved the limb/muscular function of breast cancer survivors (SMD 1.19, 95%CI 0.63, 1.75) and in mixed samples of cancer survivors reduced the levels of cortisol (MD - 0.09, 95%CI - 0.16, - 0.02), alleviated CRF (SMD - 0.37, 95%CI - 0.70, - 0.04), and promoted sleep (SMD - 0.37, 95%CI - 0.72, - 0.02). CONCLUSION: There is low-level evidence suggesting that Tai Chi improves physical and mental dimensions of QOL and sleep. There is moderate-level evidence suggesting Tai Chi reduces levels of cortisol and CRF and improves limb function. Additional studies with larger sample sizes and with higher-quality RCT designs comparing different regimens of Tai Chi are warranted.
目的:评估太极拳对癌症幸存者生活质量(QOL)的影响。
方法:检索了以下数据库:PubMed、Cochrane 中心、EBSCO(包括 MEDLINE、CINAHL 和其他数据库)、ScienceDirect、CNKI、万方数据和维普网,检索时间截至 2018 年 4 月 25 日。纳入了以英语或中文发表的评估太极拳干预对癌症幸存者影响的随机对照试验(RCT)。主要结局为 QOL;次要结局为肢体功能/肌肉力量、免疫功能指标、癌症相关疲劳(CRF)和睡眠障碍。使用 Cochrane 偏倚风险工具评估 RCT 的方法学质量。使用均数差(MD)或标准化均数差(SMD)及其 95%置信区间(CI)汇总 RCT 的结果。使用 GRADE 系统评估每个结局的证据质量。
结果:本综述纳入了 22 项 RCT。太极拳改善了癌症幸存者的身体(SMD 0.34,95%CI 0.09,0.59)和心理健康(SMD 0.60,95%CI 0.12,1.08)领域的生活质量。该干预措施改善了乳腺癌幸存者的肢体/肌肉功能(SMD 1.19,95%CI 0.63,1.75),并在混合癌症幸存者样本中降低了皮质醇水平(MD -0.09,95%CI -0.16,-0.02),减轻了 CRF(SMD -0.37,95%CI -0.70,-0.04),并促进了睡眠(SMD -0.37,95%CI -0.72,-0.02)。
结论:低水平证据表明,太极拳可改善 QOL 的身体和心理维度以及睡眠。有中等质量证据表明,太极拳可降低皮质醇和 CRF 水平,改善肢体功能。需要进一步开展纳入更多样本量、采用高质量 RCT 设计的研究,比较不同的太极拳方案。
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