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太极拳用于慢性病管理:来自随机对照试验荟萃分析的当前证据综合

Tai Chi for Chronic Illness Management: Synthesizing Current Evidence from Meta-Analyses of Randomized Controlled Trials.

机构信息

School of Psychology, Shenzhen University, Shenzhen, China.

College of Mathematics and Statistics, Shenzhen University, Shenzhen, China.

出版信息

Am J Med. 2021 Feb;134(2):194-205.e12. doi: 10.1016/j.amjmed.2020.08.015. Epub 2020 Sep 15.

Abstract

An umbrella review of systematic reviews and meta-analyses of randomized controlled trials (RCTs) was conducted to evaluate the existing evidence of Tai Chi as a mind-body exercise for chronic illness management. MEDLINE/PubMed and Embase databases were searched from inception until March 31, 2019, for meta-analyses of at least two RCTs that investigated health outcomes associated with Tai Chi intervention. Evidence of significant outcomes (P value < 0.05) was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. This review identified 45 meta-analyses of RCTs and calculated 142 summary estimates among adults living with 16 types of chronic illnesses. Statistically significant results (P value < 0.05) were identified for 81 of the 142 outcomes (57.0%), of which 45 estimates presenting 30 unique outcomes across 14 chronic illnesses were supported by high (n = 1) or moderate (n = 44) evidence. Moderate evidence suggests that Tai Chi intervention improved physical functions and disease-specific outcomes compared with nonactive controls and improved cardiorespiratory fitness compared with active controls among adults with diverse chronic illnesses. Between-study heterogeneity and publication bias were observed in some meta-analyses.

摘要

系统评价和荟萃分析的伞式审查,以评估太极拳作为一种身心锻炼在慢性病管理中的现有证据。从开始到 2019 年 3 月 31 日,检索了 MEDLINE/PubMed 和 Embase 数据库,以寻找至少两项 RCT 的荟萃分析,这些 RCT 调查了与太极拳干预相关的健康结果。使用推荐评估、制定和评估(GRADE)系统评估有意义结果(P 值 < 0.05)的证据。这项综述确定了 45 项 RCT 的荟萃分析,并计算了 16 种慢性病患者的 142 项综合估计。在 142 项结果中有 81 项(57.0%)具有统计学意义(P 值 < 0.05),其中 45 项估计提出了 14 种慢性病的 30 个独特结果,这些结果具有高(n = 1)或中等(n = 44)证据支持。中等证据表明,太极拳干预与非活动对照组相比改善了身体功能和特定疾病的结果,与活跃对照组相比改善了不同慢性病患者的心肺健康。在一些荟萃分析中观察到了研究间异质性和发表偏倚。

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