Huang Jinke, Qin Xiaohui, Shen Min, Xu Yanjuan, Huang Yong
The Second Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
Front Cardiovasc Med. 2021 Mar 18;8:589267. doi: 10.3389/fcvm.2021.589267. eCollection 2021.
Tai chi (TC) is a popular form of exercise among adults with chronic heart failure (CHF), yet services are greatly underutilized. The aim of the current study was to identify and summarize the existing evidence and to systematically determine the clinical effectiveness of Tai Chi in the management of CHF using a systematic overview. Both English and Chinese databases were searched for systematic reviews (SRs)/meta-analyses (MAs) on TC for CHF from their inception to June 2020. The methodological quality, reporting quality, and risk of bias of SRs/MAs were assessed using Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, and Risk of Bias in Systematic reviews (ROBIS), respectively. The evidence quality of outcome measures was assessed by the Grades of Recommendations, Assessment, Development and Evaluation (GRADE). Six SRs/MAs using a quantitative synthesis to assess various outcomes of TC in CHF were included in this overview. The methodological quality, reporting quality and risk of bias of the SRs/MAs and the evidence quality of the outcome measures are generally unsatisfactory. The limitations of the past SRs/MAs included the lack of either the protocol or registration, the list of excluded studies, and the computational details of meta-analysis were inadequately reported. The critical problems were that qualitative data synthesis relied on trials with small sample sizes and critical low quality. TC may be a promising complementary treatment for CHF. However, further rigorous and comprehensive SRs/MAs and RCTs are required to provide robust evidence for definitive conclusions.
太极拳（TC）是慢性心力衰竭（CHF）成人中一种流行的运动形式，但服务的利用率却很低。本研究的目的是识别和总结现有证据，并通过系统综述系统地确定太极拳在CHF管理中的临床效果。检索了英文和中文数据库，以查找从数据库建立到2020年6月关于太极拳治疗CHF的系统评价（SRs）/荟萃分析（MAs）。分别使用《系统评价方法学质量评估2》（AMSTAR-2）、《系统评价和荟萃分析优先报告项目》（PRISMA）清单以及《系统评价中的偏倚风险》（ROBIS）评估SRs/MAs的方法学质量、报告质量和偏倚风险。结局指标的证据质量通过推荐分级、评估、制定和评价（GRADE）进行评估。本综述纳入了六项使用定量综合方法评估太极拳对CHF各种结局的SRs/MAs。SRs/MAs的方法学质量、报告质量和偏倚风险以及结局指标的证据质量总体上不尽人意。过去SRs/MAs的局限性包括缺乏方案或注册信息、排除研究列表，且荟萃分析的计算细节报告不足。关键问题是定性数据综合依赖于样本量小且质量极低的试验。太极拳可能是CHF一种有前景的辅助治疗方法。然而，需要进一步进行严格和全面的SRs/MAs及随机对照试验（RCTs），以提供有力证据得出明确结论。
