传统中医运动对中老年慢性下腰痛患者的疗效及机制:一项系统评价

The effect and mechanism of traditional Chinese exercise for chronic low back pain in middle-aged and elderly patients: A systematic review.

作者信息

Wang Xue-Qiang, Xiong Huan-Yu, Du Shu-Hao, Yang Qi-Hao, Hu Li

机构信息

Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.

Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.

出版信息

Front Aging Neurosci. 2022 Oct 10;14:935925. doi: 10.3389/fnagi.2022.935925. eCollection 2022.

Abstract

BACKGROUND

Increasing lines of evidence indicate that traditional Chinese exercise (TCE) has potential benefits in improving chronic low back pain (CLBP) symptoms. To assess the clinical efficacy of TCE in the treatment of CLBP, we performed a systematic review of existing randomized controlled trials (RCTs) of CLBP and summarized the neural mechanisms underlying TCE in the treatment of CLBP.

METHODS

A systematic search was conducted in four electronic databases: PubMed, Embase, the Cochrane Library, and EBSCO from January 1991 to March 2022. The quality of all included RCTs was evaluated by the Physiotherapy Evidence Database Scale (PEDro). The primary outcomes included pain severity and pain-related disability.

RESULTS

A total of 11 RCTs with 1,256 middle-aged and elderly patients with CLBP were included. The quality of all 11 included RCTs ranged from moderate to high according to PEDro. Results suggested that TCE could considerably reduce pain intensity in patients with CLBP. Overall, most studies did not find any difference in secondary outcomes (quality of life, depression, and sleep quality).

CONCLUSION

The neurophysiological mechanism of TCE for treating CLBP could be linked to meditation and breathing, posture control, strength and flexibility training, and regulation of pain-related brain networks. Our systematic review showed that TCE appears to be effective in alleviating pain in patients with CLBP.

摘要

背景

越来越多的证据表明,传统中医运动对改善慢性下腰痛(CLBP)症状具有潜在益处。为评估传统中医运动治疗CLBP的临床疗效,我们对现有的CLBP随机对照试验(RCT)进行了系统评价,并总结了传统中医运动治疗CLBP的神经机制。

方法

于1991年1月至2022年3月在四个电子数据库中进行系统检索:PubMed、Embase、Cochrane图书馆和EBSCO。所有纳入的RCT的质量均通过物理治疗证据数据库量表(PEDro)进行评估。主要结局包括疼痛严重程度和与疼痛相关的残疾。

结果

共纳入11项RCT,涉及1256例中老年CLBP患者。根据PEDro,所有11项纳入的RCT的质量从中等到高不等。结果表明,传统中医运动可显著降低CLBP患者的疼痛强度。总体而言,大多数研究未发现次要结局(生活质量、抑郁和睡眠质量)有任何差异。

结论

传统中医运动治疗CLBP的神经生理机制可能与冥想和呼吸、姿势控制、力量和柔韧性训练以及疼痛相关脑网络的调节有关。我们的系统评价表明,传统中医运动似乎对缓解CLBP患者的疼痛有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3079/9590689/aede947322b1/fnagi-14-935925-g001.jpg

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