School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Public Health. 2023 Feb 23;11:1139483. doi: 10.3389/fpubh.2023.1139483. eCollection 2023.
With the development of rehabilitation medicine, exercise therapy has gradually become one of the methods to prevent and treat cardiovascular diseases. It is widely used in clinic because it can further reduce the mortality rate, improve clinical symptoms, restore the activity ability of the body, improve the quality of life of patients and reduce the hospitalization rate. Traditional Chinese exercises have developed rapidly in recent years, which mainly include Baduanjin, Tai Ji, etc. However, meta-analyses of all types of exercises are not well characterized.
To evaluate the effect of traditional Chinese exercises (TCEs) on the rehabilitation of patients with chronic heart failure (CHF) using a meta-analysis.
A systematic search of randomized controlled trials (RCTs) on TCEs for patients with CHF in 13 databases (PubMed, China National Knowledge Infrastructure, etc.). Meta-analysis was performed using Review Manager software (version 5.3) after two investigators independently screened the studies, assessed the quality of the studies, and extracted the data.
Meta-analysis of 21 randomized controlled trials which involved 1,665 patients with chronic heart failure showed that practicing TCEs was effective in improving patients' physiological outcomes such as VOmax [MD = 2.14, 95% CI (1.02, 3.26), < 0.001], AT [MD = 1.61, 95% CI (1.06, 2.16), < 0.001], and left ventricular ejection fraction [MD = 2.60, 95% CI (1.17, 4.02), < 0.001]. Non-physiological outcomes benefited from the application of TCEs: 6-min walking distance [MD = 38.55, 95% CI (36.67, 40.42), < 0.001], quality of life [MD = 5.52, 95% CI (3.17, 7.88), < 0.001], and single-item TCM symptom scores in CHF patients: tiredness and fatigue [MD = 0.78, 95% CI (0.03, 1.53), = 0.04], shortness of breath [MD = 0.44,95% CI (0.26, 0.62), < 0.0001], facial puffiness and limb swelling [MD = 0.44,95% CI (0.12, 0.76), = 0.007], palpitations [MD = 0.68,95% CI (0.14, 1.21), = 0.01] were improved.
TCEs improved several recovery indicators, heart failure-related clinical symptoms, quality of life, and physiological indicators in patients with CHF. It is worthwhile to expand the participants for practical application in clinical practice, but the existing evidence is insufficient and the heterogeneity of outcome is large. Therefore, more high-quality clinical trials are needed to support these results.
PROSPERO, identifier [CRD42022383246].
随着康复医学的发展，运动疗法已逐渐成为预防和治疗心血管疾病的方法之一。由于它可以进一步降低死亡率、改善临床症状、恢复身体活动能力、提高患者生活质量并降低住院率，因此在临床上得到广泛应用。近年来，中医运动疗法发展迅速，主要包括八段锦、太极拳等。然而，对各种运动疗法的荟萃分析尚不完善。
采用荟萃分析评价中医运动疗法（TCEs）对慢性心力衰竭（CHF）患者康复的影响。
系统检索PubMed、中国知网等 13 个数据库中关于 TCEs 治疗 CHF 患者的随机对照试验（RCTs）。两名研究者独立筛选研究、评估研究质量并提取数据后，采用 Review Manager 软件（版本 5.3）进行荟萃分析。
对 21 项 RCT 进行荟萃分析，共纳入 1665 例慢性心力衰竭患者，结果显示，进行 TCEs 锻炼可有效改善患者的生理结局，如最大摄氧量（VOmax）[MD = 2.14，95% CI（1.02，3.26），<0.001]、无氧阈（AT）[MD = 1.61，95% CI（1.06，2.16），<0.001]和左心室射血分数[MD = 2.60，95% CI（1.17，4.02），<0.001]。非生理结局也从 TCEs 的应用中受益：6 分钟步行距离[MD = 38.55，95% CI（36.67，40.42），<0.001]、生活质量[MD = 5.52，95% CI（3.17，7.88），<0.001]，以及中医单项症状评分：疲倦乏力[MD = 0.78，95% CI（0.03，1.53），= 0.04]、呼吸困难[MD = 0.44，95% CI（0.26，0.62），<0.0001]、面部浮肿和四肢肿胀[MD = 0.44，95% CI（0.12，0.76），= 0.007]、心悸[MD = 0.68，95% CI（0.14，1.21），= 0.01]等均得到改善。
TCEs 改善了 CHF 患者的多项恢复指标、心力衰竭相关临床症状、生活质量和生理指标。值得扩大参与者范围，将其实际应用于临床实践，但现有证据不足，结局异质性较大。因此，需要更多高质量的临床试验来支持这些结果。
PROSPERO，标识符 [CRD42022383246]。
