Zhang Jingfang, Weng Jieqiong, Yuan Mengfei, Shen Xingchen, Weng Yayi, Shen Xiaoxu
Department of Cardiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Front Cardiovasc Med. 2023 Oct 2;10:1223677. doi: 10.3389/fcvm.2023.1223677. eCollection 2023.
Traditional Chinese exercises (TCE) are excellent cardiac rehabilitation (CR) training that can effectively improve cardiorespiratory fitness. However, there is no published meta-analysis of TCE on CR in patients with myocardial infarction (MI). Therefore, this study aimed to provide a comprehensive evaluation from multiple perspectives.
This meta-analysis is based on the Cochrane Handbook of Systematic Reviews. Eight databases were searched from the date of database construction to March 15, 2023. Two investigators independently screened the literature and assessed their quality. The meta-analysis was performed with RevMan5.4 software.
A total of 21 articles involving 1,890 patients were included. N-terminal pro-brain natriuretic peptide (NT-proBNP) in the TCE group were lower than the control group (MD = -96.34, 95%CI: -140.69 ∼-51.98, < 0.00001, = 96%), the left ventricular ejection fraction (LVEF) in the TCE group was higher than the control group (MD = 4.58, 95%CI: 3.28-5.88, < 0.00001, = 79%), the left ventricular end diastolic dimension (LVDD) in TCE group was lower than the control group (MD = -3.83, 95%CI: -5.27 ∼-2.38, < 0.00001, = 94%), the left ventricular end systolic diameter (LVESD) in TCE group was lower than the control group (MD = -2.17, 95%CI: -4.10 ∼-0.24, < 0.00001, = 96%), The 6-minute walk test (6MWT) in the TCE group was higher than the control group (MD = 69.60, 95%CI: 34.59-104.60, < 0.00001, = 99%), the oxygen uptake (VO) in the TCE group was higher than the control group (MD = 4.38, 95%CI: 2.25-6.51, < 0.00001, = 94%), the 36-item short form survey (SF-36) in the TCE group was higher than the control group (MD = 13.34, 95%CI: 9.25-17.42, = 0.008, = 75%), the Hamilton Anxiety Scale (HAMA) in the TCE group was lower than the control group (MD = -4.34, 95%CI: -5.18 ∼-3.50, = 1.00, = 0%), the Hamilton Depression Scale (HAMD) in the TCE group was lower than the control group (MD = -3.48, 95%CI: -5.35 ∼-1.61, = 0.0002, = 88%), the incidence of major adverse cardiac events (MACEs) in the TCE group was lower than the control group (RR = 0.31, 95%CI: 0.20-0.47, = 0.52, = 0%). Subgroup analysis revealed differences in TCE types could be a potential source of heterogeneity.
MI patients who used TCE have not only notable improvements in cardiopulmonary function, physical function, quality of life, and emotions but also reduced the incidence of MACEs. Tai Chi might be more efficient than Ba Duan Jin.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023408675.
传统中式锻炼（TCE）是出色的心脏康复（CR）训练方式，能有效提高心肺适能。然而，尚无已发表的关于TCE对心肌梗死（MI）患者心脏康复影响的荟萃分析。因此，本研究旨在从多个角度提供全面评估。
本荟萃分析基于《Cochrane系统评价手册》进行。检索了从数据库建立之日至2023年3月15日的八个数据库。两名研究者独立筛选文献并评估其质量。使用RevMan5.4软件进行荟萃分析。
共纳入21篇文章，涉及1890例患者。TCE组的N末端脑钠肽前体（NT-proBNP）低于对照组（MD = -96.34，95%CI：-140.69 ∼ -51.98，P < 0.00001，I² = 96%），TCE组的左心室射血分数（LVEF）高于对照组（MD = 4.58，95%CI：3.28 - 5.88，P < 0.00001，I² = 79%），TCE组的左心室舒张末期内径（LVDD）低于对照组（MD = -3.83，95%CI：-5.27 ∼ -2.38，P < 0.00001，I² = 94%），TCE组的左心室收缩末期内径（LVESD）低于对照组（MD = -2.17，95%CI：-4.10 ∼ -0.24，P < 0.00001，I² = 96%），TCE组的6分钟步行试验（6MWT）高于对照组（MD = 69.60，95%CI：34.59 - 104.60，P < 0.00001，I² = 99%），TCE组的摄氧量（VO）高于对照组（MD = 4.38，95%CI：2.25 - 6.51，P < 0.00001，I² = 94%），TCE组的36项简短健康调查（SF - 36）高于对照组（MD = 13.34，95%CI：9.25 - 17.42，P = 0.008，I² = 75%），TCE组的汉密尔顿焦虑量表（HAMA）低于对照组（MD = -4.34，95%CI：-5.18 ∼ -3.50，P = 1.00，I² = 0%），TCE组的汉密尔顿抑郁量表（HAMD）低于对照组（MD = -3.48，95%CI：-5.35 ∼ -1.61，P = 0.0002，I² = 88%），TCE组的主要不良心脏事件（MACEs）发生率低于对照组（RR = 0.31，95%CI：0.20 - 0.47，P = 0.52，I² = 0%）。亚组分析显示，TCE类型的差异可能是异质性的一个潜在来源。
采用TCE的MI患者不仅在心肺功能、身体功能、生活质量和情绪方面有显著改善，而且MACEs的发生率降低。太极拳可能比八段锦更有效。
