太极拳对中老年抑郁的影响：一项更新的系统评价和荟萃分析。

AIM: The objective of this study was to evaluate the efficacy of Tai Chi, a mind-body movement therapy originating from China, on depression in middle-aged and older adults. METHODS: A systematic search was conducted in seven databases (Embase, Cochrane, Medline, Wanfang, SinoMed, Weipu date, CNKI) for Randomized Controlled Trials (RCTs) published until Apr 16, 2023. The quality assessment, heterogeneity analysis, subgroup analysis, and sensitivity analysis of 12 RCTs selected from the literature were performed. Meta-analyses were conducted using RevMan 5.4 software. RESULTS: The study included 12 trials comprising 731 participants that met the inclusion criteria. The findings revealed that Tai Chi significantly improved depression in middle-aged and older adults [SMD = -1.21, 95% CI (-1.59, -0.83), I = 87.6%, P < 0.001]. Subgroup analysis revealed that the number of exercise weeks within the specified range, the total duration of exercise, and Tai Chi maneuvers had the greatest benefits on depression in middle-aged and elderly people. The results demonstrated that interventions lasting more than 24 weeks were more effective [SMD = -1.66, 95% CI (-2.28, -1.04), P < 0.05] than those lasting only 12 weeks [SMD = -0.73, 95% CI (-1.08, -0.38), P < 0.05]. The effect size was more significant when the total duration of the intervention was more than 2400 min [SMD = -1.31, 95% CI (-1.71, -0.92), P < 0.001], and when the 24-style Tai Chi exercise was selected [SMD = -1.06, 95% CI (-1.37, -0.75), P < 0.001], the difference was also statistically significant. Funnel plots combined with sensitivity analyses, Begg's and Egger's tests indicated no publication bias. CONCLUSION: The study suggests that Tai Chi can be an alternative therapy for reducing depression in middle-aged and older adults. It is recommended to prolong the Tai Chi exercise period to more than 24 weeks, with a total exercise duration of more than 2400 min, and 24-style Tai Chi should be selected to achieve the best therapeutic effect in middle-aged and older adults with depression. It should be noted that there may be lower-quality studies in the RCT literature analyzed, which may limit the general applicability and credibility of the conclusions.

目的：本研究旨在评估源自中国的身心运动疗法——太极拳对中老年人群抑郁的疗效。

方法：系统检索了 7 个数据库（Embase、Cochrane、Medline、万方、SinoMed、维普、中国知网）截至 2023 年 4 月 16 日发表的随机对照试验（RCT）。对纳入文献进行质量评价、异质性分析、亚组分析和敏感性分析。采用 RevMan 5.4 软件进行荟萃分析。

结果：研究纳入了 12 项符合纳入标准的 RCT，共 731 名参与者。研究结果表明，太极拳可显著改善中老年人群的抑郁症状[SMD=-1.21，95%CI（-1.59，-0.83），I=87.6%，P<0.001]。亚组分析显示，在规定范围内运动周数、运动总时长和太极拳动作对中老年人群抑郁的改善效果最大。结果表明，运动干预时长超过 24 周的效果优于仅 12 周[SMD=-1.66，95%CI（-2.28，-1.04），P<0.05]，运动干预总时长超过 2400 分钟的效果优于运动总时长不超过 2400 分钟[SMD=-1.31，95%CI（-1.71，-0.92），P<0.001]，选择 24 式太极拳运动的效果优于其他运动方式[SMD=-1.06，95%CI（-1.37，-0.75），P<0.001]。漏斗图结合敏感性分析、贝叶斯检验和 Egger 检验表明不存在发表偏倚。

结论：本研究表明，太极拳可以作为治疗中老年人群抑郁的替代疗法。建议将太极拳运动周期延长至 24 周以上，运动总时长超过 2400 分钟，选择 24 式太极拳运动，以达到最佳的治疗效果。需要注意的是，分析中纳入的 RCT 文献可能存在质量较低的研究，这可能限制了结论的普遍适用性和可信度。