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传统身心锻炼对慢性疲劳综合征患者的影响:系统评价和荟萃分析。

Effects of traditional Chinese mind-body exercises for patients with chronic fatigue syndrome: A systematic review and meta-analysis.

机构信息

Department of Tuina, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.

出版信息

J Glob Health. 2023 Nov 24;13:04157. doi: 10.7189/jogh.13.04157.

Abstract

BACKGROUND

Chronic fatigue syndrome (CFS) is a global public health concern. We performed this systematic review of randomised controlled trials (RCTs) to evaluate the effects and safety of traditional Chinese mind-body exercises (TCME) for patients with CFS.

METHODS

We comprehensively searched MEDLINE, Embase, Web of Science, PsycINFO, Cochrane Library, CNKI, VIP databases, and Wanfang Data from inception to October 2022 for eligible RCTs of TCME for CFS management. We used Cochran's Q statistic and I to assess heterogeneity and conducted subgroup analyses based on different types of TCME, background therapy, and types of fatigue. We also assessed the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach.

RESULTS

We included 13 studies (n = 1187) with a maximal follow-up of 12 weeks. TCME included Qigong and Tai Chi. At the end of the treatment, compared with passive control, TCME probably reduces the severity of fatigue (standardised mean differences (SMD) = 0.85; 95% confidence interval (CI) = 0.64, 1.07, moderate certainty), depression (SMD = 0.53; 95% CI = 0.34, 0.72, moderate certainty), anxiety (SMD = 0.29; 95% CI = 0.11, 0.48, moderate certainty), sleep quality (SMD = 0.34; 95% CI = 0.10, 0.57, low certainty) and mental functioning (SMD = 0.90; 95% CI = 0.50, 1.29, low certainty). Compared with other active control therapies, TCME results in little to no difference in the severity of fatigue (SMD = 0.08; 95% CI = -0.18, 0.34, low certainty). For long-term outcomes, TCME may improve anxiety (SMD = 1.74; 95% CI = 0.44, 3.03, low certainty) compared to passive control. We did not identify TCME-related serious adverse events.

CONCLUSIONS

In patients with CFS, TCME probably reduces post-intervention fatigue, depression, and anxiety and may improve sleep quality and mental function compared with passive control, but has limited long-term effects. These findings will help health professionals and patients with better clinical decision-making.

REGISTRATION

PROSPERO: CRD42022329157.

摘要

背景

慢性疲劳综合征(CFS)是一个全球性的公共卫生问题。我们进行了这项系统评价,以评估针对 CFS 患者的传统中医身心锻炼(TCME)的效果和安全性。

方法

我们全面检索了 MEDLINE、Embase、Web of Science、PsycINFO、Cochrane 图书馆、CNKI、VIP 数据库和万方数据,以获取从成立到 2022 年 10 月期间关于 CFS 管理的 TCME 随机对照试验(RCT)的相关信息。我们使用 Cochran's Q 统计量和 I 来评估异质性,并根据不同类型的 TCME、背景治疗和疲劳类型进行亚组分析。我们还使用推荐评估、制定与评价分级(GRADE)方法评估证据质量。

结果

我们纳入了 13 项研究(n=1187),最长随访时间为 12 周。TCME 包括气功和太极拳。在治疗结束时,与被动对照相比,TCME 可能会降低疲劳的严重程度(标准化均数差(SMD)=0.85;95%置信区间(CI)=0.64,1.07,中等确定性)、抑郁(SMD=0.53;95%CI=0.34,0.72,中等确定性)、焦虑(SMD=0.29;95%CI=0.11,0.48,中等确定性)、睡眠质量(SMD=0.34;95%CI=0.10,0.57,低确定性)和心理功能(SMD=0.90;95%CI=0.50,1.29,低确定性)。与其他积极对照疗法相比,TCME 在疲劳严重程度上几乎没有差异(SMD=0.08;95%CI=−0.18,0.34,低确定性)。对于长期结局,与被动对照相比,TCME 可能会改善焦虑(SMD=1.74;95%CI=0.44,3.03,低确定性)。我们未发现与 TCME 相关的严重不良事件。

结论

对于 CFS 患者,与被动对照相比,TCME 可能会降低干预后的疲劳、抑郁和焦虑程度,并且可能会改善睡眠质量和心理功能,但长期效果有限。这些发现将帮助卫生专业人员和患者做出更好的临床决策。

登记号

PROSPERO:CRD42022329157。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59ae/10666566/d3e771d248a6/jogh-13-04157-F1.jpg

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