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四种传统中医运动疗法治疗 2 型糖尿病的系统评价和网络荟萃分析。

Four kinds of traditional Chinese exercise therapy in the treatment of type 2 diabetes: a systematic review and network meta-analysis.

机构信息

College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, China.

College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China.

出版信息

Syst Rev. 2023 Dec 13;12(1):231. doi: 10.1186/s13643-023-02384-1.


DOI:10.1186/s13643-023-02384-1
PMID:38093392
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10717901/
Abstract

OBJECTIVE: To perform an evidence-based evaluation of the clinical efficacy of Taijiquan, Baduanjin, Yijinjing and Wuqinxi in interventions for type 2 diabetes. DESIGN: A systematic review and network meta-analysis. METHODS: The comprehensive search included Chinese and other language databases such as the MEDLINE (PubMed), Web of Science, Excerpta Medica Database (Embase), The Cochrane Library, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, China Scientific Journal Database, VIP and China Biomedical Literature Database (CBM). Clinical randomized controlled trials of four traditional Chinese exercise therapies in the treatment of type 2 diabetes, including Taijiquan, Baduanjin, Yijinjing and Wuqinxi, were retrieved. The search time was conducted from the establishment of the database to 30 October 2022. Two researchers screened the documents that met the inclusion criteria, extracted data according to the preset table and evaluated the methodological quality of the included studies according to the quality evaluation tools recommended by the Cochrane System Reviewer Manual V.5.1. The R language, Stata and ADDIS statistical software programs were used to conduct statistics and analysis of intervention measures. RESULTS: A total of 33 randomized controlled trials with 2609 patients were identified. All patients were from China. The results of the network meta-analysis showed that Taijiquan ranked the best for improving HbA1c, 2-h postprandial blood glucose (2hPG), low-density lipoprotein cholesterol (LDL-C) and insulin sensitivity index indicator levels; Yijinjing reduced fasting plasma glucose (FPG) and total cholesterol (TC) indicator levels for the best probability ranking; Baduanjin improved the triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) probability ranking the most. When the training period was less than 12 weeks, Baduanjin had better effects in improving 2hPG, TC, TG, HDL-C and LDL-C indicator levels. Taijiquan had better effects in reducing FPG levels. When the training period was 12 weeks, the effect of Yijinjing in improving FPG, HbAlc, TC and HDL-C levels was better than that in other traditional Chinese exercise, and Taijiquan had better effects in improving 2hPG, TG and LDL-C indicator levels. When the training period was longer than 12 weeks, Taijiquan had better effects in improving FPG, HbAlc, 2hPG and LDL-C indicator levels, and Baduanjin had better effects in improving TC, TG and HDL-C indicator levels. CONCLUSION: The four traditional Chinese exercise therapies can improve blood glucose levels, blood lipid levels and insulin-related indicators of type 2 diabetes to varying degrees. Studies have shown that Taijiquan has a better targeted treatment effect on type 2 diabetes. SYSTEMATIC REVIEW REGISTRATION: CRD42020214786. PROTOCOL PUBLISHED: We published the protocol article "Network meta-analysis of four kinds of traditional Chinese exercise therapy in the treatment of type 2 diabetes: Protocol for a systematic review" in the BMJ Open magazine 2021, Issue 11, Volume 7.

摘要

目的:对太极拳、八段锦、易筋经和五禽戏治疗 2 型糖尿病的临床疗效进行基于证据的评价。

设计:系统评价和网络荟萃分析。

方法:全面检索包括 MEDLINE(PubMed)、科学引文索引扩展版(Web of Science)、荷兰医学文摘数据库(Embase)、考科蓝图书馆、中国知网、万方数据知识服务平台、中国科学引文数据库、维普中文期刊服务平台和中国生物医学文献数据库(CBM)在内的中文和其他语言数据库,以获取太极拳、八段锦、易筋经和五禽戏四种传统中医运动疗法治疗 2 型糖尿病的临床随机对照试验。检索时间从数据库建立到 2022 年 10 月 30 日。两名研究人员筛选符合纳入标准的文献,根据预设表格提取数据,并根据 Cochrane 系统评价员手册 V.5.1 推荐的质量评估工具评估纳入研究的方法学质量。使用 R 语言、Stata 和 ADDIS 统计软件程序对干预措施进行统计和分析。

结果:共纳入 33 项随机对照试验,涉及 2609 名患者。所有患者均来自中国。网络荟萃分析结果显示,在改善糖化血红蛋白(HbA1c)、餐后 2 小时血糖(2hPG)、低密度脂蛋白胆固醇(LDL-C)和胰岛素敏感指数等指标水平方面,太极拳排名最佳;易筋经在降低空腹血糖(FPG)和总胆固醇(TC)指标水平方面效果最佳;八段锦在改善甘油三酯(TG)和高密度脂蛋白胆固醇(HDL-C)水平方面的概率排名最高。当训练周期小于 12 周时,八段锦在改善 2hPG、TC、TG、HDL-C 和 LDL-C 指标水平方面效果更好。太极拳在降低 FPG 水平方面效果更好。当训练周期为 12 周时,易筋经在改善 FPG、HbA1c、TC 和 HDL-C 水平方面的效果优于其他传统中医运动疗法,太极拳在改善 2hPG、TG 和 LDL-C 指标水平方面的效果优于其他传统中医运动疗法。当训练周期长于 12 周时,太极拳在改善 FPG、HbA1c、2hPG 和 LDL-C 指标水平方面效果更好,八段锦在改善 TC、TG 和 HDL-C 指标水平方面效果更好。

结论:四种传统中医运动疗法均可在一定程度上改善 2 型糖尿病患者的血糖水平、血脂水平和胰岛素相关指标。研究表明,太极拳对 2 型糖尿病具有更好的靶向治疗效果。

系统评价注册:CRD42020214786。

方案已发表:我们于 2021 年在《英国医学杂志开放》杂志第 7 卷第 11 期发表了题为“四种传统中医运动疗法治疗 2 型糖尿病的网络荟萃分析:系统评价方案”的方案文章。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa1/10717901/0065e72e12ba/13643_2023_2384_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa1/10717901/a14ed63ffdaf/13643_2023_2384_Fig1_HTML.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa1/10717901/0065e72e12ba/13643_2023_2384_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa1/10717901/a14ed63ffdaf/13643_2023_2384_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa1/10717901/53e45ce20e83/13643_2023_2384_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa1/10717901/949f7006a71f/13643_2023_2384_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa1/10717901/c86e6bf0348a/13643_2023_2384_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa1/10717901/287afeb32ac9/13643_2023_2384_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9fa1/10717901/0065e72e12ba/13643_2023_2384_Fig6_HTML.jpg

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[3]
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[4]
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本文引用的文献

[1]
IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045.

Diabetes Res Clin Pract. 2022-1

[2]
2. Classification and Diagnosis of Diabetes: .

Diabetes Care. 2019-1

[3]
Physical exercise as therapy for type 2 diabetes mellitus.

Diabetes Metab Res Rev. 2014-3

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