School of Sport Science, Beijing Sport University, 48 Xinxi Road, Haidian District, Beijing, 100084, China.
Sports Med. 2024 Sep;54(9):2327-2355. doi: 10.1007/s40279-024-02046-9. Epub 2024 Jun 14.
Currently, most studies on the health benefits of traditional Chinese exercises on type 2 diabetes mellitus have explored the effects of a single type of traditional Chinese exercise on type 2 diabetes. Although a previous study evaluated the combined clinical effects of traditional Chinese exercises on type 2 diabetes, the studies included in that review were deficient in their study design. In addition, previous studies have not explored the ideal exercise dose that should be taken by patients with type 2 diabetes when performing traditional Chinese exercises.
To understand whether the findings of previous systematic reviews and meta-analyses are still applicable and to try to address the deficiencies in the previous review, this review conducted a meta-analysis of existing randomized controlled trials to investigate the impact of traditional Chinese exercises on glycemic control with type 2 diabetes.
The literature was searched in seven Chinese and English databases. Randomized controlled trials published in English and Chinese, from database inception to March 2023, were included in this review. Two reviewers independently reviewed the search results, extracted the data, and assessed the risk of bias. A meta-analysis of the included studies was conducted using Rev Man 5.4 and Stata 15.1 software. Heterogeneity was investigated using a sensitivity analysis, a subgroup analysis, and a meta-regression analysis. Pre-determined subgroups included the duration of the intervention, frequency of exercise, and duration of the single exercise session.
A total of 31 randomized controlled trials (2077 subjects) were selected in this review. The meta-analysis revealed that traditional Chinese exercises were more effective than control groups in lowering glycated hemoglobin (Z = 6.06; mean difference [MD] = - 0.64, 95% confidence interval [CI] - 0.85, - 0.44; P < 0.00001), fasting blood glucose (Z = 7.81; MD = - 0.82, 95% CI - 1.03, - 0.62; P < 0.00001), 2-h plasma glucose (Z = 5.61; MD = - 1.03, 95% CI - 1.39, - 0.67; P < 0.00001), total cholesterol (Z = 4.23; MD = - 0.37, 95% CI - 0.54, - 0.20; P < 0.0001), high-density lipoprotein cholesterol (Z = 5.94; MD = 0.12, 95% CI 0.08, 0.16; P < 0.00001), low-density lipoprotein cholesterol (Z = 6.20; MD = - 0.34, 95% CI - 0.44, - 0.23; P < 0.00001), and triglyceride levels (Z = 3.74; MD = - 0.44, 95% CI - 0.67, - 0.21; P = 0.0002) among patients with type 2 diabetes.
Traditional Chinese exercises can significantly improve blood glucose and lipid levels in patients with type 2 diabetes. When performing traditional Chinese exercise interventions for type 2 diabetes, it is recommended that exercise programs are designed for 30-50 min/session, 4-5 sessions/week for at least 3 months.
目前，大多数关于中医锻炼对 2 型糖尿病益处的研究都探讨了单一类型的中医锻炼对 2 型糖尿病的影响。尽管之前的一项研究评估了中医锻炼对 2 型糖尿病的综合临床效果，但该综述中包含的研究在研究设计上存在缺陷。此外，以前的研究尚未探讨 2 型糖尿病患者进行中医锻炼时应采用的理想运动剂量。
为了了解以前的系统评价和荟萃分析的结果是否仍然适用，并试图解决以前综述的不足，本研究对现有的随机对照试验进行荟萃分析，以了解中医锻炼对 2 型糖尿病患者血糖控制的影响。
在七个中英文数据库中进行文献检索。纳入本综述的研究为发表于英文和中文数据库、从数据库建立到 2023 年 3 月的随机对照试验。两位评审员独立审查检索结果、提取数据并评估偏倚风险。使用 Rev Man 5.4 和 Stata 15.1 软件对纳入的研究进行荟萃分析。使用敏感性分析、亚组分析和荟萃回归分析来研究异质性。预定的亚组包括干预持续时间、运动频率和单次运动时间。
本综述共纳入 31 项随机对照试验（2077 例受试者）。荟萃分析显示，与对照组相比，中医锻炼更能有效降低糖化血红蛋白（Z=6.06；MD=-0.64，95%置信区间[CI]：-0.85，-0.44；P<0.00001）、空腹血糖（Z=7.81；MD=-0.82，95%CI：-1.03，-0.62；P<0.00001）、2 小时血浆葡萄糖（Z=5.61；MD=-1.03，95%CI：-1.39，-0.67；P<0.00001）、总胆固醇（Z=4.23；MD=-0.37，95%CI：-0.54，-0.20；P<0.0001）、高密度脂蛋白胆固醇（Z=5.94；MD=0.12，95%CI：0.08，0.16；P<0.00001）、低密度脂蛋白胆固醇（Z=6.20；MD=-0.34，95%CI：-0.44，-0.23；P<0.00001）和三酰甘油水平（Z=3.74；MD=-0.44，95%CI：-0.67，-0.21；P=0.0002）。
中医锻炼可显著改善 2 型糖尿病患者的血糖和血脂水平。在为 2 型糖尿病患者设计中医锻炼干预方案时，建议运动方案为每次 30-50 分钟，每周 4-5 次，至少持续 3 个月。
