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传统中医易筋经锻炼对类风湿关节炎患者手部功能障碍的影响:一项随机对照试验。

Effect of traditional Chinese Yijinjing exercise on hand dysfunction in rheumatoid arthritis patients: a randomized controlled trial.

作者信息

Chang Tian, Ma Xieli, Gong Xun, Xia Congmin, Jiang Quan, Zhang Rouman

机构信息

Graduate College, Beijing University of Chinese Medicine, Beijing, China.

Department of Medical Affairs, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.

出版信息

Front Med (Lausanne). 2024 Nov 11;11:1454982. doi: 10.3389/fmed.2024.1454982. eCollection 2024.

Abstract

INTRODUCTION

Rheumatoid arthritis (RA) patients often experience significant hand dysfunction. Yijinjing, a traditional Chinese exercise, has been recognized for its benefits to mind-body health. This study aimed to evaluate the efficacy and safety of Yijinjing in improving hand dysfunction among individuals with RA.

METHODS

This research was conducted as a single-center, outcome-blinded, randomized controlled trial. A total of 66 eligible RA participants were randomly assigned in a 1:1 ratio to either the Yijinjing exercise group (YJJG) with sessions conducted three times per week over a 12-week period or the control group (CG), which maintained ordinary activities. Various outcomes were assessed, including the Michigan Hand Outcomes Questionnaire (MHQ), handgrip strength, active range of motion (AROM), RA disease activity, the Health Assessment Questionnaire Disability Index (HAQ-DI), levels of anxiety and depression, and wrist ultrasound, all of which were collected at baseline and the week 12.

RESULTS

At the end of the 12 weeks, the YJJG demonstrated significant improvements in MHQ scores compared to the CG ( < 0.05), alongside enhancements in handgrip strength and AROM, specifically in wrist extension, radial deviation, and metacarpophalangeal flexion ( < 0.05). Wrist ultrasound scores did not exhibit a significant increase in the YJJG, meaning no inflammation aggravation ( > 0.05). Additionally, morning stiffness duration, Disease Activity Score 28-ESR (DAS28-ESR), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels showed significant improvement in the YJJG ( < 0.05). Both groups reported enhancements in quality of life, as well as reductions in anxiety and depression scores, with the YJJG displaying greater improvements overall ( < 0.05). Importantly, no adverse events or significant abnormalities in vital signs were observed in either group.

CONCLUSION

Yijinjing exercise may effectively enhance hand function, handgrip strength, and flexibility in RA patients with low disease activity. Furthermore, it appears to improve quality of life and reduce anxiety and depression without exacerbating joint inflammation.

CLINICAL TRIAL REGISTRATION

https://clinicaltrials.gov/study/NCT05527158, Identifier NCT05527158.

摘要

引言

类风湿关节炎(RA)患者常出现明显的手部功能障碍。易筋经作为一种传统的中国运动,因其对身心健康的益处而得到认可。本研究旨在评估易筋经对改善RA患者手部功能障碍的疗效和安全性。

方法

本研究作为一项单中心、结果盲法、随机对照试验进行。总共66名符合条件的RA参与者以1:1的比例随机分配到易筋经运动组(YJJG),每周进行3次训练,为期12周,或对照组(CG),后者维持日常活动。评估了各种结果,包括密歇根手部结果问卷(MHQ)、握力、主动活动范围(AROM)、RA疾病活动度、健康评估问卷残疾指数(HAQ-DI)、焦虑和抑郁水平以及手腕超声,所有这些均在基线和第12周收集。

结果

在12周结束时,与CG相比,YJJG在MHQ评分方面有显著改善(<0.05),同时握力和AROM增强,特别是在手腕伸展、桡偏和掌指关节屈曲方面(<0.05)。YJJG组手腕超声评分没有显著增加,这意味着没有炎症加重(>0.05)。此外,YJJG组的晨僵持续时间、28-红细胞沉降率疾病活动评分(DAS28-ESR)、红细胞沉降率(ESR)和C反应蛋白(CRP)水平均有显著改善(<0.05)。两组均报告生活质量有所提高,焦虑和抑郁评分有所降低,YJJG组总体改善更大(<0.05)。重要的是,两组均未观察到不良事件或生命体征的显著异常。

结论

易筋经运动可能有效增强疾病活动度较低的RA患者的手部功能、握力和灵活性。此外,它似乎可以改善生活质量,减轻焦虑和抑郁,而不会加重关节炎症。

临床试验注册

https://clinicaltrials.gov/study/NCT05527158,标识符NCT05527158。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3560/11586198/7778764be77e/fmed-11-1454982-g001.jpg

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