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气功和太极拳练习对成人慢性下腰痛的影响：随机对照试验的系统评价和荟萃分析

The Effects of Qigong and Tai Chi Exercises on Chronic Low Back Pain in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

作者信息

Sotiropoulos Spyridon, Papandreou Maria, Mavrogenis Andreas, Tsaroucha Athanasia, Georgoudis George

机构信息

Department of Physiotherapy, University of West Attica, Athens, GRC.

Musculoskeletal Physiotherapy Research Laboratory, University of West Attica, Athens, GRC.

出版信息

Cureus. 2025 May 18;17(5):e84342. doi: 10.7759/cureus.84342. eCollection 2025 May.

DOI:10.7759/cureus.84342
PMID:40530198
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12173434/
Abstract

Qigong and Tai Chi are mind-body exercises that may provide therapeutic benefits for individuals with chronic low back pain (CLBP), yet their efficacy remains uncertain. This systematic review and meta-analysis assessed their effects on pain and disability in individuals with CLBP. Randomized controlled trials (RCTs) evaluating Qigong or Tai Chi for CLBP were included. A systematic search was conducted in MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, Physiotherapy Evidence Database (PEDro), and the Cochrane Library up to September 2023. Pain and disability were the primary outcomes. Risk of bias (RoB) was assessed independently by two reviewers using Cochrane's RoB 2 tool. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach was used to assess the certainty of the evidence. Eight RCTs (n = 729 adults, age range 31.5-73 years, intervention duration 4-24 weeks) were included. Meta-analysis was performed using a random-effects model, with heterogeneity quantified via I² statistics. Eight RCTs (n = 729 participants) were included. Qigong and Tai Chi significantly reduced pain intensity (standardized mean difference (SMD) = -1.07, 95%CI: -1.64 to -0.49, I² = 93%) and disability (SMD = -0.77, 95%CI: -1.39 to -0.15, I² = 93%) compared to control groups. Subgroup analyses suggested greater effect sizes against passive controls (SMD = -1.17, 95%CI: -1.91 to -0.43, I² = 90%) than against active controls (SMD = -0.98, 95%CI: -1.95 to -0.01, I² = 95%). Limitations include substantial heterogeneity among studies and imprecision in effect estimates. The certainty of evidence was rated moderate to high. Qigong and Tai Chi appear effective in reducing pain and disability in individuals with CLBP. However, substantial heterogeneity and the lack of direct comparisons with structured exercise programs necessitate further high-quality RCTs to confirm their long-term effectiveness.

摘要

气功和太极拳是身心锻炼方式，可能对慢性下腰痛（CLBP）患者具有治疗益处，但其疗效仍不确定。本系统评价和荟萃分析评估了它们对CLBP患者疼痛和功能障碍的影响。纳入了评估气功或太极拳治疗CLBP的随机对照试验（RCT）。截至2023年9月，在MEDLINE（医学文献分析与检索系统在线）、Embase、物理治疗证据数据库（PEDro）和Cochrane图书馆进行了系统检索。疼痛和功能障碍是主要结局。由两名评价者使用Cochrane的RoB 2工具独立评估偏倚风险（RoB）。采用GRADE（推荐分级评估、制定与评价）方法评估证据的确定性。纳入了8项RCT（n = 729名成年人，年龄范围31.5 - 73岁，干预持续时间4 - 24周）。使用随机效应模型进行荟萃分析，通过I²统计量对异质性进行量化。纳入了8项RCT（n = 729名参与者）。与对照组相比，气功和太极拳显著降低了疼痛强度（标准化均数差（SMD）= -1.07，95%CI：-1.64至-0.49，I² = 93%）和功能障碍（SMD = -0.77，95%CI：-1.39至-0.15，I² = 93%）。亚组分析表明，与被动对照组相比（SMD = -1.17，95%CI：-1.91至-0.43，I² = 90%），对主动对照组的效应量更大（SMD = -0.98，95%CI：-1.95至-0.01，I² = 95%）。局限性包括研究间存在大量异质性以及效应估计不精确。证据的确定性被评为中等至高。气功和太极拳似乎对减轻CLBP患者的疼痛和功能障碍有效。然而，大量异质性以及缺乏与结构化运动项目的直接比较，需要进一步开展高质量的RCT来证实其长期有效性。

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