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| 太极拳锻炼防治骨质疏松症效果的Meta 分析 |
| Meta-analysis of Tai Chi in the prevention and treatment of osteoporosis |
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| DOI：10.3969/j.issn.1006.7108.2019.09.015 |
| 中文关键词: 太极拳 骨质疏松症 预防 治疗 骨密度 |
| 英文关键词:Tai Chi osteoporosis prevention treatment bone mineral density |
| 基金项目:国家体育总局中医特色技术在体育运动中的应用（HXKT2017001）;北京地区中医骨科康复服务能力与技术平台规范化建设项目(110019);国家自然科学基金(81774330);国家中医药管理局国家中医临床研究基地业务建设科研专项课题(JDZX2015274) |
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| 中文摘要: |
| 目的 系统评价太极拳预防和治疗骨质疏松症的有效性及安全性。方法 计算机检索所有关于太极拳治疗和预防骨质疏松症的国内外随机对照试验。由2 名研究人员独立进行文献筛选、数据提取和纳入文献评价，用Cochrane协作网提供的偏倚风险评估工具进行质量评价，使用RevMan 5.3 软件进行Meta 分析。结果 共纳入18篇文献，涉及1664例研究。分析结果显示：在改善腰椎和股骨颈骨密度方面，进行太极拳锻炼干预优于无太极拳干预[SMD=0.16, 95% CI (0.01,0.30), P=0.03]、[SMD=0.18, 95% CI (0,0.36), P=0.05]；但尚不能确定太极拳是否能改善股骨大转子和Ward三角的骨密度[SMD=0.30, 95% CI (-0.23,0.83), P=0.27]、[SMD=0.25, 95% CI (-0.03,0.53, P= 0.07 ]；在临床有效率方面，太极拳锻炼优于未行太极拳锻炼[RR=1.53, 95% CI (1.28,1.83), P<0.0001]；对于骨代谢标志物血钙的影响，太极拳锻炼是有效的[SMD=-0.32, 95% CI (-0.60,-0.04), P=0.03]。但血磷和碱性磷酸酶方面，尚不能确定太极拳的有效性[SMD=0.10, 95% CI (-0.18,0.37), P=0.49]、[SMD=0.04, 95% CI (-0.24,0.32), P=0.78]；在安全性方面，太极拳锻炼具有很好的安全性。结论 太极拳锻炼可以有效地改善腰椎和股骨颈的骨密度，提高临床有效率，降低血钙，安全性高，但仍需大量高质量的研究以提供更充足的证据。 |
| 英文摘要: |
| Objective To systematically evaluate the effectiveness and safety of Tai Chi in the prevention and treatment of osteoporosis. Methods Computer-based search for all randomized controlled trials on the treatment and prevention of osteoporosis using Tai Chi. Two researchers independently conducted literature screening, data extraction, and literature review. Quality assessments were performed using the Cochrane risk of bias tool. Meta-analysis was performed using RevMan 5.3 software. Results A total of 18 articles were included and 1 664 cases were studied. The results showed that the intervention of Tai Chi is better than no Tai Chi intervention in terms of bone mineral density in lumbar spine and femoral neck [SMD=0.16, 95% CI (0.01, 0.30), P=0.03], [SMD=0.18, 95% CI (0, 0.36), P=0.05]. In terms of the bone mineral density of greater trochanter of the femur and Ward's triangle, it is unclear whether Tai Chi is superior to no Tai Chi intervention [SMD=0.30, 95% CI (-0.23, 0.83), P=0.27], [SMD=0.25, 95% CI (-0.03, 0.53), P=0.07]. Tai Chi is superior to no Tai Chi intervention in clinical efficiency [RR=1.53, 95% CI (1.28, 1.83), P<0.0001]. In terms of reducing blood calcium, the intervention with Tai Chi is better than no Tai Chi intervention [SMD=-0.32, 95% CI (-0.60,-0.04), P=0.03]. In terms of rising serum phosphorus and alkaline phosphatase, it is not yet clear whether Tai Chi is better than no Tai Chi intervention [SMD=0.10, 95% CI (-0.18, 0.37), P=0.49], [SMD=0.04, 95% CI (-0.24, 0.32), P=0.78]. In terms of safety, Tai Chi exercise has good safety. Conclusion Tai Chi can effectively improve the bone density of the lumbar vertebrae and the neck of the femur, improve clinical efficiency, reduce blood calcium, and have good safety, but it still needs a lot of high quality research to provide more sufficient evidence. |
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