[1]邓叶龙,孔令俊,刘朝晖,等.太极拳锻炼防治骨质疏松症的Meta分析[J].中医正骨,2021,33(02):44-50.
　DENG Yelong,KONG Lingjun,LIU Zhaohui,et al.Tai Chi Chuan exercises for prevention and treatment of osteoporosis:a meta analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(02):44-50.
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太极拳锻炼防治骨质疏松症的Meta分析()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第33卷
期数:
2021年02期
页码:
44-50
栏目:
文献研究
出版日期:
2021-02-20

文章信息/Info

Title:
Tai Chi Chuan exercises for prevention and treatment of osteoporosis:a meta analysis
作者:
邓叶龙1; 孔令俊2; 刘朝晖2; 李兴国2; 杨德龙2; 王晨亮1; 黄晓焱1; 袁剑1; 陈文丽1; 常旭东2
(1.甘肃中医药大学,甘肃 兰州 730000; 2.甘肃省中医院,甘肃 兰州 730050)
Author(s):
DENG Yelong1; KONG Lingjun2; LIU Zhaohui2; LI Xingguo2; YANG Delong2; WANG Chenliang1; HUANG Xiaoyan1; YUAN Jian1; CHEN Wenli1; CHANG Xudong2
1.Gansu University of Chinese Medicine,Lanzhou 730000,Gansu,China2.Gansu Provincial Hospital of TCM,Lanzhou 730050,Gansu,China
关键词:
太极;  骨质疏松;  Meta分析;  系统评价
Keywords:
Tai Ji;  osteoporosis;  meta-analysis;  systematic review
摘要:
目的:评价太极拳锻炼防治骨质疏松症的有效性。方法:计算机检索PubMed、Web of science、The Cochrane Library、Embase、中国生物医学文献数据库、维普网、万方数据库、中国知网收录的太极拳锻炼防治骨质疏松症的随机对照试验文献,检索时限为建库至2020年7月15日。对照组不干预或口服常规抗骨质疏松药物,试验组在对照组的基础上联合太极拳锻炼干预。由2名研究人员独立检索、筛选文献,提取资料并评价纳入研究的偏倚风险。采用Revman5.3软件进行Meta分析。结果:共纳入18篇文献。Meta分析结果显示,试验组腰椎骨密度改善程度优于对照组[I2=0%,P=0.960; SMD=0.17,95%CI(0.01,0.33),P=0.030],股骨颈骨密度改善程度优于对照组[I2=0%,P=0.910; SMD=0.24,95%CI(0.09,0.38),P=0.001],Ward三角骨密度改善程度优于对照组[I2=0%,P=0.730; SMD=0.21,95%CI(-0.00,0.43),P=0.050],2组患者股骨大转子骨密度改善程度的差异无统计学意义[I2=0%,P=0.720; SMD=0.14,95%CI(-0.08,0.36),P=0.210]; 2组患者的跟骨超声振幅衰减改善程度、跟骨骨质指数改善程度比较,组间差异均无统计学意义[I2=0%,P=0.980; SMD=0.13,95%CI(-0.24,0.50),P=0.490; I2=0%,P=0.940; SMD=0.11,95%CI(-0.26,0.47),P=0.570]; 试验组跟骨超声传播速度改善程度优于对照组[I2=0%,P=0.980; SMD=0.50,95%CI(-0.13,0.87),P=0.009]; 试验组血清钙浓度改善程度优于对照组[I2=0%,P=0.860; SMD=-0.33,95%CI(-0.58,-0.07),P=0.010]; 2组患者的血清磷浓度和血清碱性磷酸酶浓度改善程度比较,组间差异均无统计学意义[I2=0%,P=0.980; SMD=0.09,95%CI(-0.16,0.34),P=0.480; I2=0%,P=0.610; SMD=-0.01,95%CI(-0.27,0.24),P=0.930]; 试验组的治疗有效率高于对照组[I2=0%,P=0.680; RR=11.74,95%CI(3.71,37.17),P=0.000]。利用股骨颈骨密度作发表偏倚分析,结果显示漏斗图上各研究点分布基本对称,提示存在发表偏倚的可能性较小。结论:现有的证据表明,太极拳锻炼可以有效提高锻炼者的骨密度,改善骨代谢,对骨质疏松症有较好的防治作用。
Abstract:
To review the clinical efficacy of Tai Chi Chuan(TCC)exercises in prevention and treatment of osteoporosis(OP).Methods:All randomized controlled trial(RCT)articles about TCC exercises for prevention and treatment of OP included from database establishing to July 15,2020 were retrieved from PubMed,Web of science,The Cochrane Library,Embase,Chinese biomedical literature database,VIP Database,WanFang Database and China national knowledge internet through computer.All patients in the 2 groups were treated with oral application of conventional anti-osteoporosis drugs or not given any intervention; moreover,the patients in experimental group were treated with TCC exercises.The articles were retrieved and screened and the information was extracted independently by two searchers.The risk of bias of included researches in the articles was assessed and a Meta-analysis was conducted by using Revman5.3 software.Results:Eighteen articles were included in the final analysis.The results of Meta-analysis demonstrated that the degree of improvement in bone mineral density(BMD)of lumbar vertebrae,femoral neck and Ward’s triangle were better in experimental group compared to control group(I2=0%,P=0.960; SMD=0.17,95%CI(0.01,0.33),P=0.030; I2=0%,P=0.910; SMD=0.24,95%CI(0.09,0.38),P=0.001; I2=0%,P=0.730; SMD=0.21,95%CI(-0.00,0.43),P=0.050).There was no statistical difference in the degree of improvement in BMD of greater trochanter of femur between the 2 groups(I2=0%,P=0.720; SMD=0.14,95%CI(-0.08,0.36),P=0.210).There was no statistical difference in the degree of improvement in broadband ultrasound attenuation(BUA)and bone quality index(BQI)of calcaneus between the 2 groups(I2=0%,P=0.980; SMD=0.13,95%CI(-0.24,0.50),P=0.490; I2=0%,P=0.940; SMD=0.11,95%CI(-0.26,0.47),P=0.570).The degree of improvement in speed of ultrasound(SOU)in calcaneus was better in experimental group compared to control group(I2=0%,P=0.980; SMD=0.50,95%CI(-0.13,0.87),P=0.009).The degree of improvement in serum concentration of calcium was better in experimental group compared to control group(I2=0%,P=0.860; SMD=-0.33,95%CI(-0.58,-0.07),P=0.010).There was no statistical difference in the degree of improvement in serum concentrations of Phosphorus and alkaline phosphatase(ALP)between the 2 groups(I2=0%,P=0.980; SMD=0.09,95%CI(-0.16,0.34),P=0.480; I2=0%,P=0.610; SMD=-0.01,95%CI(-0.27,0.24),P=0.930).The clinical curative effective rate was higher in experimental group compared to control group(I2=0%,P=0.680; RR=11.74,95%CI(3.71,37.17),P=0.000).Publication bias was analyzed according to femoral neck BMD,and the basically symmetrical funnel plot demonstrated that publication bias was a remote possibility.Conclusion:Available evidences suggest that TCC exercises can effectively increase BMD and improve bone metabolism in exercisers,and it has good preventive and therapeutic effects on OP.

参考文献/References:

[1] DAS A K,RAJKUMAR V.Effect of different fat level on microwave cooking properties of goat meat patties[J].J Food Sci Technoln,2013,50(6):1206-1211.
[2] MARTíN-MERINO E,PETERSEN I,HAWLEY S,et al.Risk of venous thromboembolism among users of different anti-osteoporosis drugs:a population-based cohort analysis including over 200,000 participants from Spain and the UK[J].Osteoporos Int,2018,29(2):467-478.
[3] 白璧辉,谢兴文,李鼎鹏,等.我国近5年来骨质疏松症流行病学研究现状[J].中国骨质疏松杂志,2018,24(2):253-258.
[4] 李平顺,王钢,周孟茹.“脑-肠-骨骼”轴对骨质疏松症发病机制的影响[J].中国骨质疏松杂志,2020,26(7):1068-1073.
[5] 中华医学会骨质疏松和骨矿盐疾病分会.中国骨质疏松症流行病学调查及“健康骨骼”专项行动结果发布[J].中华骨质疏松和骨矿盐疾病杂志,2019,12(4):317-318.
[6] MACIASZEK J,OSINSKI W,SZEKLICKI R,et al.Effect of Tai Chi on body balance:randomized controlled trial in men with osteopenia or osteoporosis[J].Am J Chin Med,2007,35(1):1-9.
[7] WAYNE P M,BURING J E,DAVIS R B,et al.Tai Chi for osteopenic women: design and rationale of a pragmatic randomized controlled trial[J].BMC Musculoskelet Disord,2010(11):40.
[8] WOO J,HONG A,LAU E,et al.A randomised controlled trial of Tai Chi and resistance exercise on bone health,muscle strength and balance in community-living elderly people[J].Age Ageing,2007,36(3):262-268.
[9] 徐世民,刘鹏.太极对预防绝经后女性骨密度的荟萃分析[J].中国骨质疏松杂志,2012,18(10):932-936.
[10] 梁龙,韩涛,朱立国,等.太极拳锻炼防治骨质疏松症效果的Meta分析[J].中国骨质疏松杂志,2019,25(9):1280-1289.
[11] SHUSTER J J.Review:Cochrane handbook for systematic reviews for interventions,version 5.1.0[J].Research Synthesis Methods,2011,2(2):126-130.
[12] CHAN K,QIN L,LAU M,et al.A randomized,prospective study of the effects of Tai Chi Chun exercise on bone mineral density in postmenopausal women[J].Arch Phys Med Rehabil,2004,85(5):717-722.
[13] 徐飞.24式简化太极拳对绝经后女性骨密度的影响[J].实用中医药杂志,2017,33(12):1428-1429.
[14] SHEN C L,CHYU M C,PENCE B C,et al.Green tea polyphenols supplementation and Tai Chi exercise for postmenopausal osteopenic women:safety and quality of life report[J].BMC Complement Altern Med,2010,10:76.
[15] SONG R,ROBERTS B L,LEE E O,et al.A randomized study of the effects of t’ai chi on muscle strength,bone mineral density,and fear of falling in women with osteoarthri-tis[J].J Altern Complement Med,2010,16(3):227-233.
[16] WANG H,YU B,CHEN W,et al.Simplified Tai Chi resistance training versus traditional Tai Chi in slowing bone loss in postmenopausal women[J/OL].Evid Based Complement Alternat Med,2015
[2020-07-01].https://downloads.hindawi.com/journals/ecam/2015/379451.pdf.
[17] WAYNE P M,KIEL D P,BURING J E,et al.Impact of Tai Chi exercise on multiple fracture-related risk factors in post-menopausal osteopenic women:a pilot pragmatic,randomized trial[J].BMC Complement Altern Med,2012,12:7.
[18] 周勇.传统体育项目锻炼对绝经女性骨密度的影响[J].山东体育科技,2003,25(1):21-23.
[19] 宋桦.太极拳锻炼对原发性骨质疏松症患者骨密度及骨代谢的影响[J].体育学刊,2008,15(11):106-108.
[20] 毛红妮.太极拳锻炼结合补钙对绝经后女性骨密度的影响[J].中国康复医学杂志,2009,24(9):814-816.
[21] 叶超群,王崇伟,王广云,等.太极拳对中老年女性健康状况的影响[J].中华保健医学杂志,2016,18(6):494-495.
[22] 单鑫,康靖汶.太极拳辅助治疗绝经后骨质疏松症的效果[J].中华现代护理杂志,2015,21(31):3729-3731.
[23] 孙威,王疆娜,杨春荣,等.太极拳和快走练习对老年女性骨密度和骨代谢影响的跟踪研究[J].中国骨质疏松杂志,2017,23(8):1034-1040.
[24] 周逸波,汪亚群,莫幼芳.太极拳配合六味地黄汤治疗原发性骨质疏松症肾阴亏虚证患者45例[J].浙江中医杂志,2018,53(4):268.
[25] 张文宙.太极拳运动配合钙尔奇D治疗原发性骨质疏松症疗效观察[D].广州:广州中医药大学,2011.
[26] 赵静.围绝经期女性接受太极拳运动后骨密度的变化[J].中国组织工程研究,2020,24(2):176-180.
[27] 范琳红.太极拳与快走练习对老年人身体机能影响的对比实验研究[D].济南:山东体育学院,2013.
[28] 刘栋.太极拳和快走锻炼对中老年女性骨量影响的实验研究[D].济南:山东体育学院,2010.
[29] 陈晨.运动疗法对绝经后骨质疏松症骨密度、瘦体重、脂肪含量的影响[D].江苏:南京中医药大学,2016.
[30] 《中国老年骨质疏松症诊疗指南》(2018)工作组,中国老年学和老年医学学会骨质疏松分会.中国老年骨质疏松症诊疗指南(2018)[J].中国实用内科杂志,2019,39(1):38-61.
[31] 高元元,王志鹏,刘晓军.长期习练太极拳对老年女性骨健康状况与骨代谢的影响[J].北京体育大学学报,2010,33(9):60-62.
[32] 邱贵兴,陈宾,翁习生.老年骨质疏松性骨折主要部位的骨折阈值测定研究[J].中华医学杂志,2005,85(16):1113-1116.
[33] 付晓宁,胡朝晖.骨代谢生化指标对于骨质疏松症诊断与治疗的临床意义[J].中国骨与关节损伤杂志,2018,33(9):1003-1005.
[34] 张瑾,邓敬兰,欧阳巧洪,等.原发性骨质疏松症患者骨密度和骨代谢指标的对比研究[J].中国骨质疏松杂志,2005,11(3):319-320.
[35] 郭宏焘.户外负重有氧运动结合局部肌力训练在老年骨质疏松预防中的效果研究[J].中国骨质疏松杂志,2015,21(8):941-944.
[36] 刘魏,童培建,肖鲁伟,等.益骨汤口服联合太极拳锻炼治疗老年性骨质疏松症肾阳虚证[J].中医正骨,2018,30(11):6-12.
[37] ZOU L,WANG C,CHEN K,et al.The effect of Taichi practice on attenuating bone mineral density loss:a systematic review and meta-analysis of randomized controlled trials[J].Int J Environ Res Public Health,2017,14(9):1000.

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更新日期/Last Update: 2021-02-20