太极拳对心力衰竭患者作用效果的系统评价  

Efficacy of Tai Chi on patients with heart failure: a systematic review

作　　者：魏洪悦 靳英辉[2] 谷晓玲[1] 张凤喆 谢雨露[4] 唐琪[5] 孙文茜[6] 

机构地区：[1]天津中医药大学第一附属医院护理部,天津300000 [2]天津中医药大学护理学院,天津300000 [3]天津医科大学口腔医院,天津300000 [4]重庆医科大学附属第一医院,重庆400000 [5]天津医院,天津300000 [6]天津医科大学肿瘤医院,天津300000

出　　处：《中国循证医学杂志》2017年第6期677-684,共8页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价太极拳对心力衰竭患者的作用效果。方法计算机检索CNKI、VIP、Wan Fang Data、Web of Science、Pub Med、EMbase和The Cochrane Library(2016年8期)中有关太极拳对心力衰竭患者作用效果的随机对照试验(RCT),检索时限均为建库至2016年8月。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,应用Rev Man 5.3软件进行Meta分析。结果共纳入10个RCT,合计689例患者。Meta分析结果显示:与对照组相比,太极拳组患者的明尼苏达生活质量分数(MLHFQ)更优[MD=–9.37,95%CI(–13.09,–5.65),P<0.000 01]、6分种步行试验(6MWT)距离更长[MD=40.37,95%CI(9.48,71.27),P=0.01]、左室射血分数(LVEF)更高[MD=7.89,95%CI(3.01,12.77),P=0.002]、脑钠肽(BNP)水平更低[MD=–10.75,95%CI(–13.20,–8.30),P<0.000 01],其差异有统计学意义;但在最大摄氧量(VO2max)[MD=0.29,95%CI(–1.23,1.81),P=0.71]、收缩压(SBP)[MD=–2.81,95%CI(–8.52,2.90),P=0.33]、舒张压(DBP)[MD=0.37,95%CI(–3.73,4.48),P=0.86]方面,差异无统计学意义。结论当前证据显示,太极拳在生活质量、生理功能等方面均对心力衰竭患者有积极作用。受纳入研究数量和质量的限制,上述结论尚需开展更多高质量研究予以证实。Objective To systematically review the efficacy of Tai Chi on patients with heart failure. Methods Databases including CNKI, VIP, WanFang Data, Web of Science, PubMed, EMbase and The Cochrane Library （Issue 8, 2016） were searched from inception to August, 2016 to collect randomized controlled trials （RCTs） of Tai Chi for heart failure patients. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software. Results A total of 10 RCTs involving 689 patients were included. The results of meta-analysis showed that, compared with the control group, the heart failure patients in Tai Chi group had better score of minnesota living with heart failure questionnaire （MLHFQ） （MD=-9.37, 95%CI -13.09 to -5.65, P〈0.000 01）, longer six minute walk test （6MWT） （MD=40.37, 95%CI 9.48 to 71.27, P=0.01）, higher left ventricular ejection fractions （LVEF） （MD=7.89, 95%CI 3.01 to 12.77, P=0.002） and lower level of BNP （brain natriuretic peptide） （MD=-10.75, 95%CI -13.20 to -8.30, P〈0.000 01）; however, as to the maximal oxygen consumption （VO2max） （MD=0.29, 95%CI -1.223 to 1.81, P=0.71）, systolic pressure （SBP） （MD=-2.81, 95%CI -8.52 to 2.90, P=0.33） and diastolic pressure （DBP） （MD=0.37, 95%CI -3.73 to 4.48, P=0.86）, there were no significant differences between both groups. Conclusion The current evidence shows that Tai Chi is feasible for patients with heart failure as it has positive effects on life quality, physiological functions. Due to the limited quality and quantity of included studies, the above conclusion should be validated by more high quality studies.

关 键 词：太极 心力衰竭 系统评价 META分析 随机对照试验 明尼苏达生活质量分数 6分钟步行试验 

分 类 号：R541.6[医药卫生—心血管疾病]