太极拳锻炼防治骨质疏松症的Meta分析  

Tai Chi Chuan exercises for prevention and treatment of osteoporosis:a meta analysis

作　　者：邓叶龙 孔令俊[2] 刘朝晖[2] 李兴国[2] 杨德龙 王晨亮 黄晓焱 袁剑 陈文丽 常旭东 DENG Yelong;KONG Lingjun;LIU Zhaohui;LI Xingguo;YANG Delong;WANG Chenliang;HUANG Xiaoyan;YUAN Jian;CHEN Wenli;CHANG Xudong(Gansu University of Chinese Medicine,Lanzhou 730000,Gansu,China;Gansu Provincial Hospital of TCM,Lanzhou 730050,Gansu,China)

机构地区：[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

出　　处：《中医正骨》2021年第2期44-50,53,共8页The Journal of Traditional Chinese Orthopedics and Traumatology

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[I^(2)=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[I^(2)=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[I^(2)=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[I^(2)=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[I^(2)=0%,P=0.980;SMD=0.13,95%CI(-0.24,0.50),P=0.490;I^(2)=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[I^(2)=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[I^(2)=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[I^(2)=0%,P=0.980;SMD=0.09,95%CI(-0.16,0.34),P=0.480;I^(2)=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[I^(2)=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Objective: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;I^2= 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 c

关 键 词：太极 骨质疏松 META分析 系统评价 

分 类 号：R259[医药卫生—中西医结合]