太极拳运动对骨量骨密度及骨转换标志物影响

Effects of T'ai Chi on bone density and bone turnover markers

背景:太极拳作为一种身心运动正逐渐被国外所认可,其既可作为一种预防疾病、保持健康的运动方式,也可以作为某些健康问题譬如骨质疏松症的干预手段。目的:分析太极拳运动对老年人和骨质疏松症患者骨量、骨密度以及血液和尿样本中骨转换标志物水平的影响。方法:计算机检索Pub Med数据库和万方医学网相关文献,英文检索词为"Taichi,bone mass,bone mineral density,bone turnover biochemical markers,bone formation,bone resorption,estrogen,alkaline phosphotase,PICP,PINP,pyridinoline";中文检索词为"太极拳;骨量;骨密度;骨转换生化标志物;骨形成;骨吸收;雌激素;碱性磷酸酶;Ⅰ型前胶原羧基末端(C端)前肽和氨基末端(N端)前肽;吡啶啉"。收集太极拳运动对骨骼影响的相关文章48篇进行探讨。结果与结论:总结太极拳对老年人和骨质疏松症患者骨量、骨密度等相关指标的实验研究,发现太极拳通过影响骨转换相关激素、调节雌激素和细胞因子来维持人体骨密度和骨矿含量。由于动物学实验行不通,加之涉及到机制研究的骨组织形态计量学、蛋白和RNA定位定量、细胞活性增殖分化实验一概无法进行,所以太极拳对骨骼的影响机制研究较少,仅仅只能从血液和尿液中骨转化生化标记物的水平来判断,虽然生化标志物较之于骨密度较早地出现变化,多项研究也结合骨密度指标,进一步推论其机制可能是通过抑制骨吸收、促进骨形成来维持老年人的骨量,但是太极拳对于骨质疏松症患者骨量的影响尚未明确。

BACKGROUND： T’ai Chi as a physical and mental movement is gradually being recognized abroad. It can be used as a kind of exercise for preventing disease and remaining health, and of course, it can also be used as an intervention in some health problems such as osteoporosis. OBJECTIVE： To analyze the effect of T’ai Chi on bone mass, bone mineral densit and levels of bone turnover markers in the blood and urine samples of the elderly and osteoporosis patients. METHODS： Databases of Pub Med and Wanfang were retrieved with key words of ＂Taichi, bone mass, bone mineral density, bone turnover biochemical markers, bone formation, bone resorption, estrogen, alkalinephosphotase, PICP, PINP, pyridinoline＂ in English and Chinese, respectively, by screening titles and abstracts to search papers related to T’ai Chi effects on the bone. Finally, 48 relevant papers were discussed. RESULTS AND CONCLUSION： T’ai Chi effects on bone mass, bone density and other related indicators of the elderly and patients with osteoporosis in some experimental research were summarized and we found that T’ai Chi maintains bone mass through influencing bone turnover related hormones, estrogen and cytokines. Because the general zoology experiment and the involved mechanism studies about bone histomorphometry, positioning and quantification of protein and RNA, active cell proliferation and differentiation experiments cannot work, little is reported on the effects of T’ai Chi on bone mechanism. We can only make a judgment based on the levels of bone turnover markers in the blood and urine. Although the bone biochemical markers have earlier changes than the bone mineral density and based on the bone mineral density, several studies have further deduced that T’ai Chi can maintain the bone mass in the elderly by inhibiting bone resorption and promoting bone formation, T’ai Chi effects on the bone mass of osteoporosis patients are still unclear.